Discussions about Contraception or STDs Prior to Sex. Fact Sheet. Publication #2008-14

ERIC Educational Resources Information Center

Holcombe, Emily; Ryan, Suzanne; Manlove, Jennifer

2008-01-01

Since decisions about sexual behavior are made by couples, communication between sexual partners is essential for preventing risky sexual behavior. In particular, teens who discuss contraception and sexually transmitted diseases (STDs) with their partners before they engage in sex are more likely to use contraception when they do have sex, which…

The relationship between female adolescent self-esteem, decision making, and contraceptive behavior.

PubMed

Commendador, Kathleen

2007-11-01

To examine the relationship between female adolescent self-esteem, decision making, and contraceptive behavior in multiethnic, 14- to 17-year-olds, residing on the Big Island of Hawaii. This was a descriptive cross-sectional survey design using a convenience sample of 98 female adolescents aged 14-17 who came to five different clinics on the Big Island of Hawaii for health care. Along with a brief demographic questionnaire, global self-esteem was measured by Rosenberg's Self-Esteem Scale, decision making was measured by the Flinders Adolescent Decision Making Questionnaire, and sexual activity and contraception use was measured by a nonnormed Sexual History and Contraceptive Use Questionnaire developed for this study. Descriptive statistics, logistic regression, and correlations were used to analyze associations and correlations between age, global self-esteem, decision self-esteem, decision coping (vigilant and maladaptive), and contraceptive use for sexually active female adolescents. No significant associations or correlations were found between age, global self-esteem, decision self-esteem, decision coping (vigilance), and the decision to use contraception in sexually active adolescent females. There was, however, significant negative correlation (p < .05) between overall maladaptive decision making and contraceptive use in sexually active female adolescents. This suggests that sexually active adolescent females with higher maladaptive scores are less likely to use contraception. There was also significant association (p < .05) between maladaptive decision making in contraceptive use and sexually active female adolescents. For every one unit increase on the maladaptive scale, the odds of using contraception were estimated to decrease by 7%. Adolescence is a period of transition that involves biological, cognitive, psychological, and social changes. During the vulnerable transition period of adolescence, decisions relating to contraception may occur. Interventions focused on improving decision-making skills and stimulating thinking around not only sexual issues but also on relationship and communication in adolescent issues may facilitate more competent decision making. Understanding the relationship between female adolescent self-esteem, decision making, and contraceptive behavior has contributed to the knowledge base about female contraceptive behavior. Gaining further insight into these relationships will help healthcare professionals provide counseling and health care to female adolescents.

Non-Heterosexuality, Relationships, and Young Women's Contraceptive Behavior.

PubMed

Ela, Elizabeth J; Budnick, Jamie

2017-06-01

Non-heterosexual young women have a higher rate of unintended pregnancy than their heterosexual peers, but their fertility behaviors are understudied. We use longitudinal data from the Relationship Dynamics and Social Life study to investigate mechanisms contributing to non-heterosexual women's higher pregnancy risk. These data include weekly reports of relationships, sex, and contraceptive use over 30 months. We compare the relationships and fertility behaviors of three groups: exclusively heterosexual (consistent heterosexual behavior, identity, and attraction); mostly heterosexual (heterosexual identity with same-sex behavior and/or same-sex attraction); and LGBTQ (any non-heterosexual identity). We find that mostly heterosexual and LGBTQ women behave differently from exclusively heterosexual women in ways likely to elevate their risk of unintended pregnancy: more distinct partners during the study period, more sexual intercourse with men, less frequent contraceptive use, less use of a dual method (condom plus hormonal method), and more gaps in contraceptive coverage. Mostly heterosexual women resemble LGBTQ women in their contraceptive behavior but have significantly more intercourse with men, which may increase their pregnancy risk relative to both LGBTQ and exclusively heterosexual women. We conclude by considering implications for LGBTQ health and the measurement of sexual minority populations.

Factors associated with lack of effective contraception among obese women in the United States.

PubMed

Callegari, Lisa S; Nelson, Karin M; Arterburn, David E; Prager, Sarah W; Schiff, Melissa A; Schwarz, Eleanor Bimla

2014-09-01

To identify factors associated with contraceptive nonuse and use of less effective methods among obese women in the US. We analyzed data from sexually active obese women (body mass index >30 kg/m²) age 20-44 using the 2006-2010 National Survey of Family Growth. We conducted multinomial logistic regression to assess associations between current contraceptive use and demographic, reproductive and health services factors. Specifically, we compared contraceptive nonusers, behavioral method users (withdrawal and fertility awareness) and barrier method users (condoms) to prescription method users (pill, patch, ring, injection, implant and intrauterine device). Of 1345 obese respondents, 21.5% used no method, 10.3% behavioral methods, 20.8% barrier methods and 47.4% prescription methods. Only 42.4% of respondents overall and 20.4% of nonprescription method users reported discussing contraception with a provider in the past year. Similar to findings in the general population, behavioral method users were more likely to have previously discontinued a contraceptive method due to dissatisfaction [adjusted RR (aRR), 1.93; 95% confidence interval (CI), 1.09-3.44], and nonusers were more likely to perceive difficulty becoming pregnant (aRR, 3.86; 95% CI, 2.04-7.29), compared to prescription method users. Respondents using nonprescription methods were significantly less likely to have discussed contraception with a healthcare provider (nonusers: aRR, 0.16; 95% CI, 0.10-0.27; behavioral methods: aRR, 0.13; 95% CI, 0.06-0.25, barrier methods: aRR, 0.15; 95% CI, 0.09-0.25) than prescription method users. Obese women who discuss contraception with a provider are more likely to use effective contraception and may be less likely to experience unintended pregnancy; however, over half report no recent discussion of contraception with a provider. Efforts are needed to increase contraceptive counseling for obese women, who face increased risks of morbidity from unintended pregnancy. Published by Elsevier Inc.

Fertility Regulation in an Economic Crisis

PubMed Central

McKelvey, Christopher; Thomas, Duncan; Frankenberg, Elizabeth

2015-01-01

Substantial international aid is spent reducing the cost of contraception in developing countries, as part of a larger effort to reduce global fertility and increase investment per child worldwide. The importance for fertility behaviors of keeping contraceptive prices low, however, remains unclear. Targeting of subsidies and insufficient price variation have hindered prior attempts to estimate the effect of monetary and non-monetary contraceptive costs on fertility behavior. Using longitudinal survey data from the Indonesia Family Life Survey, we exploit dramatic variation in prices and incomes that was induced by the economic crisis in the late 1990s to pin down the effect of contraceptive availability and costs as well as household resources on contraceptive use and method choice. The results are unambiguous: monetary costs of contraceptives and levels of family economic resources have a very small (and well-determined) impact on contraceptive use and choice of method. PMID:25843969

Menstrual pattern, sexual behaviors, and contraceptive use among postpartum women in Nairobi urban slums.

PubMed

Ndugwa, Robert P; Cleland, John; Madise, Nyovani J; Fotso, Jean-Christophe; Zulu, Eliya M

2011-06-01

Postpartum months provide a challenging period for poor women. This study examined patterns of menstrual resumption, sexual behaviors and contraceptive use among urban poor postpartum women. Women were eligible for this study if they had a birth after the period September 2006 and were residents of two Nairobi slums of Korogocho and Viwandani. The two communities are under continuous demographic surveillance. A monthly calendar type questionnaire was administered retrospectively to cover the period since birth to the interview date and data on sexual behavior, menstrual resumption, breastfeeding patterns, and contraception were collected. The results show that sexual resumption occurs earlier than menses and postpartum contraceptive use. Out of all postpartum months where women were exposed to the risk of another pregnancy, about 28% were months where no contraceptive method was used. Menstrual resumption acts as a trigger for initiating contraceptive use with a peak of contraceptive initiation occurring shortly after the first month when menses are reported. There was no variation in contraceptive method choice between women who initiate use before and after menstrual resumption. Overall, poor postpartum women in marginalized areas such as slums experience an appreciable risk of unintended pregnancy. Postnatal visits and other subsequent health system contacts provide opportunities for reaching postpartum women with a need for family planning services.

Twenty-seven Strategies for Teaching Contraception to Adolescents.

ERIC Educational Resources Information Center

Chesler, Joan

1980-01-01

Research on the effects of education on adolescents' contraceptive behaviors is summarized and 27 teaching strategies, each related to a particular contraceptive problem adolescents encounter, are outlined. (JMF)

Does contraceptive treatment in wildlife result in side effects? A review of quantitative and anecdotal evidence.

PubMed

Gray, Meeghan E; Cameron, Elissa Z

2010-01-01

The efficacy of contraceptive treatments has been extensively tested, and several formulations are effective at reducing fertility in a range of species. However, these formulations should minimally impact the behavior of individuals and populations before a contraceptive is used for population manipulation, but these effects have received less attention. Potential side effects have been identified theoretically and we reviewed published studies that have investigated side effects on behavior and physiology of individuals or population-level effects, which provided mixed results. Physiological side effects were most prevalent. Most studies reported a lack of secondary effects, but were usually based on qualitative data or anecdotes. A meta-analysis on quantitative studies of side effects showed that secondary effects consistently occur across all categories and all contraceptive types. This contrasts with the qualitative studies, suggesting that anecdotal reports are insufficient to investigate secondary impacts of contraceptive treatment. We conclude that more research is needed to address fundamental questions about secondary effects of contraceptive treatment and experiments are fundamental to conclusions. In addition, researchers are missing a vital opportunity to use contraceptives as an experimental tool to test the influence of reproduction, sex and fertility on the behavior of wildlife species.

Pharmacists' and prescribers' neonatal abstinence syndrome (NAS) prevention behaviors: a preliminary analysis.

PubMed

Hagemeier, Nicholas E; Click, Ivy A; Flippin, Heather; Gilliam, Holly; Ross, Alexandra; Basden, Jeri Ann; Carico, Ronald

2018-02-01

Background Maternal opioid use and neonatal abstinence syndrome (NAS) incidence have increased markedly in the US in recent years. Objectives (1) To assess prescribers' and community pharmacists' guideline-based NAS prevention behaviors; (2) to describe providers' perceptions of contraceptive appropriateness in female patients of childbearing age. Method Cross-sectional study of 100 randomly selected primary care physicians, 100 prescribers authorized to engage in in-office treatment of opioid use disorders with buprenorphine, 100 pain management clinic directors, and 100 community pharmacists in Tennessee (N = 400 providers total) to evaluate self-reported engagement in 15 NAS prevention behaviors and perceived appropriateness of 8 contraceptive methods in opioid using women of childbearing age. Results An overall response rate of 17.5% was obtained. Pain clinic directors reported the most engagement in NAS prevention, engaging 80% or more of female patients of childbearing age prescribed an opioid in 11 prevention behaviors, followed by buprenorphine prescribers (8 behaviors), primary care physicians (5 behaviors), and community pharmacists (2 behaviors). Pain clinic directors, primary care physicians, and community pharmacists perceived oral contraceptive pills and patches to be as appropriate as long-acting, reversible forms of contraception (e.g., implants, injectable depots, intrauterine devices). Conclusion Provider engagement in behaviors that could prevent NAS is variable. Interventions should be implemented that equip providers to engage patients in conversations about long-acting, reversible contraception.

Contraceptive Behavior in Young Women

DTIC Science & Technology

1993-01-01

They found the sample of teens perceived birth control as being dangerous to their health. Other important reasons included postponement until the...contraceptive services were fear of parents knowledge, fear of a pelvic exam and the belief that CONTRACEPTIVE BEHAVIOR 14 birth control was dangerous to their...experimentation generally precedes formation and acceptance of gender identity (Kastner, 1984). Kastner observed that teens using birth control more effectively

Relationships between Contraceptive Behavior and Love Attitudes, Sex Attitudes, and Self-Esteem.

ERIC Educational Resources Information Center

Adler, Nancy L.; Hendrick, Susan S.

1991-01-01

Identified variables related to contraception that could be addressed during contraceptive counseling and to aid persons in deciding the most effective contraceptive method within context of an intimate relationship. Used questionnaire responses from 350 college students. Results indicated both general self-esteem and sexual self-esteem were…

Contraceptive use and sexual behavior in obese women.

PubMed

Kaneshiro, Bliss

2012-12-01

Obesity and unintended pregnancy differentially affect women based on sociodemographic factors. Because of the overlap of these factors, obesity and unintended pregnancy have been described as colliding epidemics. Understanding the relationship between obesity and unintended pregnancy, contraceptive use, and sexual behavior is important in improving the reproductive health of women given the increasing weight demographic. A review of the literature reveals contraceptive use versus nonuse does not differ in women of different body weights. Obese women use oral contraceptives less than normal weight women and are more likely to use procedural methods like sterilization. No difference was noted in most types of sexual behavior for women of different body weights. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The contribution of school-level factors to contraceptive use among adolescents in New York city public high schools

NASA Astrophysics Data System (ADS)

Kaplan, Deborah L.

Every year approximately 17,000 adolescents ages 15-19 become pregnant in New York City. Most of these pregnancies are unintended and only a small percent of adolescents use effective contraception, with wide disparities by race/ethnicity and poverty level. While many studies have identified factors associated with contraceptive use, most research has focused on individual level factors, with little attention to the contribution of the school environment to sexual risk behavior and contraceptive use. This study investigates the effect of school-level factors on contraceptive use among adolescents in NYC public high schools before and after controlling for individual-level factors, and whether this effect varies with race/ethnicity. Using a cross-sectional design, the NYC Youth Risk Behavior Survey (YRBS) individual-level datasets for 2007, 2009 and 2011 were linked to a school-level dataset. Variables were selected based on empirical findings on factors associated with sexual behaviors, including contraceptive use, by adolescents. The analytic sample included all YRBS respondents aged 14 or older who reported having sexual intercourse in the past three months and had complete responses to the YRBS questions on contraceptive use at last sex (N=8,054). The chi square test of significance was used to evaluate significant associations between independent variables and contraceptive use in bivariate analyses; variables with a p value < 0.1 were included in the multivariable analyses. Binary and multinomial logistic regression analyses were conducted to estimate the strength of the associations of school-level factors with contraceptive use among sexually active adolescents. Findings included that use of any contraception and/or hormonal contraception at last sexual intercourse was associated with attending schools with a higher six-year graduation rate, higher percent of students strongly agreeing they were safe in their classrooms, higher percent of teachers at the school for over two years, and having a School-Based Health Center (SBHC) in the building. No known study has examined the contribution of school-level effects to contraceptive use in a dataset linking YRBS and school-level datasets. Implications of research findings are that schools providing a supportive, engaging and safe environment can protect students from sexual risk behaviors and increase contraceptive use among sexually active adolescents.

Correlates of and Couples’ Concordance in Reports of Recent Sexual Behavior and Contraceptive Use

PubMed Central

Koffi, Alain K.; Adjiwanou, Visseho D.; Becker, Stan; Olaolorun, Funmilola; Tsui, Amy O.

2014-01-01

This study uses couple-level data to measure couples’ concordance of self-reported time since last coitus and of condom and other contraceptive use at last sexual intercourse among monogamous couples in Liberia (N = 1,673), Madagascar (N = 4,138), and Namibia (N = 588). The study also examines the characteristics associated with sexual behavior and contraceptive use occurring in the 28 days prior to the interviews among couples whose reports are concordant. Overall, our study finds less than 75 percent concordance in reporting of time since last coitus. Use of condoms and other contraceptives yielded fair (0.27) to substantial (0.67) agreement on the kappa index. Factors predicting a shorter time since last coitus among concordant couples in at least two of the countries included wealth, spousal age difference, education, and both partners wanting another child. The discordant reports of recent sexual behavior and contraceptive use suggest that caution should be exercised when inferring couples’ behavior from the report of one spouse, that concordant reports should be examined when possible, that methodological changes to improve the validity of spousal reports should be pursued, and that family planning and HIV-prevention programs should target those groups found to be using condoms and other contraceptives less frequently, particularly poorer couples. PMID:23185870

Correlates of and couples' concordance in reports of recent sexual behavior and contraceptive use.

PubMed

Koffi, Alain K; Adjiwanou, Visseho D; Becker, Stan; Olaolorun, Funmilola; Tsui, Amy O

2012-03-01

This study uses couple-level data to measure couples' concordance of self-reported time since last coitus and of condom and other contraceptive use at last sexual intercourse among monogamous couples in Liberia (N = 1,673), Madagascar (N = 4,138), and Namibia (N = 588). The study also examines the characteristics associated with sexual behavior and contraceptive use occurring in the 28 days prior to the interviews among couples whose reports are concordant. Overall, our study finds less than 75 percent concordance in reporting of time since last coitus. Use of condoms and other contraceptives yielded fair (0.27) to substantial (0.67) agreement on the kappa index. Factors predicting a shorter time since last coitus among concordant couples in at least two of the countries included wealth, spousal age difference, education, and both partners wanting another child. The discordant reports of recent sexual behavior and contraceptive use suggest that caution should be exercised when inferring couples' behavior from the report of one spouse, that concordant reports should be examined when possible, that methodological changes to improve the validity of spousal reports should be pursued, and that family planning and HIV-prevention programs should target those groups found to be using condoms and other contraceptives less frequently, particularly poorer couples.

Across many behaviors, long-term oral contraceptive use lowers risk for ovarian, endometrial cancer

Cancer.gov

DCEG researchers investigated whether the relationship between oral contraceptive use and risks for ovarian, endometrial, breast, and colorectal cancers change when looking at groups of women who have different health behaviors.

Trend in the use of modern contraception in sub-Saharan Africa: Does women's education matter?

PubMed

Emina, Jacques B O; Chirwa, Tobias; Kandala, Ngianga-Bakwin

2014-08-01

Existing literature revealed positive association between women's education and modern contraceptive use in sub-Saharan Africa (SSA). Overall modern contraception prevalence (MCP) and proportion of women with formal education have increased in region. However, little is known about how much the change in the prevalence of modern contraceptive methods is relative to the compositional change in population and how much of the change is actually due to increases in the number of women adopting the new behavior. This study aims to (1) describe trends in modern contraception prevalence by female education; and (2) identify the source of changes in modern contraceptive use by educational attainment (changes in structure or in population behavior). This is a cross-sectional study using Demographic and Health Surveys from 27 SSA countries where at least two comparable surveys have been conducted. Overall modern contraception prevalence (MCP) has increased in SSA over the study period. The ongoing increase in the contraceptive use is due to changes in behavior consistent with the ongoing family planning promotion over the past 30 years. By contrast, an increase in the proportion of women with secondary education does not explain the change in MCP in most SSA countries. To achieve universal access to family planning, efforts in promoting female education should be complemented with economic, cultural and geographical access to MCP. Household-based sensitization, general hospitals, mobile family planning clinics, and community-based distributors of modern contraceptive methods are key strategies to improve access to modern contraceptive use. Findings from this study suggest that countries should combine social investments, including health services and education, with family planning programs using reproductive health services, mobile family planning clinics and community-based distributors of modern contraceptive methods. Therefore, governments' legislation measures that promote universal secondary education as well as universal access to modern contraception can be put in place. Copyright © 2014 Elsevier Inc. All rights reserved.

Factors Influencing College Women's Contraceptive Behavior: An Application of the Integrative Model of Behavioral Prediction

ERIC Educational Resources Information Center

Sutton, Jazmyne A.; Walsh-Buhi, Eric R.

2017-01-01

Objective: This study investigated variables within the Integrative Model of Behavioral Prediction (IMBP) as well as differences across socioeconomic status (SES) levels within the context of inconsistent contraceptive use among college women. Participants: A nonprobability sample of 515 female college students completed an Internet-based survey…

Sexual and Contraceptive Behaviors among Adolescents Requesting Emergency Contraception.

PubMed

Cwiak, Carrie; Howard, Brandon; Hsieh, Jennifer; Ricciotti, Nancy; Sucato, Gina S

2016-12-01

Unintended pregnancy rates in the United States remain high among adolescents. Emergency contraception (EC) provides the only option for pregnancy prevention after unprotected sex. To better define the population of adolescents who request and use EC pills, we performed a post hoc analysis of an over-the-counter simulation study of EC pills. Teen reproductive health clinics in 5 cities. Adolescents between the ages of 13 and 17 years who requested EC. Single-tablet levonorgestrel 1.5 mg. We calculated the correlations between age and baseline sexual and contraceptive behaviors. χ 2 Tests were used to compare behaviors of first-time and repeat EC users. Overall, the most commonly reported contraceptive methods ever used were condoms, oral contraceptives, none, and withdrawal; the most common method ever used in each age group was no method for 13- to 14-year-olds and condom for 15-, 16-, and 17-year-olds. The percentage of participants who had never used contraception before requesting EC decreased with age (53% [20/28] of 13- to 14-year-olds vs 15% [10/65] of 17-year-olds). First-time EC users were more likely to report no previous contraceptive use compared with repeat EC users (42% [88/208] vs 10% [13/135]; P < .001). Regardless of age, the most commonly reported reason for requesting EC was nonuse of any contraceptive method (ie, "unprotected sex"). Adolescents who requested EC most commonly reported ever-use of contraceptive methods that rely on user adherence or no method at all, with younger adolescents more likely than older adolescents to have used no previous method. The provision of EC presents an opportunity to provide education and access to highly effective, long-term contraceptive methods. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Swedish teenager perceptions of teenage pregnancy, abortion, sexual behavior, and contraceptive habits--a focus group study among 17-year-old female high-school students.

PubMed

Ekstrand, Maria; Larsson, Margareta; Von Essen, Louise; Tydén, Tanja

2005-10-01

Sweden has the highest abortion numbers among the Nordic countries. Since 1995, the abortion rate among teenagers has increased by nearly 50%. We therefore undertook a study where the overall aim was to gain a deeper understanding on which factors female teenagers believe may explain the increasing numbers of teenage abortions. Teenagers' perceptions of teenage pregnancy, abortion, sexual behavior, and contraceptive habits were investigated. Six focus group interviews with 17-year-old Swedish girls were conducted. The interviews were tape-recorded, transcribed verbatim, and analyzed by manifest content analysis. Negative attitudes toward teenage pregnancy and supportive attitudes toward abortion were expressed. Risk-taking behaviors such as negligence in contraceptive use and intercourse under the influence of alcohol were suggested as main reasons behind the increasing numbers of abortions among Swedish teenagers. The contemporary, sexualized, media picture was believed to influence adolescents' sexual behavior, and liberal attitudes toward casual sex were expressed. Girls were perceived as more obliged than boys in taking responsibility for contraceptive compliance and avoidance of pregnancy. The apprehension that hormonal contraceptives cause negative side-effects was widely spread, and the participants were found to have a somewhat limited knowledge of abortion. The majority were unsatisfied with the quality of sexual education provided by the schools. Possible reasons for increased abortion numbers among teenagers in Sweden could be liberal attitudes toward casual sex in combination with negligence in contraceptive use, use of alcohol followed by sexual risk-taking, fear of hormonal contraceptives, and a deterioration of sexual education in the schools.

Parents' Behavioral Norms as Predictors of Adolescent Sexual Activity and Contraceptive Use.

ERIC Educational Resources Information Center

Baker, Sharon A.; And Others

1988-01-01

Used clustered sample household survey of 329 males and females aged 14 to 17, and 470 of their parents to examine influence of parental factors on adolescent sexual behavior and contraceptive use. Found parents' reported behavioral norms accounted for 5% of variance in whether adolescents had had intercourse, and for 33% of variance in…

Relationships between attitudes toward sexuality, sexual behaviors, and contraceptive practices among Chinese medical and nursing undergraduates.

PubMed

Zeng, Yingchun; Luo, Taizhen; Zhou, Ying

2015-09-01

In this study, we investigated attitudes toward sexuality, the prevalence of sexual behaviors and contraceptive use among Chinese medical and nursing undergraduates, and relationships between attitudes toward sexuality and sexual and contraceptive practices among these participants. This was a descriptive, cross-sectional study carried out by using a Personal Attitude toward Sexuality Scale and Sexual and Contraceptive Questionnaire. The participants were recruited in the researcher's lectures. A total of 158 participants joined this study. Overall, Chinese medical and nursing undergraduates in this study held relatively conservative attitudes toward sexuality. The prevalence of sexually-active students was relatively low, and the percentage of contraceptive use among those sexually-active students was also low. Participants' attitudes toward sexuality had statistically-significant effects on their sexual and contraceptive practices. Nearly half of the sexually-active participants reported never using any contraceptive method during sexual intercourse. This finding has important public health implications, as young people represent the group with the largest rate of new infections of HIV/AIDS in China. A more comprehensive sexual education program that extends to college undergraduates and promotes the social acceptability of using contraception, specifically condoms, is needed. © 2014 Wiley Publishing Asia Pty Ltd.

Awareness and Perceptions of Emergency Contraceptive Pills Among Women in Kinshasa, Democratic Republic of the Congo.

PubMed

Hernandez, Julie H; Muanda, Mbadu; Garcia, Mélissa; Matawa, Grace

2017-09-01

Despite the commitment of the Democratic Republic of the Congo (DRC) to expand the family planning method mix and increase access to services, awareness of emergency contraception is low among women, and the method remains underused and poorly integrated in family planning programming. Data from 15 focus group discussions conducted in 2016 among women aged 15-35 were used to examine awareness and perceptions of, and attitudes toward, emergency contraceptives. After facilitators explained emergency contraceptive pills' mechanism of action and other characteristics, participants were asked about the potential benefits and risks of making the method more widely available. Transcripts were analyzed using an iterative approach. Women reported employing a wide range of postcoital contraceptive behaviors, albeit often using inappropriate products, and generally agreed that emergency contraceptive pills seemed to be a potentially effective solution to their family planning needs. Perceived benefits and limitations of the method were almost always framed in reference to other, better-known contraceptives, and women expressed strong preferences for pharmacy-based provision that aligned with their usual behaviors for obtaining contraceptives. Participants were reluctant to see the method available for free. Emergency contraceptive pills have the potential to address gaps in the family planning method mix in the DRC. Assessing whether women have incomplete or erroneous information about family planning methods can provide better understanding of women's contraceptive choices in low-income countries.

Sexual Behavior and Contraceptive Use among 18- to 19-Year-Old Adolescent Women by Weight Status: A Longitudinal Analysis.

PubMed

Chang, Tammy; Davis, Matthew M; Kusunoki, Yasamin; Ela, Elizabeth J; Hall, Kelli S; Barber, Jennifer S

2015-09-01

To describe the association between weight status and sexual practices among 18- to 19-year-old women. We analyzed a population-based longitudinal study of 18- to 19-year-old women residing in a Michigan county at cohort inception. Weekly journal surveys measured sexual practices, including contraceptive behaviors. Outcomes included proportion of weeks with a partner, proportion of weeks with sexual intercourse, number of partners, average length of relationships, proportion of weeks with contraception use, and proportion of weeks where contraception was used consistently. We examined 26,545 journal surveys from 900 women over the first study year. Ordinary least squares regression models for each outcome examined differences by weight status, controlling for sociodemographic characteristics. The mean proportion of weeks in which adolescents reported sexual intercourse was 52%; there was no difference by weight status. Among weeks in which adolescents reported sexual activity, obese adolescents had a lower proportion of weeks where any contraception was used compared with normal weight adolescents (84% vs 91%, P = .011). Among weeks in which adolescents reported sexual activity and contraceptive use, obese adolescents had a lower proportion of weeks with consistent contraceptive use (68% vs 78%, P = .016) and oral contraceptive pill use (27% vs 45%, P = .001) compared with normal weight adolescents. All other relationships by weight status were not statistically significant. In this longitudinal study, obese adolescent women were less likely to use contraception, and less likely to use it consistently when compared with normal weight peers. Findings suggest obesity may be an important factor associated with adolescent women's sexual behavior. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Sexual Behavior and Contraceptive Use Among 18 to 19 year old Adolescent Women By Weight Status: A Longitudinal Analysis

PubMed Central

Chang, Tammy; Davis, Matthew M.; Kusunoki, Yasamin; Ela, Elizabeth J.; Hall, Kelli S.; Barber, Jennifer S.

2015-01-01

Objective To describe the association between weight status and sexual practices among 18-19 year-old women. Study design We analyzed a population-based longitudinal study of 18-19 year-old women residing in a Michigan county at cohort inception. Weekly journal surveys measured sexual practices, including contraceptive behaviors. Outcomes included proportion of weeks with a partner, proportion of weeks with sexual intercourse, number of partners, average length of relationships, proportion of weeks with contraception use, and proportion of weeks where contraception was used consistently. We examined 26,545 journal surveys from 900 women over the first study year. Ordinary least squares regression models for each outcome examined differences by weight status, controlling for sociodemographic characteristics. Results The mean proportion of weeks in which adolescents reported sexual intercourse was 52%; there was no difference by weight status. Among weeks in which adolescents reported sexual activity, obese adolescents had a lower proportion of weeks where any contraception was used compared with normal-weight adolescents (84% vs 91%, p=0.011). Among weeks in which adolescents reported sexual activity and contraceptive use, obese adolescents had a lower proportion of weeks with consistent contraceptive use (68% vs 78%, p=0.016) and oral contraceptive pill use (27% vs 45%, p=0.001) compared with normal-weight adolescents. All other relationships by weight status were not statistically significant. Conclusions In this longitudinal study, obese adolescent women were less likely to use contraception, and less likely to use it consistently when compared with normal-weight peers. Findings suggest obesity may be an important factor associated with adolescent women’s sexual behavior. PMID:26143383

Premarital Sexual Guilt and Contraceptive Attitudes and Behavior.

ERIC Educational Resources Information Center

Herold, Edward S.; Goodwin, Marilyn Shirley

1981-01-01

Studied the relationship between premarital sexual guilt and contraceptive attitudes and behavior among young single women. High-guilt subjects were significantly more embarrassed about coming to the birth control clinics and were more likely to believe that it was difficult to obtain birth control. (Author)

Impact of school-based educational programs on sexual behaviors among adolescents in northern Italy.

PubMed

Bogani, Giorgio; Cromi, Antonella; Serati, Maurizio; Monti, Zelia; Apolloni, Chiara; Nardelli, Federica; Di Naro, Edoardo; Ghezzi, Fabio

2015-01-01

This article aimed to determine sexual behaviors among female and male adolescents in northern Italy. An anonymous self-administered questionnaire evaluating sexual attitudes was distributed in middle and high schools in northern Italy. Adolescents between 13 and 19 years of age were asked to participate at the survey. The study group included 664 participants. Overall, 164 (25%) adolescents had had at least one sexual intercourse. Among adolescents who have had sexual intercourse, 90 (55%) use condoms, 25 (15%) use hormonal contraception, and 49 (30%) do not use any contraception method. A total of 559 adolescents (84%) participated in school-based sexual education programs. This group had better knowledge on sexually transmitted diseases and contraception methods in comparison with adolescents who have never participated in such educational programs (p <.05), and no difference in high-risk sexual behaviors was observed (p = 1.0). School-based sexual education programs improve knowledge of sexual transmitted diseases and contraception methods. However, this knowledge does not correlate to high-risk sexual behaviors reduction.

Factors associated with contraceptive practices of married women in Bangladesh with respect to their employment status.

PubMed

Laskar, M S; Mahbub, M H; Yokoyama, Kenjiro; Inoue, Masaiwa; Harada, Noriaki

2006-09-01

There might be a difference between non-working and working women in their perception of rights and privileges which may influence their contraceptive behavior. The purpose of this study was to examine contraceptive behavior among non-working and working women in Bangladesh determining associated factors. Analysis was based on data from the 1999-2000 Bangladesh Demographic and Health Survey which employs nationally representative sample. The prevalence of current contraceptive use (any method) was 58.2% among non-working women and 65.5% among working women. Both rates are still low for the country. Some factors, such as discussed family planning with husband, husband approves family planning, desire for more children, and husband lives together, were influential determinants of lower contraceptive prevalence among the non-working women. The results indicate a necessity for social activities promoting husband-wife communication and women's participation in employment to enhance the use of contraceptives among Bangladeshi women, especially non-working women.

Sexual Partners and Contraceptive Use: A 16-Year Prospective Study Predicting Abstinence and Risk Behavior

ERIC Educational Resources Information Center

Siebenbruner, Jessica; Zimmer-Gembeck, Melanie J.; Egeland, Byron

2007-01-01

Antecedents and correlates of sexual behavior among 167 (46 female) adolescents were examined in this multi-informant longitudinal study. Data were collected at birth through middle adolescence. Data on number of sexual partners and contraception use at age 16 defined sexual abstinence (SAs, n = 73), high-risk sexual behavior (HRTs, n = 45) and…

Increasing postpartum contraception in rural India: evaluation of a community-based behavior change communication intervention.

PubMed

Sebastian, Mary Philip; Khan, Mohammed Ejazduin; Kumari, Kaushal; Idnani, Rukma

2012-06-01

The Indian family planning program, though successful in increasing contraceptive use among couples who have achieved their desired family size, has not been equally successful in educating couples about the use of contraceptive methods for birth spacing. An evaluation was conducted of a behavior change communication intervention integrated into the existing government program to increase knowledge and use of the lactational amenorrhea method and postpartum contraception through counseling by community workers. The intervention, which ran between September 2006 and January 2007, was conducted among 959 pregnant women aged 15-24 who lived in Uttar Pradesh, India. The evaluation used logistic regression analyses to measure differences in knowledge and contraceptive use between baseline and the four- and nine-month postpartum follow-up surveys within and between the intervention and comparison groups. The follow-up data show increases in knowledge of the lactational amenorrhea method and spacing methods and in use of spacing methods. At four months postpartum, women in the intervention group were more likely to know the healthy spacing messages than those in the comparison group (odds ratio, 2.1). At nine months postpartum, women in the intervention group, those with higher knowledge of healthy spacing practices and those with correct knowledge of two or more spacing methods were more likely than others to be using a contraceptive method (1.5-3.5). Use of modern contraceptives for spacing at nine months postpartum was 57% in the intervention group versus 30% in the comparison group. Targeted behavior change communication using community workers is an effective and feasible strategy for promoting postpartum contraception.

A Brief Bibliography for the Sex Educator.

ERIC Educational Resources Information Center

Johnson, Anne D., Comp.; Turner, John, Comp.

The authors have developed a bibliography related to key issues in adolescent sexuality. Included are the following topics: (1) biological basis of sexuality; (2) adolescent sexual behavior; (3) homosexuality; (4) contraception and contraceptive behavior; (5) venereal disease; (6) morals; (7) abortion; (8) historical or anthropological view; (9)…

Premarital Contraceptive Use: A Test of Two Models

ERIC Educational Resources Information Center

Delamater, John; Maccorquodale, Patricia

1978-01-01

Tests the utility of two models for explaining contraceptive use by sexually active women (N=391). Significant relationships were found between use and permissive premarital standards and standard-behavior consistency. Neither model is particularly applicable to the contraceptive reports of sexually active males (N=354). (Author)

Understanding Adolescent Contraceptive Choice: An Empirical Test.

ERIC Educational Resources Information Center

Adler, Nancy E.; And Others

Research using expectancy models has shown contraceptive choice among adults to be a rational process in that intentions and behaviors reflect an individual's beliefs, values, attitudes, and perceptions of social norms. This study examined whether such an approach could accurately represent adolescents' contraceptive decision-making. It used the…

Associations between religiosity and sexual and contraceptive behaviors

PubMed Central

Gold, M. A.; Sheftel, A. V.; Chiappetta, L.; Young, A. J.; Zuckoff, A.; DiClemente, C. C.; Primack, B.A.

2010-01-01

Study Objective To determine associations between religiosity and female adolescents' sexual and contraceptive behaviors. Design We conducted a secondary analysis on data from a randomized controlled trial comparing interventions designed to prevent pregnancy and STDs. Multivariable modeling assessed the association between a religiosity index consisting of items related to religious behaviors and impact of religious beliefs on decisions and sexual outcomes. Participants 572 female adolescents aged 13 to 21, recruited via a hospital-based adolescent clinic and community-wide advertisements. Main Outcome Measures Sexual experience, pregnancy, STDs, number of lifetime partners, frequency of sexual activity, previous contraceptive use, and planned contraceptive use. Results Mean participant age was 17.4±2.2 years and 68% had been sexually active. Most (74.1%) had a religious affiliation and over half (52.8%) reported that their religious beliefs impact their decision to have sex at least “somewhat.” Multivariate analyses showed that, compared with those with low religiosity, those with high religiosity were less likely to have had sexual intercourse (OR=0.23, 95% CI=0.14, 0.39). Among sexually active participants, those with high religiosity were less likely to have been pregnant (OR=0.46, 95% CI=0.22, 0.97), to have had an STD (OR=0.42, 95% CI=0.22, 0.81), or to have had multiple (≥4) lifetime partners (OR=0.38, 95% CI=0.21, 0.68) compared to those with low religiosity. Levels of religiosity were not significantly associated with frequency of intercourse, contraception use at last intercourse, or planned contraceptive use. Conclusion In this cohort, religiosity appeared to be a protective factor rather than a risk factor with regard to sexual behavior and was not associated with contraception use. PMID:20493738

Alcohol and drug abuse and risky sexual behaviours in young adult women.

PubMed

Castelo-Branco, Camil; Parera, Nuria; Mendoza, Nicolás; Pérez-Campos, Ezequiel; Lete, Iñaki

2014-08-01

To assess alcohol abuse as a predictor of risky sexual behavior among adolescents and young adult women, a high-risk population for unintended pregnancies. Totally 3163 adolescent and young adult women, 18-29 years, were assessed on sociodemographics, alcohol and drug use and risky sexual behaviors. Participants answered a structured questionnaire on their leisure habits, drug and alcohol consumption, contraception and sexual behaviors. Most of the young adult women perceive that sexuality is an important part of their life but not a main concern (77.6%) and that alcohol removes the barriers to have sex (62.3%). Additionally, 77.0% claimed that contraception had "a lot" (53.4%) and "quite" (23.6%) influence on the quality of their sexuality. However, up to a 38.4% of the interviewed women had had sex without using any contraception and 29.6% of them acknowledged that had taken alcohol and of these, 40.7% said that alcohol was responsible for not using contraception. Alcohol abuse predicted an increase in risky sexual behaviours (4.45 CI: 2.01-9.75, p < 0.0001). The effect of alcohol was independent of age. These findings suggest that contraception-related behavioural interventions for young adult women should discuss the link between alcohol and sexual risk behavior.

Exposure to X-rated movies and adolescents' sexual and contraceptive-related attitudes and behaviors.

PubMed

Wingood, G M; DiClemente, R J; Harrington, K; Davies, S; Hook, E W; Oh, M K

2001-05-01

To examine the association between exposure to X-rated movies and teens' contraceptive attitudes and behaviors. Black females, 14 to 18 years old (n = 522) were recruited from adolescent medicine clinics, health departments, and school health clinics. Exposure to X-rated movies was reported by 29.7% of adolescents. Exposure to X-rated movies was associated with being more likely to have negative attitudes toward using condoms (odds ratio [OR]: 1.4), to have multiple sex partners (OR: 2.0), to have sex more frequently (OR: 1.8), to not have not used contraception during the last intercourse (OR: 1.5), to have not used contraception in the past 6 months (OR: 2.2), to have a strong desire to conceive (OR: 2.3), and to test positive for chlamydia (OR: 1.7). Additional research is needed to understand the impact of X-rated movies on adolescents' sexual and contraceptive health.

Adolescents' Interpretations of the Birth Control Behavior of a Soap Opera Couple.

ERIC Educational Resources Information Center

Walsh-Childers, Kim

A study investigated whether adolescents' schemas about contraceptive use would influence their perceptions that a soap opera couple used birth control during sex. The study also examined the effects of increasing explicitness of characters' conversations about contraceptives on viewers' perceptions of the couple's contraceptive use. Thirty-six…

Contraceptive Knowledge, Attitudes, and Behaviors of Black Adolescent Males Attending a Predominantly Black University.

ERIC Educational Resources Information Center

Leonard, Jack, Jr.

1988-01-01

Analysis of questionnaire responses of 107 Black adolescent male college students indicated that, while 85 percent used some contraceptive method, most subjects had less knowledge regarding the effectiveness of certain contraceptive methods, suggesting a need for more in-depth sex education programs. (CB)

Female Adolescent Contraceptive Decision Making and Risk Taking.

ERIC Educational Resources Information Center

Johnson, Sharon A.; Green, Vicki

1993-01-01

Findings from 60 sexually active, unmarried females, ages 14 through 18, revealed that cognitive capacity and cognitive egocentrism variables as well as age, grade, and ethnic status significantly predicted 6 of 7 decision-making variables in contraceptive use model. One cognitive capacity variable and one sexual contraceptive behavior variable…

Hybrid Masculinity and Young Men's Circumscribed Engagement in Contraceptive Management.

PubMed

Fefferman, Ann M; Upadhyay, Ushma D

2018-06-01

This research explores how gender shapes contraceptive management through in-depth interviews with 40 men and women of color ages 15 to 24, a life stage when the risk of unintended pregnancy is high in the United States. Although past research focuses on men's contraception-avoidant behaviors, little sociological work has explored ways men engage in contraception outside of condoms, such as contraceptive pills. Research often highlights how women manage these methods alone. Our research identifies how young men of color do help manage these methods through their engagement in contraceptive decision-making and use. Men accomplish this without limiting their partners' ability to prevent pregnancy. This is despite structural barriers such as poverty and gang-related violence that disproportionately affect low-income young men of color and often shape their reproductive goals. However, men's engagement is still circumscribed so that women take on a disproportionate burden of pregnancy prevention, reifying gender boundaries. We identify this as a form of hybrid masculinity, because men's behaviors are seemingly egalitarian but also sustain women's individualized risk of unintended pregnancy. This research points to the complexity of how race, class, and gender intersect to create an engaged but limited place for men in contraceptive management among marginalized youth.

Contraceptive knowledge, sexual behavior, and factors associated with contraceptive use among female undergraduate university students in Kilimanjaro region in Tanzania

PubMed Central

Sweya, Mussa N; Msuya, Sia E; Mahande, Michael J; Manongi, Rachel

2016-01-01

Background Previous studies have shown that knowledge of contraceptives, especially among the youth in universities, remains limited, and the rate of premarital sexual activity, unwanted pregnancies, and illegal abortions remains higher among university students. This study aimed to assess contraceptive knowledge, sexual behavior, and factors associated with contraceptive use among female undergraduate university students in Kilimanjaro region in Tanzania. Methods A cross-sectional analytical study was conducted from May to June 2015 among undergraduate female students in four universities in Kilimanjaro region. A self-administered questionnaire was given to the participants. Data analysis was performed using Statistical Package for Social Sciences. Descriptive statistics were used to summarize the data. An odds ratio with 95% confidence interval for factors associated with modern contraceptive use was computed using multiple logistic regression models. A P-value of <5% (two-tailed) was considered statistically significant. Results A total of 401 students were involved in the study. Two-thirds (260, 64.8%) of the participants had had sexual intercourse. The majority (93.8%) of the participants had knowledge of contraception. One hundred and seventy-five (43.6%) sexually active women reported that they used contraceptives in the past, while 162 (40.4%) were current contraceptive users. More than half (54.2%) of the sexually active group started sexual activity between the ages of 20–24 years. The most popular methods of contraception used were condoms, withdrawal, and periodic abstinence. The main sources of information about contraception were friends, television, and health care workers (44.8%, 40.3%, and 39.0%, respectively). Conclusion Most of the participants had knowledge of contraception. However, the rate of contraceptive use was low. The majority of the respondents were sexually active and started sexual activity at >18 years of age. Hence, advocacy for adolescent reproductive health education to promote the use of the available contraceptive services among university students is needed. PMID:27757057

Parent and Peer Influence on Sexual Behavior, Contraceptive Use, and Pregnancy Experience of Young Women.

ERIC Educational Resources Information Center

Shah, Farida; Zelnik, Melvin

1981-01-01

Analyzed data from a national probability sample of 15 through 19-year-old women to determine the influence of parents and peers on premarital sexual behavior, contraceptive use, and premarital pregnancy. Results show women with views resembling those of parents have low levels of premarital experience. (Author)

The Contraceptive Self-Efficacy Scale: Analysis in Four Samples.

ERIC Educational Resources Information Center

Levinson, Ruth Andrea; Wan, Choi K.; Beamer, LuAnn J.

1998-01-01

The relationship of the Contraceptive Self-Efficacy Scale to contraceptive behavior was explored in four female samples: (1) 258 California adolescents, (2) 259 Chicago (Illinois) adolescents, (3) 231 Montreal (Canada) high school students, and (4) 148 college students. Results are discussed in terms of use in research and clinical settings. (SLD)

Contraceptive Patterns of College Students Who Experienced Early Coitus.

ERIC Educational Resources Information Center

Vincent, Murray L.; And Others

1981-01-01

A study investigated the coital behavior, contraceptive use, and attitudes of 20-year-old male and female college students who experienced sexual intercourse early in adolescence (at 16 or younger) as contrasted to those who experienced coitus in late adolescence. Results indicate that older adolescents were more likely to use contraceptives and,…

Adolescents' Values, Sexuality, and Contraception in a Rural New York County.

ERIC Educational Resources Information Center

McCormick, Naomi; And Others

1985-01-01

Examined personal values and sexual and contraceptive experiences of 75 male and 88 female high school students from a rural county of New York. Results suggested that religiosity was unrelated to students' sexual behavior and use of contraceptives. The different groups of high school students exhibited remarkably homogeneous sexual and…

Effective Dual Method Contraceptive Use and HPV Vaccination Among U.S. Adolescent and Young Adult Females

PubMed Central

Vanderpool, Robin C.; Williams, Corrine M.; Klawitter, Amy R.; Eddens, Katherine

2016-01-01

Background Problem Behavior Theory posits that risky behaviors cluster in individuals, implying that protective behaviors may follow a similar pattern. The purpose of this study was to determine whether the protective behavior of effective dual method contraception use at first and most recent sexual intercourse is associated with HPV vaccination among adolescent and young adult females. Methods National Survey of Family Growth (2006–2010) data were used to examine the association between women’s contraception use during first and most recent sexual intercourse and HPV vaccination. Women aged 15 to 24 years (n = 1,820) served as the study sample. Findings At first and last sexual intercourse, effective dual method contraception use was reported by 15.3% and 16.8% women, respectively; 27.8% reported receiving at least one dose of the human papillomavirus (HPV) vaccine. Higher HPV vaccination rates were observed among dual method users at first and last sexual intercourse (36.4% and 48.2%, respectively). This trend was also observed across age groups (15–19 year olds vs. 20–24 year olds). In adjusted models, among all respondents, dual users at last sexual intercourse were significantly more likely to be vaccinated, whereas at first sexual intercourse only younger dual users were more likely to report HPV vaccination. Conclusions Findings suggest that the protective behavior of dual method contraceptive use at first and most recent sexual intercourse may serve as a predictor of another complementary health behavior, HPV vaccination, particularly among adolescent females. More research is needed to understand behavioral clustering to design related multi-focused women’s health interventions. PMID:25213746

Effective dual method contraceptive use and HPV vaccination among U.S. adolescent and young adult females.

PubMed

Vanderpool, Robin C; Williams, Corrine M; Klawitter, Amy R; Eddens, Katherine

2014-01-01

Problem Behavior Theory posits that risky behaviors cluster in individuals, implying that protective behaviors may follow a similar pattern. The purpose of this study was to determine whether the protective behavior of effective dual method contraception use at first and most recent sexual intercourse is associated with HPV vaccination among adolescent and young adult females. National Survey of Family Growth (2006-2010) data were used to examine the association between women's contraception use during first and most recent sexual intercourse and HPV vaccination. Women aged 15 to 24 years (n = 1,820) served as the study sample. At first and last sexual intercourse, effective dual method contraception use was reported by 15.3% and 16.8% women, respectively; 27.8% reported receiving at least one dose of the human papillomavirus (HPV) vaccine. Higher HPV vaccination rates were observed among dual method users at first and last sexual intercourse (36.4% and 48.2%, respectively). This trend was also observed across age groups (15-19 year olds vs. 20-24 year olds). In adjusted models, among all respondents, dual users at last sexual intercourse were significantly more likely to be vaccinated, whereas at first sexual intercourse only younger dual users were more likely to report HPV vaccination. Findings suggest that the protective behavior of dual method contraceptive use at first and most recent sexual intercourse may serve as a predictor of another complementary health behavior, HPV vaccination, particularly among adolescent females. More research is needed to understand behavioral clustering to design related multi-focused women's health interventions. Copyright © 2014 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Hormonal contraception and female pain, orgasm and sexual pleasure.

PubMed

Smith, Nicole K; Jozkowski, Kristen N; Sanders, Stephanie A

2014-02-01

Almost half of all pregnancies in the United States are unintentional, unplanned, or mistimed. Most unplanned pregnancies result from inconsistent, incorrect, or nonuse of a contraceptive method. Diminished sexual function and pleasure may be a barrier to using hormonal contraception. This study explores sexual function and behaviors of women in relation to the use of hormonal vs. nonhormonal methods of contraception. Data were collected as part of an online health and sexuality study of women. Main outcomes variables assess frequencies in two domains: (i) sexual function (proportion of sexual events with experiences of pain or discomfort, arousal, contentment and satisfaction, pleasure and enjoyment, lubrication difficulty, and orgasm) and (ii) sexual behavior (number of times engaged in sexual activity, proportion of sexual events initiated by the woman, and proportion of sexual events for which a lubricant was used). Sociodemographic variables and contraceptive use were used as sample descriptors and correlates. The recall period was the past 4 weeks. The sample included 1,101 women with approximately half (n = 535) using a hormonal contraceptive method exclusively or a combination of a hormonal and nonhormonal method, and about half (n = 566) using a nonhormonal method of contraception exclusively. Hierarchical regression analyses were conducted to examine the relation of hormonal contraceptive use to each of the dependent variables. Women using a hormonal contraceptive method experienced less frequent sexual activity, arousal, pleasure, and orgasm and more difficulty with lubrication even when controlling for sociodemographic variables. This study adds to the literature on the potential negative sexual side effects experienced by many women using hormonal contraception. Prospective research with diverse women is needed to enhance the understanding of potential negative sexual side effects of hormonal contraceptives, their prevalence, and possible mechanisms. Clinical and counseling implications are discussed. © 2013 International Society for Sexual Medicine.

Contraceptive Provision to Adolescent Females Prescribed Teratogenic Medications.

PubMed

Stancil, Stephani L; Miller, Melissa; Briggs, Holley; Lynch, Daryl; Goggin, Kathy; Kearns, Gregory

2016-01-01

Rates of adult women receiving contraceptive provision when simultaneously prescribed a known teratogen are alarmingly low. The prevalence of this behavior among pediatric providers and their adolescent patients is unknown. The objective of this study was to describe pediatric provider behaviors for prescribing teratogens concurrently with counseling, referral, and/or prescribing of contraception (collectively called contraceptive provision) in the adolescent population. A retrospective review was conducted examining visits in 2008-2012 by adolescents aged 14 to 25 years in which a known teratogen (US Food and Drug Administration pregnancy risk category D or X) was prescribed. The electronic medical records were queried for demographic information, evidence of contraceptive provision, and menstrual and sexual histories. The data were analyzed using standard statistical methods. Within 4172 clinic visits, 1694 females received 4506 prescriptions for teratogenic medications. The most commonly prescribed teratogens were topiramate, methotrexate, diazepam, isotretinoin, and enalapril. The subspecialties prescribing teratogens most frequently were neurology, hematology-oncology, and dermatology. Overall, contraceptive provision was documented in 28.6% of the visits. Whites versus nonwhites and older versus younger girls were more likely to receive contraceptive provision. The presence of a federal risk mitigation system for the teratogen also increased the likelihood of contraceptive provision. Our data demonstrate female adolescents prescribed teratogens receive inadequate contraception provision, which could increase their risk for negative pregnancy outcomes. Although the presence of a federal risk mitigation system appears to improve contraceptive provision, these systems are costly and, in some instances, difficult to implement. Efforts to improve provider practices are needed. Copyright © 2016 by the American Academy of Pediatrics.

Using Behavioral Economic Theory to Increase Use of Effective Contraceptives among Opioid-maintained Women at Risk of Unintended Pregnancy

PubMed Central

Heil, Sarah H.; Hand, Dennis J.; Sigmon, Stacey C.; Badger, Gary J.; Meyer, Marjorie C.; Higgins, Stephen T.

2016-01-01

Objective An unsettling aspect of the US opioid epidemic is the high rate of in utero exposure, especially since most of these pregnancies are unintended, due in part to low rates of effective contraceptive use among opioid-using women. This study tested an intervention informed by behavioral economic theory and aimed at promoting effective contraceptive use among opioid-maintained women at risk of unintended pregnancy in the Burlington, VT area between 2011–2013. Methods Thirty-one women were assigned (initial 5 consecutively, subsequent 26 randomly) to either usual care or an experimental intervention. Participants in usual care received condoms, a dose of emergency contraception, and referral to local providers. Participants in the experimental condition received usual care plus the World Health Organization’s contraception initiation protocol, including free prescription contraceptives, and financial incentives for attending 13 follow-up visits over 6 months to help manage side effects and other issues. Results Significantly more women in the experimental vs. usual care control conditions initiated prescription contraceptive use (100% vs. 29%) and reported prescription contraceptive use at 1-month (63% vs. 13%), 3-month (88% vs. 20%), and 6-month (94% vs. 13%) assessments. None of the experimental condition participants became pregnant during the 6-month protocol vs. three women (20%) in the control condition. Conclusions These results provide the first experimental evidence supporting the efficacy of an intervention for increasing prescription contraceptive use among opioid-maintained women at risk of unintended pregnancy. PMID:27346756

Women's household decision-making autonomy and contraceptive behavior among Bangladeshi women.

PubMed

Rahman, Md Mosfequr; Mostofa, Md Golam; Hoque, Md Aminul

2014-03-01

Women's autonomy is a potentially important but less studied indicator of using contraception among women as well as ability to control their fertility. This study explores women's decision-making autonomy as a potential indicator of the use of contraception in Bangladesh. This cross-sectional study utilizes data from the Bangladesh Demographic Health Survey (BDHS) 2007. Information of 8456 currently married and non-pregnant women aged 15-40 years are analyzed to meet up the objective of this study. The mean age of the respondents is 27.19 years and majority of the respondents are from rural areas (62.7%) and also Muslim (90.2%). A large number of women (26.1%) and their husbands (29.0%) have no education and 27.2% respondents were working at the time of interview. The mean number of living children is 2.14. 48.9% of the respondents are currently using a modern method of contraception. More than one-third women are not involved in their household decision-making. Results of this study indicate that household decision-making autonomy is significantly associated with current use of modern contraception, future intention to use contraception and discuss contraception with husband. This measure of women's autonomy provides additional independent explanatory power of contraceptive behavior net of some other socio-demographic variables. This study argues in favor of increasing women's autonomy to increase contraception using rate in this population. Copyright © 2013 Elsevier B.V. All rights reserved.

The Role of Quality Health Services and Discussion about Birth Spacing in Postpartum Contraceptive Use in Sindh, Pakistan: A Multilevel Analysis

PubMed Central

Tappis, Hannah; Dahar, Zaib; Ali, Anayat; Agha, Sohail

2015-01-01

Introduction Rapid population growth, stagnant contraceptive prevalence, and high unmet need for family planning present significant challenges for meeting Pakistan’s national and international development goals. Although health behaviors are shaped by multiple social and environmental factors, research on contraceptive uptake in Pakistan has focused on individual and household determinants, and little attention has been given to community characteristics that may affect access to services and reproductive behavior. Methods Individual and community determinants of contraceptive use were identified using multivariable multilevel logistic regression to analyze data from a 2014 cross-sectional survey of 6,200 mothers in 503 communities in Sindh, Pakistan. Results Only 27% of women who had given birth in the two years before the study reported using contraceptives. After adjusting for individual and community characteristics, there was no difference in the odds of contraceptive use between urban and rural women. Women who had delivered at a health facility had 1.4 times higher odds of contraceptive use than women who delivered at home. Those who received information about birth spacing from a doctor or relatives/friends had 1.81 and 1.38 times higher odds of contraceptive use, respectively, than those who did not. Living in a community where a higher proportion of women received quality antenatal care and where discussion of birth spacing was more common was significantly associated with contraceptive use. Community-wide poverty lowered contraceptive use. Conclusions Quality of care at the community level has strong effects on contraceptive use, independent of the characteristics of individual households or women. These findings suggest that powerful gains in contraceptive use may be realized by improving the quality of antenatal care in Pakistan. Community health workers should focus on generating discussion of birth spacing in the community. Outreach efforts should target communities where the demand for contraception appears to be depressed due to high levels of poverty. PMID:26485524

The Role of Quality Health Services and Discussion about Birth Spacing in Postpartum Contraceptive Use in Sindh, Pakistan: A Multilevel Analysis.

PubMed

Tappis, Hannah; Kazi, Anis; Hameed, Waqas; Dahar, Zaib; Ali, Anayat; Agha, Sohail

2015-01-01

Rapid population growth, stagnant contraceptive prevalence, and high unmet need for family planning present significant challenges for meeting Pakistan's national and international development goals. Although health behaviors are shaped by multiple social and environmental factors, research on contraceptive uptake in Pakistan has focused on individual and household determinants, and little attention has been given to community characteristics that may affect access to services and reproductive behavior. Individual and community determinants of contraceptive use were identified using multivariable multilevel logistic regression to analyze data from a 2014 cross-sectional survey of 6,200 mothers in 503 communities in Sindh, Pakistan. Only 27% of women who had given birth in the two years before the study reported using contraceptives. After adjusting for individual and community characteristics, there was no difference in the odds of contraceptive use between urban and rural women. Women who had delivered at a health facility had 1.4 times higher odds of contraceptive use than women who delivered at home. Those who received information about birth spacing from a doctor or relatives/friends had 1.81 and 1.38 times higher odds of contraceptive use, respectively, than those who did not. Living in a community where a higher proportion of women received quality antenatal care and where discussion of birth spacing was more common was significantly associated with contraceptive use. Community-wide poverty lowered contraceptive use. Quality of care at the community level has strong effects on contraceptive use, independent of the characteristics of individual households or women. These findings suggest that powerful gains in contraceptive use may be realized by improving the quality of antenatal care in Pakistan. Community health workers should focus on generating discussion of birth spacing in the community. Outreach efforts should target communities where the demand for contraception appears to be depressed due to high levels of poverty.

Contraceptive behavior in Ghana: a two-sex model.

PubMed

Dodoo, F N

1995-01-01

This report uses data of the 1988 Ghana Demographic and Health Survey (GDHS), a nationally representative self-weighting sample of 4488 female respondents 15-49 years old. 943 co-resident husbands of the surveyed women were also interviewed, thus the data provided 1010 dyads, which facilitated a couple-level analysis of contraceptive behavior. The determinants of modern contraceptive adoption were examined among dependent variables, including both modern and traditional methods, and the predictors of future usage among the nonusers were also assessed. For each of dependent variables, two logistic regressions were estimated, one for females, and the second one for couple measures of intentions and male preferences. Males were older and more educated than their female counterparts, and women were more likely than men to want to cease and space childbearing. 68.8% of women were in monogamous marriages, and the average age of women was 31.8 years, compared to 41 years for men among 1008 people in the sample. 43.5% of women had lost more than 1 child, and 22.9% had urban residence. 11.7% of couples agreed that contraceptives were needed for stopping childbearing. However, 14.9% said that there was no need for contraception, while 27.7% wanted contraception for spacing of births. 46% of the sample disagreed about contraceptive need and use. 6% of the women used modern contraceptives, while 8.7% used traditional methods. In addition, 29.7% of the women intended to use contraception in the future, while 55.6% did not intend to do this. Examination of contraceptive use and selected background variables indicates urban-rural differences. Also, the advancing age of wives and all levels of female schooling means increasing contraceptive use, but secondary schooling was associated with lower use for men than primary schooling. Use of contraception was also positively associated with the desire to cease childbearing for both sexes whether users or non-users. The findings indicate that female preferences were more significant than male preferences in predicting contraceptive use in Ghana.

A role for selective contraception of individuals in conservation.

PubMed

Cope, Holly R; Hogg, Carolyn J; White, Peter J; Herbert, Catherine A

2018-06-01

Contraception has an established role in managing overabundant populations and preventing undesirable breeding in zoos. We propose that it can also be used strategically and selectively in conservation to increase the genetic and behavioral quality of the animals. In captive breeding programs, it is becoming increasingly important to maximize the retention of genetic diversity by managing the reproductive contribution of each individual and preventing genetically suboptimal breeding through the use of selective contraception. Reproductive suppression of selected individuals in conservation programs has further benefits of allowing animals to be housed as a group in extensive enclosures without interfering with breeding recommendations, which reduces adaptation to captivity and facilitates the expression of wild behaviors and social structures. Before selective contraception can be incorporated into a breeding program, the most suitable method of fertility control must be selected, and this can be influenced by factors such as species life history, age, ease of treatment, potential for reversibility, and desired management outcome for the individual or population. Contraception should then be implemented in the population following a step-by-step process. In this way, it can provide crucial, flexible control over breeding to promote the physical and genetic health and sustainability of a conservation dependent species held in captivity. For Tasmanian devils (Sarcophilus harrisii), black-flanked rock wallabies (Petrogale lateralis), and burrowing bettongs (Bettongia lesueur), contraception can benefit their conservation by maximizing genetic diversity and behavioral integrity in the captive breeding program, or, in the case of the wallabies and bettongs, by reducing populations to a sustainable size when they become locally overabundant. In these examples, contraceptive duration relative to reproductive life, reversibility, and predictability of the contraceptive agent being used are important to ensure the potential for individuals to reproduce following cessation of contraception, as exemplified by the wallabies when their population crashed and needed females to resume breeding. © 2017 Society for Conservation Biology.

Sexual Behavior, Satisfaction, and Contraceptive Use Among Postpartum Women.

PubMed

Sok, Christina; Sanders, Jessica N; Saltzman, Hanna M; Turok, David K

2016-01-01

This study aimed to 1) describe the behaviors and timing of the first sexual activity postpartum, 2) compare characteristics of women who return to vaginal intercourse by 6 weeks postpartum to those who initiate intercourse after 6 weeks, 3) evaluate contraceptive use of postpartum women, and 4) describe the physical and emotional satisfaction with the first sexual activity postpartum. This prospective study recruited participants during prenatal visits or postpartum prior to hospital discharge. Women completed an initial survey regarding pregnancy intendedness, contraceptive history, breastfeeding plans, sexual activity, satisfaction, and initiation. Postpartum surveys were conducted every 2 weeks starting 6 weeks after birth until 12 weeks or return to vaginal sexual intercourse. A total of 370 participants were recruited; 304 (82%) were followed to first intercourse. By life table analysis at 6 weeks (42 days) postpartum, 132 (43%) of women had resumed sexual intercourse, but only 65 (49%) of those women reported using contraception. There were no significant demographic or obstetric differences by timing of resumption of intercourse. However, when controlling for these characteristics, women who reported using contraception at 6 weeks postpartum were 1.8 times (95% confidence interval [CI], 1.2-3.2; P = .015) more likely to have had vaginal intercourse by 6 weeks postpartum compared to women who were not using contraception then. By 12 weeks postpartum, 341 (92%) of women had resumed vaginal intercourse. Psychological and physical satisfaction during sex was lower both during pregnancy and after giving birth, relative to satisfaction before pregnancy (P < .001). By 6 weeks postpartum, 4 in 10 women had resumed vaginal intercourse, with only half using contraception. Counseling regarding postpartum contraception should meet normative behavior. Thus, contraceptive plans need to be established during prenatal care, and the postpartum visit should occur earlier than the current standard time of 6 weeks. © 2016 by the American College of Nurse-Midwives.

Understanding multiple levels of norms about teen pregnancy and their relationships to teens' sexual behaviors.

PubMed

Mollborn, Stefanie; Domingue, Benjamin W; Boardman, Jason D

2014-06-01

Researchers seeking to understand teen sexual behaviors often turn to age norms, but they are difficult to measure quantitatively. Previous work has usually inferred norms from behavioral patterns or measured group-level norms at the individual level, ignoring multiple reference groups. Capitalizing on the multilevel design of the Add Health survey, we measure teen pregnancy norms perceived by teenagers, as well as average norms at the school and peer network levels. School norms predict boys' perceived norms, while peer network norms predict girls' perceived norms. Peer network and individually perceived norms against teen pregnancy independently and negatively predict teens' likelihood of sexual intercourse. Perceived norms against pregnancy predict increased likelihood of contraception among sexually experienced girls, but sexually experienced boys' contraceptive behavior is more complicated: When both the boy and his peers or school have stronger norms against teen pregnancy he is more likely to contracept, and in the absence of school or peer norms against pregnancy, boys who are embarrassed are less likely to contracept. We conclude that: (1) patterns of behavior cannot adequately operationalize teen pregnancy norms, (2) norms are not simply linked to behaviors through individual perceptions, and (3) norms at different levels can operate independently of each other, interactively, or in opposition. This evidence creates space for conceptualizations of agency, conflict, and change that can lead to progress in understanding age norms and sexual behaviors.

Understanding multiple levels of norms about teen pregnancy and their relationships to teens’ sexual behaviors

PubMed Central

Mollborn, Stefanie; Domingue, Benjamin W.; Boardman, Jason D.

2014-01-01

Researchers seeking to understand teen sexual behaviors often turn to age norms, but they are difficult to measure quantitatively. Previous work has usually inferred norms from behavioral patterns or measured group-level norms at the individual level, ignoring multiple reference groups. Capitalizing on the multilevel design of the Add Health survey, we measure teen pregnancy norms perceived by teenagers, as well as average norms at the school and peer network levels. School norms predict boys’ perceived norms, while peer network norms predict girls’ perceived norms. Peer network and individually perceived norms against teen pregnancy independently and negatively predict teens’ likelihood of sexual intercourse. Perceived norms against pregnancy predict increased likelihood of contraception among sexually experienced girls, but sexually experienced boys’ contraceptive behavior is more complicated: When both the boy and his peers or school have stronger norms against teen pregnancy he is more likely to contracept, and in the absence of school or peer norms against pregnancy, boys who are embarrassed are less likely to contracept. We conclude that: (1) patterns of behavior cannot adequately operationalize teen pregnancy norms, (2) norms are not simply linked to behaviors through individual perceptions, and (3) norms at different levels can operate independently of each other, interactively, or in opposition. This evidence creates space for conceptualizations of agency, conflict, and change that can lead to progress in understanding age norms and sexual behaviors. PMID:25104920

Use and knowledge of contraceptive methods by patients in two substance use disorders treatment centers in Paris.

PubMed

Clergue-Duval, Virgile; Robin, Suzanne; Fortias, Maeva; Dupuy, Gaël; Badin-de-Montjoye, Béatrice; Vorspan, Florence

2017-08-04

Studies on contraceptive use by patients with substance use disorders (SUD) show a concerning low use of contraception. Mainly conducted in USA, they could be irrelevant to patients attending European SUD treatment centers, especially since these studies mostly investigate women suffering from social exclusion, severe material deprivation andopiates use with frequent high-risk drug use and sexual behaviors including sex trade, frequently not currently attending treatment centers. The purpose of this study is to describe contraceptive use by patients, both male and female, since contraception can not only be considered as a female problem, with severe SUD in two free clinics in Paris, France. An anonymous self-report questionnaire was distributed to literate patients followed in two generalist substance use disorders treatment centers in hospitals of Paris, France: Espace Murger and Centre Cassini, during 5 weeks between February and March 2016. Out of the 78 respondents (with an age mean 40.7 years, in which women are represented as 48.1%, and 29.7% of them have children), 53 have had at least one sexual partner in the last 6 months. Contraception was "always" used by 55.3% of sexually active patients, "sometimes" by 19.1%, and "not" used by 25.5%. Male condoms were the main contraceptive method. The use of intrauterine devices was low, contrarily to what is observed in the French general population. However, the knowledge of contraceptive methods was common. In this population, with a high prevalence of at risk sexual behavior, the use of contraceptive methods is lower than in French general population. During standard care for SUD, contraception and desire to be a parent should be discussed and patients empowered to make their own choices. Lack of knowledge does not seem to be a hindrance to the use of contraception, but other sociological, psychological, or medical factors may limit contraceptive access and long-term use, especially for the long-acting reversible contraception methods. It is necessary to further develop this reflection by discussing the individual contraceptive choices with the patients themselves to clarify the nature of these constraints and maybe provide several contraceptive methods within the SUD care settings.

Pleasure, power, and inequality: incorporating sexuality into research on contraceptive use.

PubMed

Higgins, Jenny A; Hirsch, Jennifer S

2008-10-01

We know surprisingly little about how contraception affects sexual enjoyment and functioning (and vice versa), particularly for women. What do people seek from sex, and how do sexual experiences shape contraceptive use? We draw on qualitative data to make 3 points. First, pleasure varies. Both women and men reported multiple aspects of enjoyment, of which physical pleasure was only one. Second, pleasure matters. Clear links exist between the forms of pleasure respondents seek and their contraceptive practices. Third, pleasure intersects with power and social inequality. Both gender and social class shape sexual preferences and contraceptive use patterns. These findings call for a reframing of behavioral models that explain why people use (or do not use) contraception.

Application of individual behavioral models to predict willingness to use modern contraceptives among pastoralist women in Afar region, Northern Ethiopia.

PubMed

Kahsay, Znabu Hadush; Tegegne, Dessie; Mohammed, Ebrahim; Kiros, Getachew

2018-01-01

Use of modern contraceptive methods reduces the risk of unwanted pregnancy, and is influenced by individual-level factors. Willingness to use modern contraceptive methods maybe a useful metric when considering health outcomes as it could predict health behaviors. Therefore, the current study aimed to assess the willingness of women to use modern contraceptives in Afar pastoralist communities. A community-based cross-sectional study was conducted from May 1 to 30, 2016. Three hundred forty-five women of childbearing age (15-49 years) were systematically sampled with proportionate allocation from seven randomly selected kebeles (neighborhoods) in Aballa District of Afar Region, Ethiopia. All women meeting the inclusion criteria in each selected household were interviewed at home using a semi-structured questionnaire. Construct validity was assured using factor analysis. A combination of individual behavioral models were applied in order to measure willingness to use modern contraceptive methods. Multiple logistic regressions were utilized to identify factors associated with willingness to use contraceptive at P-value of less than 0.05. Three hundred twenty-two women participated in the study, for a response rate of 93.3%. The mean age of respondents was 27 (±6) years. About one-third (N = 106, 32.9%) of the participants reported that they were willing to use modern contraceptives. Orthodox Christians (AOR = 4.22, 95% CI 1.94-8.92), women aged 19 or older at first marriage (AOR = 2.89, 95% CI 1.16-7.23), and women who had never experienced a stillbirth (AOR = 3.85, 95%CI 1.37-10.78) were more likely to report being willing to use modern contraceptives. Additionally, perceived severity of an unwanted pregnancy (AOR = 1.71, 95% CI 1.57-1.93) and perceived self-efficacy to use contraceptives (AOR = 1.26, 95% CI 1.17-1.65) were positively associated with the willingness. Women who had never had an abortion were less likely to express willingness to use modern contraceptives (AOR = 0.41, 95% CI 0.19-0.92) and perceived importance of cultural and religious norms (AOR = 0.85, 95% CI 0.62-0.90) was also negatively associated with willingness. The majority of women in this study were not willing to use modern contraceptive methods. A previous pregnancy outcome of stillbirth was associated with reduced willingness, while a prior abortion was associated with increased willingness. Perceived severity of unwanted pregnancy and higher self-efficacy surrounding contraceptive use were strong predictors of increased willingness to use contraceptives. Religious and cultural norms also appear to influence perception towards modern contraception. Thus, involvement of cultural and religious leaders and consideration of a woman's reproductive history are recommended when designing health education messages on contraception for Afar pastoralist women.

Women's attitudes about menstruation and associated health and behavioral characteristics.

PubMed

Morrison, Lynn A; Larkspur, Louona; Calibuso, Marites J; Brown, Susan

2010-01-01

To examine the relationships between attitudes towards menstruation, health, and behavioral characteristics. The 136 women who completed questionnaires varied in their sexual activity, sexual orientation, and use of hormonal contraception. Women's estimated cycle length was accurate when compared to observed cycle length (F (3,156) = .05; P = .98). Smokers had decreased durations of flow (P < .01). Depo-Provera users were less likely to view menstruation as natural compared to abstinent, sexually active heterosexuals or those using traditional oral contraception (F (5,141) = 2.43; P = .04). Hormonal contraception use, but not sexual orientation, was associated with attitudes about menstruation.

Sex Differences in Contraception Non-Use among Urban Adolescents: Risk Factors for Unintended Pregnancy

ERIC Educational Resources Information Center

Casola, Allison R.; Nelson, Deborah B.; Patterson, Freda

2017-01-01

Background: Contraception non-use among sexually active adolescents is a major cause of unintended pregnancy (UP). Methods: In this cross-sectional study we sought to identify overall and sex-specific correlates of contraception non-use using the 2015 Philadelphia Youth Risk Behavior Survey (YRBS) (N = 9540). Multivariate regression models were…

The Mystique of First Intercourse among College Youth: The Role of Partners, Contraceptive Practices, and Psychological Reactions.

ERIC Educational Resources Information Center

Darling, Carol Anderson; And Others

1992-01-01

First sexual intercourse of 94 male and 114 female college undergraduates was studied as it relates to gender differences in sexual behaviors, partner's role, contraceptive use, and sexual guilt and satisfaction. Sexual intercourse initiation is often characterized by contraceptive nonuse, pressure to become sexually involved, guilt, and sexual…

Sexual Attitudes and Contraceptive Practices.

ERIC Educational Resources Information Center

Byrne, Donn

1978-01-01

Discusses barriers to effective contraception, such as informational, emotional, and imaginative factors, and what might be done to avoid unwanted pregnancies by using these factors in positive programs and behaviors. (Author/RK)

Hybrid Masculinity and Young Men’s Circumscribed Engagement in Contraceptive Management

PubMed Central

Fefferman, Ann M.; Upadhyay, Ushma D.

2018-01-01

This research explores how gender shapes contraceptive management through in-depth interviews with 40 men and women of color ages 15 to 24, a life stage when the risk of unintended pregnancy is high in the United States. Although past research focuses on men’s contraception-avoidant behaviors, little sociological work has explored ways men engage in contraception outside of condoms, such as contraceptive pills. Research often highlights how women manage these methods alone. Our research identifies how young men of color do help manage these methods through their engagement in contraceptive decision-making and use. Men accomplish this without limiting their partners’ ability to prevent pregnancy. This is despite structural barriers such as poverty and gang-related violence that disproportionately affect low-income young men of color and often shape their reproductive goals. However, men’s engagement is still circumscribed so that women take on a disproportionate burden of pregnancy prevention, reifying gender boundaries. We identify this as a form of hybrid masculinity, because men’s behaviors are seemingly egalitarian but also sustain women’s individualized risk of unintended pregnancy. This research points to the complexity of how race, class, and gender intersect to create an engaged but limited place for men in contraceptive management among marginalized youth. PMID:29755203

Sports, sexual behavior, contraceptive use, and pregnancy among female and male high school students: testing cultural resource theory.

PubMed

Miller, K E; Sabo, D F; Farrell, M P; Barnes, G M; Melnick, M J

1999-01-01

This paper explores the relationship among athletic participation and sexual behavior, contraceptive use, and pregnancy in female and male high school students in the US. Using the 1995 Youth Risk Behavior Survey, the sexual behavior of 8979 high school students was analyzed using covariance and multiple covariance. After controlling for factors such as race and ethnicity, age, and maternal education, it was observed that girls who participated in sports activities had lower rates of sexual experience, fewer sex partners, later age of first intercourse, higher rates of contraceptive use, and lower rates of past pregnancies compared to girls who did not participate in sports. On the other hand, male high school athletes were reported to have higher rates of sexual experience and more partners than nonathletes, although higher prevalence of contraceptive use during their most recent intercourse was noted. Based on the cultural resource theory, it was suggested that athletic participation would most likely reduce the girls' adherence to conventional cultural scripts while providing them with additional social and personal resources on which to draw in the sexual bargaining process. In addition, sports provide boys with similar resources while strengthening their commitment to traditional masculine scripts.

Preventing Health Damaging Behaviors in Male and Female Army Recruits

DTIC Science & Technology

2009-01-01

information about pregnancy • Describe basic information about prescription and non-prescription methods of contraceptives • Increase awareness of...career • Give basic information about non-prescription methods of contraceptives , including condoms, spermicides, and the Morning After Pill...and Preview of Session 5 MODULE 1 15 MINUTES Pregnancy Facts MODULE 2 55 MINUTES Contraceptive Methods Overview and Prescription Methods of

[Sexual behavior and contraceptive practices among university students].

PubMed

Repossi, A; Araneda, J M; Bustos, L; Puente, C; Rojas, C

1994-01-01

The aim of this work was to study the knowledge, opinions and sexual behaviour of a sample of 464 students from the Universidad Austral de Chile. Results show that 78% of male and 41% of female students have had a sexual intercourse and that 78% of males and 72% of females with an active sexual life use contraceptive methods. The principal reasons to avoid the use of these methods are the irregularity of sexual intercourse and the reduction in pleasure. Most students think that these methods are harmful for their health but they should be used. The use of contraceptive methods increase with the frequency of sexual relations and university experience, but first year students use them more frequently than second year students. Most students know several contraceptive methods, but their knowledge about mechanisms of action is inadequate or distorted. Likewise, more than 50% think that it is possible to prevent pregnancy after a sexual intercourse. It is concluded that most sexually active students use contraceptive methods, but inappropriately. Stereotypes, myths and lack of information are influencing their sexual and contraceptive practices, showing incoherence between their knowledge and behavior. A possible explanation could be a scarce influence of high school and religion on their sexual formation.

Changes in sexual behavior and contraceptive use after HIV acquisition and factors associated with risky sexual practices among people living with HIV in selected Indian cities.

PubMed

Joshi, Beena; Chauhan, Sanjay; Das, Hiranya; Luaia, Rosangluaia; Sunil, Nitya

2016-01-01

Sexual behavior and contraceptive use among HIV-infected persons are a neglected issue in public health programs. To understand sexual practices and contraceptive use of people living with HIV (PLHIV) before and after being diagnosed with the infection and assess the providers' perspectives on provision of contraceptives to PLHIV, the quality of services provided and linkages between reproductive health and HIV services. A mix method design study using a purposive sampling was undertaken enrolling PLHIV from ART centers and PLHIV networks across three cities in India. Doctors and counselors providing HIV services at public hospitals were also interviewed. Use of condoms increased from 35% to 81% after being diagnosed with HIV. Consistent condom use was 69% compared to only 8.7% before being diagnosed with HIV. Nearly 41% (297) of participants indulged in one or more forms of risky sexual behaviors. Significant correlates of risky sexual practices were: participants who were middle-aged (25-33 years), formerly married, currently not on antiretroviral therapy, and received negligible information on contraception from service providers leading to poor knowledge on safe sex and dual protection. Information from service providers reveals a lack of specific program guidelines to comprehensively address family planning (FP) issues through HIV programs. The study throws light on missed opportunities to address contraceptive needs of PLHIV and recommends training service providers and operationalizing a strategy to link HIV and FP services.

Pleasure, Power, and Inequality: Incorporating Sexuality Into Research on Contraceptive Use

PubMed Central

Hirsch, Jennifer S.

2008-01-01

We know surprisingly little about how contraception affects sexual enjoyment and functioning (and vice versa), particularly for women. What do people seek from sex, and how do sexual experiences shape contraceptive use? We draw on qualitative data to make 3 points. First, pleasure varies. Both women and men reported multiple aspects of enjoyment, of which physical pleasure was only one. Second, pleasure matters. Clear links exist between the forms of pleasure respondents seek and their contraceptive practices. Third, pleasure intersects with power and social inequality. Both gender and social class shape sexual preferences and contraceptive use patterns. These findings call for a reframing of behavioral models that explain why people use (or do not use) contraception. PMID:18703457

A survey of bonobo (Pan paniscus) oral contraceptive pill use in North American zoos.

PubMed

Agnew, Mary K; Asa, Cheryl S; Clyde, Victoria L; Keller, Dominique L; Meinelt, Audra

2016-09-01

Contraception is an essential tool in reproductive management of captive species. The Association of Zoos and Aquariums (AZA) Reproductive Management Center (RMC) gathers data on contraception use and provides recommendations. Although apes have been given oral contraceptive pills (OCPs) for at least 30 years, there have been no published reports with basic information on why the pill is administered, formulations and brands used, and effects on physiology and behavior. Here, we report survey results characterizing OCP use in bonobos (Pan paniscus) housed in North American zoos, as well as information accumulated in the RMC's Contraception Database. Of 26 females treated, there have been no failures and nine reversals. The most commonly administered OCP formulation in bonobos contained ethinyl estradiol (EE) 35 μg/norethindrone 1 mg. Few females on combined oral contraceptives (COCs) were given a continuous active pill regimen; a hormone-free interval of at least 5 days was allowed in most. Crushing the pill and mixing with juice or food was common. Females on COCs seldom experienced breakthrough estrus or bleeding, while these conditions were sometimes observed for females on continuous COCs. All females on COCs exhibited some degree of perineal swelling, with a mean score of 3 or 3+ most commonly reported. Behavioral changes included less sexual behavior, dominant females becoming subordinate, and a negative effect on mood. No appreciable change in weight was noted. Taken together, these results indicate that OCPs are an effective and reversible contraceptive option for bonobos that can be used by zoos and sanctuaries to limit reproduction. Zoo Biol. 35:444-453, 2016. © Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Predicting effective contraceptive behavior in college females.

PubMed

Hughes, C B; Torre, C

1987-09-01

This article reports the results of a preliminary research project that explored the relationship between assertiveness, cognitive development and contraceptive behavior among single young women in their freshman and senior years at college. A total of 60 college women at a university health center volunteered to participate in this pilot study. They filled out three instruments: the Galassi College Self-Expression Scale (SES), the Measure of Intellectual Development (MID) tool and an author-developed sexuality questionnaire. Although there was a significant relationship between cognitive development and assertiveness, no significant relationships were found between cognitive development, assertiveness and use of effective contraception. Interesting descriptive characteristics were identified. Clinical implications are discussed.

Decreased allopregnanolone induced by hormonal contraceptives is associated with a reduction in social behavior and sexual motivation in female rats.

PubMed

Santoru, Francesca; Berretti, Roberta; Locci, Andrea; Porcu, Patrizia; Concas, Alessandra

2014-09-01

Allopregnanolone is a neurosteroid involved in depression, memory, social, and sexual behavior. We have previously demonstrated that treatment with a combination of ethinylestradiol (EE) and levonorgestrel (LNG), two compounds frequently used in hormonal contraception, decreased brain allopregnanolone concentrations. These changes may contribute to some of the emotional and sexual disorders observed in hormonal contraceptive users. We thus examined whether the reduction in allopregnanolone concentrations induced by long-term EE/LNG administration was associated with altered emotional, learning, social, and sexual behaviors. Rats were orally treated with a combination of EE (0.030 mg) and LNG (0.125 mg) once a day for 4 weeks and were subjected to behavioral tests 24 h after the last administration. EE/LNG treatment reduced immobility behavior in the forced swim test, without affecting sucrose preference and spatial learning and memory. In the resident-intruder test, EE/LNG-treated rats displayed a decrease in dominant behaviors associated with a reduction in social investigation. In the paced mating test, EE/LNG treated rats showed a reduction in proceptive behaviors, while the lordosis quotient was not affected. Progesterone, but not estradiol, administration to EE/LNG-treated rats increased sexual activity and cerebrocortical allopregnanolone concentrations. Prior administration of finasteride decreased allopregnanolone concentrations and abolished the increase in proceptivity induced by progesterone administration. The decrease in brain allopregnanolone concentrations induced by EE/LNG treatment is associated with a reduction in social behavior and sexual motivation in female rats. These results might be relevant to the side effects sometimes exhibited by women taking hormonal contraceptives.

Risk and protective factors for sexual risk taking among adolescents involved in Prime Time.

PubMed

Garwick, Ann; Nerdahl, Peggy; Banken, Rachel; Muenzenberger-Bretl, Lynn; Sieving, Renee

2004-10-01

This article describes a preliminary qualitative evaluation of risk and protective factors associated with consistent contraceptive use and healthy sexual decision-making among ten of the first participants in the Prime Time intervention study. Prime Time is an 18-month intervention including one-on-one case management and peer educator training targeting sexually active 13-17-year-old girls who are recruited from health care clinics. Using an approach grounded in findings from previous research, social cognitive theory, and the social development model, Prime Time aims to improve participants' contraceptive use consistency, reduce number of sexual partners, and reduce unwanted sexual activity. Findings from this preliminary evaluation alert health care providers to the complex and dynamic nature of adolescent girls' sexual behaviors and to a broad range of risk and protective factors within individuals and their environments that may influence adolescent girls' sexual behaviors and contraceptive use. Findings suggest that an ongoing, supportive relationship with a case manager who is able to pace and tailor an intervention to the individual young person can have positive effects on adolescent girls' sexual behaviors and contraceptive use.

Do the emotional side-effects of hormonal contraceptives come from pharmacologic or psychological mechanisms?

PubMed

Robinson, Stephen A; Dowell, Matt; Pedulla, Dominic; McCauley, Larry

2004-01-01

Hormonal preparations have become one of the most popular methods used for controlling fertility. The literature over the last 40 years continues to reveal how their numerous side effects negatively impact many users and even society at large. Three large cohort trials were the first to demonstrate, on a grand scale, certain emotional and behavioral associations with contraceptive use. Current contraceptive use was associated with an increase rate in depression, divorce, tranquilizer use, sexual dysfunction, and suicide and other violent and accidental deaths. Despite the advent of more "user friendly" contraceptives, the discontinuation rate secondary to side effects has changed little through the years. While in rare cases hormonal preparations can be deadly to the user, there is substantial evidence that their negative effect issues more from their emotional and behavioral properties. This paper reviews the results of over seven studies which further characterize these prominent associations, particularly with hormonal contraception, in an attempt to demonstrate their association with the intrinsic pharmacologic properties of hormonal preparations. Hormonal contraceptive users, in contrast with non users, were found to have higher rates of depression, anxiety, fatigue, neurotic symptoms, sexual disturbances, compulsion, anger, and negative menstrual effects. The question of whether the association of these maladies is directly due to the effect of taking exogenous hormones versus the psychological impact of the contraceptive behavior itself had yet to be studied. Seven small randomized-controlled trials were found in a review of the literature which studied this hypothesis in a direct way. They do not support the origination of these side effects being from the pharmacological properties of hormones. No association was found between hormone levels and emotional functioning in females. Psychiatric evaluations among IUD and oral contraceptive pill (OCP) users reveal no significant differences. Women who were given an OCP placebo experienced a similar side effect profile of OCP users. Different hormonal concentrations and combinations made no significant difference in the side effect profile. A study of women who were given either "weak female hormones" or a placebo failed to duplicate the side effect profile found in all of the other studies where the hormones were labeled as contraceptives. The evidence suggests that most of the side effects of hormonal contraception are a result of a psychological response to the practice of contraception. More study is warranted to further understand this psychological phenomenon, especially now that an effective non-contraceptive method of fertility regulation and more reliable psychological instruments are available. Furthermore, it is reasonable to hypothesize, given the present data, that contraceptive activity itself is inherently damaging to women.

The intensive and extensive margins of contraceptive use: comparing the effects of method choice and method initiation.

PubMed

Thomas, Adam; Karpilow, Quentin

2016-08-01

The risk of pregnancy is estimated to be 20 times as high among women who use oral contraception, and 90 times as high among condom users, as among women who use certain long-acting contraceptive methods. We explored the population-level implications of this variation in contraceptive efficacy. We used the FamilyScape 3.0 microsimulation model to study the effects on the nonmarital pregnancy rate of movements along two different margins of contraceptive behavior: the extensive margin, which captures decisions about whether to initiate use of any method of contraception among noncontraceptors; and the intensive margin, which captures the choice of methods among contraceptors. The model is populated with a nationally representative sample of 50,000 women who are of childbearing age. The impact on the number of nonmarital pregnancies would not be substantially different if noncontraceptors adopted long-acting methods than if they began using oral contraception. Moreover, the nonmarital pregnancy rate would be reduced by about twice as much if a subset of noncontraceptors began using condoms as if an equal number of pill users took up long-acting methods. The prevailing emphasis on long-acting contraception is somewhat misplaced. Policymakers and practitioners will have the largest effects on fertility outcomes if they can change the behavior of sexually active women who neglect to use birth control when they are not seeking pregnancy. Women's decisions about which methods to use are less impactful than their decisions about whether to use contraception at all. The policies that affect method choice are likely to differ from the policies that address the underlying motivations of noncontraceptors who are not seeking pregnancy. Copyright © 2016 Elsevier Inc. All rights reserved.

Knowledge, attitudes and beliefs about contraceptive and sexual consent negotiation among college women.

PubMed

Fantasia, Heidi Collins; Sutherland, Melissa A; Fontenot, Holly; Ierardi, Janet A

2014-01-01

College women have the highest rates of sexual violence, sexually transmitted infections, and unintended pregnancy compared with women in all other age groups. Although much is known about sexual risk behaviors among college women, less is known about how women negotiate consent for contraceptive use during sexual encounters. Therefore, the purpose of this qualitative descriptive study was to explore college women's knowledge, attitudes, and beliefs about contraceptive and sexual consent during dating relationships. Twenty-six women participated in five focus groups on two college campuses in the northeastern United States. Content analysis was used to analyze the data. The three main categories that emerged from the analysis included the influence of alcohol on sexual behaviors, lack of negotiation for sexual consent and contraceptive use, and fear of pregnancy. The results of this study highlight the complex social interactions and norms that college women encounter when making decisions regarding sexual activity and contraceptive use. The results of this study can inform the role of college health providers and forensic nurses to promote sexual health and safety when they interact with college women.

Men's behavior surrounding use of contraceptives in Guinea.

PubMed

Baldé, Mamadou Diouldé; Diallo, Boubacar Alpha; Compaoré, Rachidatou; Bah, Abdoul Karim; Ali, Moazzam; Kabra, Rita; Kouanda, Seni

2016-11-01

To analyze the sociocultural determinants that influence the attitude and practices of men toward contraceptive use in Guinea. A sequential, mixed methods, qualitative and quantitative study was carried out in two regions of Guinea with a low rate of contraceptive prevalence, and in the capital city of Conakry. A total of 1170 people (men and women) were interviewed. Findings showed a positive perception of family planning overall, but reluctance to use modern contraception. The reasons for non-use of contraceptive methods were primarily the hope of having many children and religious prohibition associated with customs. Making decisions on contraceptive use within a couple represents a major cause of misunderstanding between spouses. Communication within a couple on the use of contraception is quickly declined by men. The findings demonstrate the need to develop communication strategies within a couple to improve the use of contraceptives. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Effect of village midwife program on contraceptive prevalence and method choice in Indonesia.

PubMed

Weaver, Emily H; Frankenberg, Elizabeth; Fried, Bruce J; Thomas, Duncan; Wheeler, Stephanie B; Paul, John E

2013-12-01

Indonesia established its Village Midwife Program in 1989 to combat high rates of maternal mortality. The program's goals were to address gaps in access to reproductive health care for rural women, increase access to and use of family planning services, and broaden the mix of available contraceptive methods. In this study, we use longitudinal data from the Indonesia Family Life Survey to examine the program's effect on contraceptive practice. We find that the program did not affect overall contraceptive prevalence but did affect method choice. Over time, for women using contraceptives, midwives were associated with increased odds of injectable contraceptive use and decreased odds of oral contraceptive and implant use. Although the Indonesian government had hoped that the Village Midwife Program would channel women into using longer-lasting methods, the women's "switching behavior" indicates that the program succeeded in providing additional outlets for and promoting the use of injectable contraceptives. © 2013 The Population Council, Inc.

Sex-role attitudes as predictors of contraceptive use among unmarried university students.

PubMed

Fox, G L

1977-06-01

A survey of the literature led to 3 propositions: 1) the most usual response of young women when deciding whether to use a contraceptive is to avoid the decision by not using any or by leaving it to the male, 2) contraceptive inertia is reinforced by the joint operation of external locus of control and traditional sex-role attitudes, and 3) contraceptive use is facilitated by nontraditional sex-role attitudes in conjunction with a positive sense of personal control. A stratified random sample of 1009 male and female students at a large Midwestern university provided survey research data. Findings indicate a majority of students do not use contraceptive protection at 1st intercourse but increase usage. 22% of the females and 31% of the males did not use contraceptives at their last sexual encounter. The results suggest that nontraditional sex-role-related attitudes in conjunction with an internal locus of control orientation are predictive of effective contraception for women respondents. Neither variable alone or jointly explained contraceptive behavior of men respondents.

Theory-based interventions for contraception.

PubMed

Lopez, Laureen M; Tolley, Elizabeth E; Grimes, David A; Chen-Mok, Mario

2011-03-16

The explicit use of theory in research helps expand the knowledge base. Theories and models have been used extensively in HIV-prevention research and in interventions for preventing sexually transmitted infections (STIs). The health behavior field uses many theories or models of change. However, educational interventions addressing contraception often have no stated theoretical base. Review randomized controlled trials (RCTs) that tested a theoretical approach to inform contraceptive choice; encourage contraceptive use; or promote adherence to, or continuation of, a contraceptive regimen. We searched computerized databases for trials that tested a theory-based intervention for improving contraceptive use (MEDLINE, POPLINE, CENTRAL, PsycINFO, EMBASE, ClinicalTrials.gov, and ICTRP). We also wrote to researchers to find other trials. Trials tested a theory-based intervention for improving contraceptive use. We excluded trials focused on high-risk groups and preventing sexually transmitted infections or HIV. Interventions addressed the use of one or more contraceptive methods for contraception. The reports provided evidence that the intervention was based on a specific theory or model. The primary outcomes were pregnancy, contraceptive choice, initiating or changing contraceptive use, contraceptive regimen adherence, and contraception continuation. The primary author evaluated abstracts for eligibility. Two authors extracted data from included studies. We calculated the odds ratio for dichotomous outcomes. No meta-analysis was conducted due to intervention differences. Fourteen RCTs met our inclusion criteria. In 2 of 10 trials with pregnancy or birth data, a theory-based group showed better results. Four of 10 trials with contraceptive use data (other than condoms) showed better outcomes in an experimental group. For condom use, a theory-based group had favorable results in three of eight trials. Social Cognitive Theory was the main theoretical basis for five trials, of which three showed positive results. Two based on other social cognition models had favorable results, as did two of four focused on motivational interviewing. Thirteen trials provided multiple sessions or contacts. Of seven effective interventions, five targeted adolescents, including four with group sessions. Three effective trials had individual sessions. Seven trials were rated as having high or moderate quality; three of those had favorable results. Family planning researchers and practitioners could adapt the effective interventions. Reproductive health needs high-quality research on behavior change, especially for clinical and low-resource settings. More thorough use of single theories would help, as would better reporting on research design and intervention implementation.

Impact of a theory-based video on initiation of long-acting reversible contraception after abortion.

PubMed

Davidson, AuTumn S; Whitaker, Amy K; Martins, Summer L; Hill, Brandon; Kuhn, Caroline; Hagbom-Ma, Catherine; Gilliam, Melissa

2015-03-01

Adoption of long-acting reversible contraception (LARC) (ie, the intrauterine device or the contraceptive implant) immediately after abortion is associated with high contraceptive satisfaction and reduced rates of repeat abortion. Theory-based counseling interventions have been demonstrated to improve a variety of health behaviors; data on theory-based counseling interventions for postabortion contraception are lacking. Informed by the transtheoretical model of behavioral change, a video intervention was developed to increase awareness of, and dispel misconceptions about, LARC methods. The intervention was evaluated in a randomized controlled trial among women aged 18-29 years undergoing surgical abortion at a clinic in Chicago, IL. Participants were randomized 1:1 to watch the intervention video or to watch a stress management video (control), both 7 minutes in duration. Contraceptive methods were supplied to all participants free of charge. Rates of LARC initiation immediately after abortion were compared. Rates of LARC initiation immediately after abortion were not significantly different between the 2 study arms; 59.6% in the intervention and 51.6% in the control arm chose a LARC method (P = .27). This study resulted in an unexpectedly high rate of LARC initiation immediately after abortion. High rates of LARC initiation could not be attributed to a theory-based counseling intervention. Copyright © 2015 Elsevier Inc. All rights reserved.

Migration Experiences and Reported Sexual Behavior Among Young, Unmarried Female Migrants in Changzhou, China.

PubMed

Zong, Zhanhong; Yang, Wenjian; Sun, Xiaoming; Mao, Jingshu; Shu, Xingyu; Hearst, Norman

2017-09-27

China has a large migrant population, including many young unmarried women. Little is known about their sexual behavior, contraceptive use, and risk of unintended pregnancy. 475 unmarried female migrants aged 15-24, working in 1 of 6 factories in 2 districts of Changzhou city, completed an anonymous self-administered questionnaire in May 2012 on demographic characteristics, work and living situation, and health. We examined demographic and migration experience predictors of sexual and contraceptive behavior using bivariate and multivariate regressions. 30.1% of the respondents were sexually experienced, with the average age at first sex of 19 years (standard deviation=3). 37.8% reported using contraception at first sex, 58.0% reported using consistent contraception during the past year, and 28.0% reported having at least 1 unintended pregnancy with all unintended pregnancies resulting in abortion. Those who had had at least 1 abortion reported having on average 1.6 abortions [SD=1] in total. Migrating with a boyfriend and changing jobs fewer times were associated with being sexually experienced. Younger age, less education, and changing jobs more times were associated with inconsistent contraceptive use. These findings demonstrate there is an unmet need for reproductive health education and services where these women work as well as in their hometown communities. This education must begin early to reach young women before they migrate. © Zong et al.

An Exploratory Study of Acculturation and Reproductive Health Among Haitian and Haitian-American Women in Little Haiti, South Florida.

PubMed

Cyrus, E; Gollub, E L; Jean-Gilles, M; Neptune, S; Pelletier, V; Dévieux, J

2016-06-01

There is unmet contraceptive need among Haitian immigrants and Haitian-American women (Haitian women). The study explored associations of three measures of acculturation with contraceptive/reproductive health history among Haitian women residing in the Little Haiti community of Miami. This was a cross-sectional, exploratory study among 57 Haitian women. We conducted descriptive univariate analyses, then bivariate analyses to investigate the association of acculturation with reproductive health risk behavior including contraceptive use, tampon use, and parity, as well as interest in a female-initiated barrier contraceptive method. The most commonly ever-used contraceptive methods were male condoms (78.9 %) and oral contraceptives (OC 19.3 %). Women who primarily spoke Créole at home were less likely than those who did not to use OC (11.9 vs. 42.9 %, p = .01). Among women who resided in the U.S. ≥10 years, tampon use was 51.9 % compared to 16.7 % among those who were in the U.S. for less time (p = .005). Among U.S. born women, 60 % were tampon users compared to 22.7 % among those born in Haiti (p = .05). Women not speaking primarily Créole at home (p = .06) and those born in U.S. (p = .008) had fewer children. Contraceptive use was low among Haitian women but influenced by acculturation, where greater acculturation was associated with protective reproductive health behavior. Despite traditional norms discouraging contraceptive use, and little experience with female barriers, Haitian women indicated an interest in learning about and using a female-initiated barrier contraceptive. Increasing contraceptive uptake of potential multipurpose technologies is a potential point of intervention for decreasing HIV/STI transmission in this at-risk population.

Partner roles in contraceptive use: what do adolescent mothers say?

PubMed

Lewis, Dinah A; Martins, Summer L; Gilliam, Melissa L

2012-12-01

To examine the role of sexual partners in adolescent mothers' use of non-coital dependent contraceptive methods in the postpartum period. 40 African American adolescent mothers completed surveys and qualitative interviews during the first postpartum year as part of a larger longitudinal study in Chicago, Illinois. Themes related to contraception and sexual partners were analyzed. Adolescent mothers' reports of partners' roles in the use of non-coital dependent contraceptive methods (i.e., oral contraceptives, intrauterine contraception, and depot medroxyprogesterone acetate). Partners largely supported the use of non-coital dependent contraceptive methods, yet mechanisms of support varied greatly, from advocating for specific methods to facilitating participants' continuation of their chosen method. Unsupportive partners either expressed concerns about the safety and side effects of specific methods or desired another child in the near future. Participants valued these preferences to different degrees when making their contraceptive decisions. Partners of adolescent mothers play varying roles in postpartum contraceptive decisions. They thus have the potential both to inhibit and to facilitate the use of non-coital dependent contraception. Quantitative research is needed to further evaluate how partner attitudes and support behaviors, among other factors, affect contraceptive initiation and continuation among adolescent mothers. Copyright © 2012 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

[Profile of sexual behavior in 12- to 19-year-old Mexican adolescents. Results of ENSA 2000].

PubMed

González-Garza, Carlos; Rojas-Martínez, Rosalba; Hernández-Serrato, María I; Olaiz-Fernández, Gustavo

2005-01-01

To describe traits associated with sexual behaviors in Mexican adolescents, their knowledge about contraception, and factors associated with pregnancy and utilization of contraceptives during first sexual intercourse. Data from the Mexican National Health Survey 2000 (ENSA 2000) were analyzed. This study, conducted between September 1999 and March 2000, was a complex survey with a probabilistic, stratified, and cluster sampling design. The sample population included 15 241 adolescents 12 to 19 years of age. Data analysis included descriptive statistics and a chi-squared test for differences of proportions; also, logistic regression was used to obtain odds ratios. A total of 69.2% adolescents reported knowledge of at least one contraception method; 16.4% of subjects reported having had sexual intercourse. Males initiated sexual intercourse earlier than females and only 37% of all adolescents utilized contraceptives during their first sexual intercourse. Logistic regression analysis showed that being male, having a higher education, having knowledge of at least one contraception method, and having initiated sexual intercourse at an older age, were factors associated with utilization of a contraception method in their first sexual intercourse. A total of 55.7% of sexually active female adolescents had been pregnant. Pregnancy among adolescents was associated with low educational level, sexual activity at early age, and to have sometime lived in free union. The majority of sexually active adolescents did not use contraception during their first sexual intercourse, rendering them at risk of unwanted pregnancies.

Religion, contraception, and method choice of married women in Ghana.

PubMed

Gyimah, Stephen Obeng; Adjei, Jones K; Takyi, Baffour K

2012-12-01

Using pooled data from the 1998 and 2003 Demographic and Health Surveys, this paper investigates the association between religion and contraceptive behavior of married women in Ghana. Guided by the particularized theology and characteristics hypotheses, multinomial logit and complementary log-log models are used to explore denominational differences in contraceptive adoption among currently married women and assess whether the differences could be explained through other characteristics. We found that while there were no differences between women of different Christian faiths, non-Christian women (Muslim and Traditional) were significantly more likely to have never used contraception compared with Christian women. Similar observations were made on current use of contraception, although the differences were greatly reduced in the multivariate models.

An Intervention Delivered by App Instant Messaging to Increase Acceptability and Use of Effective Contraception Among Young Women in Bolivia: Protocol of a Randomized Controlled Trial

PubMed Central

Osorio Calderon, Veronica; Makleff, Shelly; Huaynoca, Silvia; Leurent, Baptiste; Edwards, Phil; Lopez Gallardo, Jhonny; Free, Caroline

2017-01-01

Background Unintended pregnancy is associated with numerous poorer health outcomes for both women and their children. Fulfilling unmet need for contraception is essential in avoiding unintended pregnancies, yet millions of women in low- and middle-income countries continue to face obstacles in realizing their fertility desires. In Bolivia, family planning progress has improved in recent decades but lags behind other countries in the region. Unmet need for contraception among women aged 15 to 19 years is estimated to be 38%, with the adolescent fertility rate at 70 per 1000 women. Mobile phones are an established and popular mode in which to deliver health behavior support. The London School of Hygiene & Tropical Medicine and the Centro de Investigación, Educación y Servicios in Bolivia have partnered to develop and evaluate a contraceptive behavioral intervention for Bolivian young women delivered by mobile phone. The intervention was developed guided by behavioral science and consists of short instant messages sent through an app over 4 months. Objective The objective of this study is to evaluate the effect of the intervention on young women’s use of and attitudes toward the most effective contraceptive methods. Methods We will allocate 1310 women aged 16 to 24 years with an unmet need for contraception in a 1:1 ratio to receive the intervention messages or the control messages about trial participation. The messages are sent through the Tú decides app, which contains standard family planning information. Coprimary outcomes are use and acceptability of at least one effective contraceptive method, both measured at 4 months. Results Recruitment commenced on March 1, 2017 and was completed on July 29, 2017. We estimate that the follow-up period will end in January 2018. Conclusions This trial will evaluate the effect of the intervention on young women’s use of and attitudes toward the (nonpermanent) effective contraception methods available in Bolivia. Trial Registration ClinicalTrials.gov NCT02905526; https://clinicaltrials.gov/ct2/show/NCT02905526 (Archived by WebCite at http://www.webcitation.org/6vT0yIFfN) PMID:29254910

The prescribing of contraceptives for adolescents in German gynecologic practices in 2007 and 2011: a retrospective database analysis.

PubMed

Ziller, M; Rashed, A N; Ziller, V; Kostev, K

2013-10-01

To investigate the prescribing trend of contraceptives in adolescent girls aged 12-18 years and to compare prescribing patterns of the most frequently used contraceptives among this population in Germany in 2007 and 2011. A retrospective cohort study was conducted to analyze contraceptive prescriptions written by gynecologists in 2007 and 2011 in Germany by using the IMS Disease Analyzer database (IMS HEALTH). All adolescent girls aged 12-18 years with at least 1 prescription of a contraceptive drug in 2007 or 2011 were identified. The prevalence of contraceptive prescriptions was calculated and the types of contraceptive substances prescribed were examined. A total of 21,026 teenage girls in 2007 and 18,969 in 2011 received contraceptive prescriptions. The prevalence of contraceptive prescribing rose significantly between 2007 and 2011 (P < .001). The percentage of teen girls who received prescriptions of levonorgestrel and chlormadinone pills was significantly higher in 2011 compared to 2007 (P < .001). However, the portion of contraceptive pills containing drospirenone or desogestrel significantly decreased in 2011 compared to 2007 (P < .01). There was a significant increase in contraceptive prescription usage among adolescent girls between 2007 and 2011 in Germany. However, the prescription behavior of doctors also changed; they consequently prescribed contraceptives with more evidence. Further research is needed to better understand the various factors associated with contraceptive use among this population. Copyright © 2013 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Knowledge, attitude and practice of modern contraception among single women in a rural and urban community in southeast Nigeria.

PubMed

Ozumba, B C; Obi, S N; Ijioma, N N

2005-04-01

The contraceptive information and services offered to single women in most developing countries is compromised by stigma attached to premarital sex. This study was to ascertain the knowledge, attitude and practice of contraception among single women in a rural and urban community in southeast Nigeria, using a cross-sectional survey of 279 and 295 single women in Ngwo (rural) and Enugu (urban) community. The mean age of the population was 21.3 years. Contraceptive awareness was more among the urban than rural respondents (90.2% vs 34.1%). The major sources of contraceptive knowledge were mass media (68%) and peer groups (86.3%) for the urban and rural respondents, respectively. Most respondents in both groups had positive attitude towards contraception. More urban than rural respondents (68.3% vs 12.5%) began sexual activity during adolescence and the level of contraceptive use during first coitus were 48.4% and 13.7%, respectively. Of the currently sexually active respondents, 32.5% (rural) and 59.7% (urban) were using a form of modern contraception. Condoms, followed by oral pills were the most popular contraceptive method because they can easily procure them over the counter. Poor contraceptive information, highly critical behavior of family planning providers towards unmarried women seeking contraception and attitude of male partners militate against contraceptive practice. There is need to promote information and education on contraception among single women, their male partners and family planning providers.

Contraception: a questionnaire on knowledge and attitude of adolescents, distributed on Facebook.

PubMed

Denis, Lies; Storms, Machteld; Peremans, Lieve; Van Royen, Kathleen; Verhoeven, Veronique

2016-11-01

The contraceptive pill is widely used. An accurate knowledge is necessary for correct use. This study sheds light on adolescents' knowledge, attitude and behavior in regard to contraceptive use, in the year 2014. The goal is to provide general practitioners (GP) with information about the potential gaps in knowledge concerning contraceptive use in order to give better counseling and prevent high-risk behavior in adolescents. A quantitative descriptive study was carried out among 14-25-year-old female and male adolescents. Data were collected through a web-based survey using the online survey software Qualtrics (Qualtrics, Provo, UT, USA) and was distributed via the social networking site Facebook. The survey was started by 1185 participants. The most popular contraceptive method among females is the oral contraceptive pill (63.7%). Four out of ten females (42.6%) do not know that when using an emergency pill, they must still take their regular contraceptive pill on the same day. The majority of female respondents (80.0%) go to their general practitioner for a prescription for the pill. Ninety-five percent (95.1%) of the females would feel comfortable asking their GP for extra information about the drug. The sex of the GP does not influence the likelihood of female patients seeking more information. The Internet also seems to serve as an important source of information. We defined a female subgroup, called "vulnerable". The majority of females in the non-vulnerable group (70.4%) protected themselves before their first sexual contact instead of only half of the members in the vulnerable group (51.0%). The level of knowledge among adolescents about contraception is not alarming, but there are a few blind spots. Eliminating these gaps should be the aim of the doctor and pharmacologist.

Sexual activity and contraceptive use among young female students of tertiary educational institutions in Ilorin, Nigeria.

PubMed

Abiodun, Omoniyi M; Balogun, Olayinka R

2009-02-01

A survey was conducted to evaluate the pattern of sexual behavior and contraceptive use among female students aged 15 to 24 years attending tertiary institutions in Ilorin, Nigeria. A valid and reliable semistructured questionnaire was self-administered to a sampled population of 600 students aged 15 to 24 years. Of the 600 students, 562 (93.7%) completed the questionnaire. Most (98.6%) of the respondents were unmarried, 77.6% have had sexual intercourse, 67.8% have had an unwanted pregnancy while 63.5% have had induced abortion. All the respondents were aware of contraceptives, but only 25.4% have ever used any contraceptive method. The most common sources of information about contraception among the respondents were friends/relatives (73.7%), while the fear of side effects of modern contraceptives was the most common reason (77.5%) for nonuse. The fear of side effects is the main reason for low contraceptive prevalence among young female students of tertiary institutions in Ilorin. Reproductive health services should focus more on delivery of adequate and accurate information about contraceptives to improve use among young women.

Lifetime prevalence of sexual intercourse and contraception use at last sex among adolescents and young adults with congenital heart disease.

PubMed

Fry, Kevin M; Gerhardt, Cynthia A; Ash, Jerry; Zaidi, Ali N; Garg, Vidu; McBride, Kim L; Fitzgerald-Butt, Sara M

2015-04-01

Because of the increased risks associated with unplanned pregnancy for males and females with congenital heart disease (CHD), we investigated sexual intercourse and contraception use in these adolescents and young adults (AYA) and compared the same with national and state population data. We recruited 337 AYA with structural CHD aged 15-25 years (Mage = 19 years, standard deviation = 3.1; 53% male, 84% white) from an outpatient cardiology clinic to participate in a larger study assessing genetic knowledge and health behaviors. Cumulative lifetime prevalence of adolescent (aged 15-18 years) sexual intercourse was compared with the 2011 Youth Risk Behavior Surveillance System and the 2007 Ohio Youth Risk Behavior Survey. Cumulative lifetime prevalence of young adult (aged 19-25 years) sexual intercourse and contraception use at last sex were compared with the 2006-2008 National Survey of Family Growth. Reported rates of ever having sexual intercourse, 26% of adolescents and 74% of young adults with CHD, were significantly lower than general population rates (47% and 86% respectively; p < .001). Similar to the general population, 77% of previously sexually active young adults with CHD reported using at least one effective method of contraception at last intercourse, whereas 25% used dual effective methods and 23% used no effective method. Lower rates of ever having sexual intercourse in this population suggest that the psychosexual development of AYA with CHD may lag behind their peers. As nearly one in four participants reported using no effective method of contraception, health care providers should increase discussions of contraception with males and females with CHD. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Ten Years of Experience in Contraception Options for Teenagers in a Family Planning Center in Thrace and Review of the Literature

PubMed Central

Tsikouras, Panagiotis; Deuteraiou, Dorelia; Bothou, Anastasia; Anthoulaki, Xanthi; Chalkidou, Anna; Chatzimichael, Eleftherios; Gaitatzi, Fotini; Manav, Bachar; Koukouli, Zacharoula; Zervoudis, Stefanos; Trypsianis, Grigorios; Galazios, George

2018-01-01

Introduction: The goal of our study was to investigate and evaluate the contraceptive behavior in teenagers from our family planning centre that services two different religious and socioeconomic populations living in the Thrace area. Methods: During the last 10 years 115 Christian Orthodox (group A) and 53 Muslim teenagers (group B) were enrolled in our retrospective study. Contraceptive practice attitudes were assessed by a questionnaire. Religion, demographics, socio-economic characteristics were key factors used to discuss contraception and avoid unplanned pregnancy in each group and to compare with the contraceptive method used. Results: The most used contraceptive method—about two times more frequently—among Christian Orthodox participants was the oral contraceptive pill (p = 0.015; OR = 1.81, 95% CI = 1.13–2.90), while in the other group the use of condoms and IUDs was seven and three times more frequent, respectively. Our family planning centre was the main source of information for contraception. Conclusions: During adolescence, the existence of a family planning centre and participation in family planning programs plays a crucial role to help the teenagers to improve their knowledge and choose an effective contraception method. PMID:29462872

Behavioral interventions for improving dual-method contraceptive use.

PubMed

Lopez, Laureen M; Stockton, Laurie L; Chen, Mario; Steiner, Markus J; Gallo, Maria F

2014-03-30

Dual-method contraception refers to using condoms as well as another modern method of contraception. The latter (usually non-barrier) method is commonly hormonal (e.g., oral contraceptives) or a non-hormonal intrauterine device. Use of two methods can better prevent pregnancy and the transmission of HIV and other sexually transmitted infections (STIs) compared to single-method use. Unprotected sex increases risk for disease, disability, and mortality in many areas due to the prevalence and incidence of HIV/STI. Millions of women, especially in lower-resource areas, also have an unmet need for protection against unintended pregnancy. We examined comparative studies of behavioral interventions for improving use of dual methods of contraception. Dual-method use refers to using condoms as well as another modern contraceptive method. Our intent was to identify effective interventions for preventing pregnancy as well as HIV/STI transmission. Through January 2014, we searched MEDLINE, CENTRAL, POPLINE, EMBASE, COPAC, and Open Grey. In addition, we searched ClinicalTrials.gov and ICTRP for current trials and trials with relevant data or reports. We examined reference lists of pertinent papers, including review articles, for additional reports. Studies could be either randomized or non-randomized. They examined a behavioral intervention with an educational or counseling component to encourage or improve the use of dual methods, i.e., condoms and another modern contraceptive. The intervention had to address preventing pregnancy as well as the transmission of HIV/STI. The program or service could be targeted to individuals, couples, or communities. The comparison condition could be another behavioral intervention to improve contraceptive use, usual care, other health education, or no intervention.Studies had to report use of dual methods, i.e., condoms plus another modern contraceptive method. We focused on the investigator's assessment of consistent dual-method use or use at last sex. Outcomes had to be measured at least three months after the behavioral intervention began. Two authors evaluated abstracts for eligibility and extracted data from included studies. For the dichotomous outcomes, the Mantel-Haenszel odds ratio (OR) with 95% CI was calculated using a fixed-effect model. Where studies used adjusted analysis, we presented the results as reported by the investigators. No meta-analysis was conducted due to differences in interventions and outcome measures. We identified four studies that met the inclusion criteria: three randomized controlled trials and a pilot study for one of the included trials. The interventions differed markedly: computer-delivered, individually tailored sessions; phone counseling added to clinic counseling; and case management plus a peer-leadership program. The latter study, which addressed multiple risks, showed an effect on contraceptive use. Compared to the control group, the intervention group was more likely to report consistent dual-method use, i.e., oral contraceptives and condoms. The reported relative risk was 1.58 at 12 months (95% CI 1.03 to 2.43) and 1.36 at 24 months (95% CI 1.01 to 1.85). The related pilot study showed more reporting of consistent dual-method use for the intervention group compared to the control group (reported P value = 0.06); the investigators used a higher alpha (P < 0.10) for this pilot study. The other two trials did not show any significant difference between the study groups in reported dual-method use or in test results for pregnancy or STIs at 12 or 24 months. We found few behavioral interventions for improving dual-method contraceptive use and little evidence of effectiveness. A multifaceted program showed some effect but only had self-reported outcomes. Two trials were more applicable to clinical settings and had objective outcomes measures, but neither showed any effect. The included studies had adequate information on intervention fidelity and sufficient follow-up periods for change to occur. However, the overall quality of evidence was considered low. Two trials had design limitations and two had high losses to follow up, as often occurs in contraceptive trials. Good quality studies are still needed of carefully designed and implemented programs or services.

Contraceptive discontinuation and switching among couples receiving integrated HIV and family planning services in Lusaka, Zambia

PubMed Central

Haddad, Lisa; Wall, Kristin M; Vwalika, Bellington; Htee Khu, Naw; Brill, Ilene; Kilembe, William; Stephenson, Rob; Chomba, Elwyn; Vwalika, Cheswa; Tichacek, Amanda; Allen, Susan

2014-01-01

Objective To describe predictors of contraceptive method discontinuation and switching behaviors among HIV positive couples receiving couples' voluntary HIV counseling and testing services in Lusaka, Zambia. Design Couples were randomized in a factorial design to two family planning educational intervention videos, received comprehensive family planning services, and were assessed every 3-months for contraceptive initiation, discontinuation and switching. Methods We modeled factors associated with contraceptive method upgrading and downgrading via multivariate Andersen-Gill models. Results Most women continued the initial method selected after randomization. The highest rates of discontinuation/switching were observed for injectable contraceptive and intrauterine device users. Time to discontinuing the more effective contraceptive methods or downgrading to oral contraceptives or condoms was associated with the women's younger age, desire for more children within the next year, heavy menstrual bleeding, bleeding between periods, and cystitis/dysuria. Health concerns among women about contraceptive implants and male partners not wanting more children were associated with upgrading from oral contraceptives or condoms. HIV status of the woman or the couple was not predictive of switching or stopping. Conclusions We found complicated patterns of contraceptive use. The predictors of contraception switching indicate that interventions targeted to younger couples that address common contraception-related misconceptions could improve effective family planning utilization. We recommend these findings be used to increase the uptake and continuation of contraception, especially long acting reversible contraceptive (LARC) methods, and that fertility-goal based, LARC-focused family planning be offered as an integral part of HIV prevention services. PMID:24088689

Changes in state prescription contraceptive mandates for insurers: the effect on women's contraceptive use.

PubMed

Atkins, Danielle N; Bradford, W David

2014-03-01

Access to effective contraceptives is critical to reducing levels of unintended childbearing in the United States. Since 1998, more than half the states have passed legislation requiring insurers that cover prescription drugs to cover prescription contraceptives approved by the Food and Drug Administration. An assessment of the impact of these laws on women's contraceptive use is needed to determine whether such policies are effective. Information was collected on state contraceptive coverage policies, and contraceptive use data among women at risk of unintended pregnancy were drawn from Behavioral Risk Factor Surveillance System surveys conducted between 1998 and 2010. Logit regression analysis was used to calculate the marginal effects of state contraceptive coverage laws on insured and uninsured women's use of prescription methods. Insured women who lived in a state with a contraceptive coverage law were 5% more likely than their counterparts in states without such laws to use an effective method (i.e., a prescription method, condoms or sterilization). Among women who used such methods, those in contraceptive coverage states were 5% more likely than women in other states to use any prescription method, and 4% more likely to use the pill. No associations were found between contraceptive mandates and method use by uninsured women. Among both users and nonusers, contraceptive coverage was associated with a 5% increase in pill use. Contraceptive coverage mandates appear to play a role in increasing the use of prescription contraceptives among insured women, and hence may help to reduce the numbers of unintended pregnancies. Copyright © 2014 by the Guttmacher Institute.

Schools, Their Spatial Distribution and Characteristics, and Fertility Limitation*

PubMed Central

Brauner-Otto, Sarah R.

2012-01-01

This paper investigates the complex relationship between various dimensions of women’s educational context and their later life contraceptive use. Using data from rural Nepal on all the schools that ever existed in one community, I create geographically weighted measures of school characteristics—specifically teacher and student characteristics—that capture exposure to the complete array of schools and investigate the direct relationship between these dimensions of school characteristics and contraceptive use. These analyses provide new information on the broader issue of how social context influences the adoption of innovative behaviors by exploring the wide-reaching effects of school characteristics on individuals. Findings show that the gender of teachers and of other students, and the level of teacher education are all related to women’s use of contraception; that increased exposure to these school characteristics throughout the study area, but not necessarily at the closest school, is related to higher rates of contraceptive use; and that school characteristics early in the life course can have long-term consequences for individual behavior. PMID:23162168

Contraceptive use before first pregnancy by women in India (2005-2006): determinants and differentials.

PubMed

Pandey, Anjali; Singh, K K

2015-12-29

There exist ample of research literature investigating the various facet of contraceptive use behaviors in India but the use of contraception by married Indian women, prior to having their first pregnancy has been neglected so far. This study attempts to identify the socio demographic determinants and differentials of contraceptive use or non use by a woman in India, before she proceeds to have her first child. The analysis was done using data from the third National Family Health Survey (2005-2006), India. This study utilized information from 54,918 women who ever have been married and whose current age at the time of NFHS-3 survey was 15-34 years. To identify the crucial socio-demographic determinants governing this pioneering behavior, logistic regression technique has been used. Hosmer Lemeshow test and ROC curve analysis was also performed in order to check the fitting of logistic regression model to the data under consideration. Of all the considered explanatory variables religion, caste, education, current age, age at marriage, media exposure and zonal classifications were found to be significantly affecting the study behavior. Place of residence i.e. urban--rural locality came to be insignificant in multivariable logistic regression. In the light of sufficient evidences confirming the presence of early marriages and child bearing practices in India, conjunct efforts are required to address the socio demographic differentials in contraceptive use by the young married women prior to their first pregnancy. Encouraging women to opt for higher education, ensuring marriages only after legal minimum age at marriage and promoting the family planning programs via print and electronic media may address the existing socio economic barriers. Also, the family planning programs should be oriented to take care of the geographical variations in the study behavior.

Selected aspects of adolescent postpartum behavior.

PubMed

Smith, P B; Mumford, D M; Goldfarb, J L; Kaufman, R H

1975-04-01

Contraceptive, educational, and vocational behavior patterns of postpartum adolescents were examined. Eight months after delivery 269 teenage girls who participated in a comprehensive antepartum psycho-social program were mailed follow-up questionnaires. Eighty-three percent of teenage mothers who responded reported using birth control pills as a form of contraception. We found that single girls were more actively involved in vocational and educational training. This and other observations indicate that marital status of teenage participants is important to their postpartum actions.

Factors Associated with Interest in Same-Day Contraception Initiation Among Females in the Pediatric Emergency Department

PubMed Central

Miller, Melissa K.; Randell, Kimberly A.; Barral, Romina; Sherman, Ashley K.; Miller, Elizabeth

2015-01-01

Purpose The purpose was to describe interest in hormonal contraception initiation among female adolescent in the emergency department and to assess for associations with factors known to increase pregnancy risk such as violence victimization. Methods We used a computerized survey to assess sexual and dating practices, pregnancy history/likelihood, contraception use (including long acting reversible contraception [LARC]) and concerns, contraception initiation interest, violence victimization, medical utilization, and demographics among sexually-experienced females aged 14–19 years in our ED. The primary outcome was interest in contraception initiation. We compared responses between subgroups using the Chi-square test. Results 168 adolescents participated (82% of approached; mean age 16.6 years; 41% White, 48% Black; 21% commercial insurance). Interest in contraception initiation was high: 60% overall and 70% among those not using hormonal contraception (n=96). Among those using non-LARC contraception (n=59), 29% were interested in LARC initiation. Contraception/LARC interest was positively associated with lack of recent well care (p < .06), and concerns about cost (p < .01), privacy (p=0.03), and where to obtain contraception (p<0.01). Nearly all planned on avoiding pregnancy, though many (23%) used no contraception at last intercourse. One-third (36%) reported violence victimization. Most (70%) reported ≥1 concern about contraception (most commonly cost). Conclusions Many reported behaviors and exposures, including violence victimization, that increase their risk for pregnancy and most expressed interest in same day initiation of hormonal contraception, including LARC. These findings may inform novel strategies for increased adolescent access to contraception and pregnancy prevention through use of non-traditional sites such as EDs. PMID:26802990

Factors Associated With Interest in Same-Day Contraception Initiation Among Females in the Pediatric Emergency Department.

PubMed

Miller, Melissa K; Randell, Kimberly A; Barral, Romina; Sherman, Ashley K; Miller, Elizabeth

2016-02-01

The purposes were to describe interest in hormonal contraception initiation among female adolescent in the emergency department (ED) and to assess for associations with factors known to increase pregnancy risk such as violence victimization. We used a computerized survey to assess sexual and dating practices, pregnancy history/likelihood, contraception use (including long-acting reversible contraception [LARC]) and concerns, contraception initiation interest, violence victimization, medical utilization, and demographics among sexually experienced females aged 14-19 years in our ED. The primary outcome was interest in contraception initiation. We compared responses between subgroups using the chi-square test. A total of 168 adolescents participated (82% of approached; mean age 16.6 years; 41% white; 48% black; 21% commercial insurance). Interest in contraception initiation was high: 60% overall and 70% among those not using hormonal contraception (n = 96). Among those using non-LARC contraception (n = 59), 29% were interested in LARC initiation. Contraception/LARC interest was positively associated with lack of recent well care (p < .06) and concerns about cost (p < .01), privacy (p = .03), and where to obtain contraception (p < .01). Nearly all planned on avoiding pregnancy, although many (23%) used no contraception at last intercourse. One third (36%) reported violence victimization. Most (70%) reported ≥1 concern about contraception (most commonly cost). Many reported behaviors and exposures, including violence victimization, that increase their risk for pregnancy and most expressed interest in same-day initiation of hormonal contraception, including LARC. These findings may inform novel strategies for increased adolescent access to contraception and pregnancy prevention through use of nontraditional sites such as EDs. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Black-White Differences in Sex and Contraceptive Use Among Young Women.

PubMed

Kusunoki, Yasamin; Barber, Jennifer S; Ela, Elizabeth J; Bucek, Amelia

2016-10-01

This study examines black-white and other sociodemographic differences in young women's sexual and contraceptive behaviors, using new longitudinal data from a weekly journal-based study of 1,003 18- to 19-year-old women spanning 2.5 years. We investigate hypotheses about dynamic processes in these behaviors during early adulthood in order to shed light on persisting racial differences in rates of unintended pregnancies in the United States. We find that net of other sociodemographic characteristics and adolescent experiences with sex and pregnancy, black women spent less time in relationships and had sex less frequently in their relationships than white women, but did not differ in the number of relationships they formed or in their frequency or consistency of contraceptive use within relationships. Black women were more likely to use less effective methods for pregnancy prevention (e.g., condoms) than white women, who tended to use more effective methods (e.g., oral contraceptives). And although the most effective method for pregnancy prevention-long-acting reversible contraception (LARC)-was used more often by black women than white women, LARC use was low in both groups. In addition, black women did not differ from white women in their number of discontinuations or different methods used and had fewer contraceptive method switches. Further, we find that net of race and adolescent experiences with sex and pregnancy, women from more-disadvantaged backgrounds had fewer and longer (and thus potentially more serious) relationships, used contraception less frequently (but not less consistently), and used less effective methods (condoms) than women from more-advantaged backgrounds.

Black-White Differences in Sex and Contraceptive Use Among Young Women

PubMed Central

Kusunoki, Yasamin; Barber, Jennifer S.; Ela, Elizabeth J.; Bucek, Amelia

2016-01-01

This study examines black-white and other sociodemographic differences in young women’s sexual and contraceptive behaviors, using new longitudinal data from a weekly journal-based study of 1,003 18- to 19-year-old women spanning 2.5 years. We investigate hypotheses about dynamic processes in these behaviors during early adulthood in order to shed light on persisting racial differences in rates of unintended pregnancies in the United States. We find that net of other sociodemographic characteristics and adolescent experiences with sex and pregnancy, black women spent less time in relationships and had sex less frequently in their relationships than white women, but did not differ in the number of relationships they formed or in their frequency or consistency of contraceptive use within relationships. Black women were more likely to use less effective methods for pregnancy prevention (e.g., condoms) than white women, who tended to use more effective methods (e.g., oral contraceptives). And although the most effective method for pregnancy prevention—long-acting reversible contraception (LARC)—was used more often by black women than white women, LARC use was low in both groups. In addition, black women did not differ from white women in their number of discontinuations or different methods used and had fewer contraceptive method switches. Further, we find that net of race and adolescent experiences with sex and pregnancy, women from more-disadvantaged backgrounds had fewer and longer (and thus potentially more serious) relationships, used contraception less frequently (but not less consistently), and used less effective methods (condoms) than women from more-advantaged backgrounds. PMID:27624320

[The relationships among self-identity, self-esteem and attitude towards sexual behavior in university students].

PubMed

Kuno, Takako; Tachi, Etsuko; Ogasawara, Akihiko; Shimokata, Hiroshi; Yamaguchi, Yoko

2002-10-01

It has been reported that the young people of today tend to engage in sexual behavior at an early age and the abortion rate is high. The purpose of this study was to investigate the attitudes of post-adolescents with regard to sexual behaviors and the relationship to self-identity and self-esteem. The subjects were 234 males (mean +/- SD 20.2 +/- 1.1 years) and 460 females (mean +/- SD 19.5 +/- 1.1 years) 4-year university students aged 18 to 23 years in Aichi Prefecture. An anonymous, self-report questionnaire was used to survey the subjects with regard to self-identity ("Establishment of Self" scale), self-esteem (Rosenberg Self-Esteem Scale), and sexual attitude and behavior. The scores on both scales and subscales of the "Establishment of Self" scale, "Foundation of Identity (Foundation)" and "Establishment of Identity (Establishment)", were calculated and intercompared, along with sexual attitude and behavior, controlled for age and school type. The mean total score of the "Establishment of Self" scale for males was 55.3 (SD9.2) and for females 52.2 (SD9.3), while those for the Rosenberg Self-Esteem Scale were 27.2 (SD5.5) and 25.7 (SD5.2), respectively. There was significant positive correlation all scales in both sexes. Both male and female students had positive attitude towards sex and a negative view of "traditional gender roles" particularly females. Of the subjects, 82.4% of males and 69.5% of females were thinking of accepting a request for sexual intercourse from their partners. Many students understood the "need for contraception", that is a component of contraceptive behavior. Most of them, however, didn't acquire the other components. A total of 68.3% of males and 48.2% of females had experienced sexual intercourse during the last year. Of these, 50.6% of males and 58.2% of females consistently used contraception. The score on the "Establishment of Self" scale was higher among both the male and female students who responded positively to having "communication ability," "learning ability," and "acquisition ability." Significant differences were found in total and "Establishment" scales among males, and all scales among females. The score on the Rosenberg Self-Esteem Scale was significantly higher with "learning ability" among males, and with "communication ability" and "learning ability" among females. However, no significant relationship was found between actual contraceptive behavior and any of the scales. In dealing with contraception, a gap exists between university students' attitudes and actual behavior. The scores on the "Establishment of Self" scale and the Rosenberg Self-Esteem Scale were found to be significantly higher for those who exhibited higher values for components of contraceptive behavior.

Brief report: Risky sexual behavior of adolescents in Belgrade: association with socioeconomic status and family structure.

PubMed

Vukovic, Dejana S; Bjegovic, Vesna M

2007-10-01

The aim of this study was to investigate the association between socioeconomic status and family structure with risky sexual behaviors in adolescents. A total of 1782 15-year-old Belgrade schoolchildren (47.5% boys and 52.5% girls) completed a questionnaire from the WHO study, "Health behavior of schoolchildren". Adolescents with a higher weekly disposable income, those who perceived their family as wealthy, and those with difficulties in communication with their mothers were more likely to have had been sexually active (odds ratios (OR)=2.497, 1.876, and 1.253, respectively). Adolescents with a higher weekly disposable income were more likely to use contraception (OR=0.233), but those who perceived their families as better-off and those living with only one parent were more likely not to use contraception (OR=4.794, 22.295 [living with father], and 6.169 [living with mother], respectively). The perceived family wealth was significantly associated with having sexual intercourse and having sexual intercourse without using contraception. Family structure had a limited independent association with sexual behavior.

The parent-adolescent relationship education (PARE) program: a curriculum for prevention of STDs and pregnancy in middle school youth.

PubMed

Lederman, Regina P; Mian, Tahir S

2003-01-01

The Parent-Adolescent Relationship Education (PARE) Program, designed for parents and middle school students, focuses on strengthening family communication about sexual issues and behaviors to help prevent teen pregnancy, human immunodeficiency virus (HIV), and other sexually transmitted diseases (STDs). The program includes content about reproduction, STDs and Acquired Immune Deficiency Syndrome (AIDS), contraception, sex risks, and safe-sex behaviors. The course uses social learning and cognitive behavioral concepts to enhance decision-making, refusal, and resistance skills. A randomized treatment or control group design is used to assign parent-child dyads to an experimental education group (social learning) or an attention-control group (traditional didactic teaching). Three post-program maintenance or booster sessions are held at 6-month intervals and at times prior to peak teen conception periods to reinforce the knowledge and skills learned. Pre- and posttests for parents and students assess group differences in parental involvement and communication, contraception, sex attitudes and intentions, sex behaviors (initiation of sexual intercourse, frequency, number of partners, contraceptive practices, refusal skills), and the incidence of pregnancy.

Injectable contraception. New and existing options.

PubMed

Kaunitz, A M

2000-12-01

DMPA and MPA/E2C contraception offer women safe, effective, convenient, and reversible birth control choices. The use of DMPA, a 3-month injectable, is characteristically associated with amenorrhea. Lactating women and women in whom contraceptive doses of estrogen are contraindicated can use this progestin-only birth control method. Return of fertility can be delayed in women discontinuing DMPA to become pregnant. In some cases, the use of DMPA also confers important noncontraceptive and therapeutic benefits. A monthly estrogen/progestin injectable contraceptive, MPA/E2C should appeal to women who are concerned about daily pill taking, who prefer regular cycles to amenorrhea, and who find monthly injections acceptable and accessible. As is true for oral contraceptives, MPA/E2C represents an appropriate choice for women who prefer a rapidly reversible contraceptive. Currently, the proposed contraindications for MPA/E2C parallel those for combined oral contraceptives. As MPA/E2C contraception becomes available for American women, clinicians will learn how to best include this new method among the array of contraceptive choices. By individualizing contraceptive selection, counseling, and management approaches based on the relevant behavioral and medical considerations reviewed herein, clinicians can maximize their patients' success with injectable contraceptives. The more innovative that clinicians, family planning agencies, and insurers are in facilitating access to care (including reinjections), the more women will be able to avail themselves of safe, effective, and reversible methods of contraception. In addition to the physician's office or health clinic, other sites at which women might receive contraceptive injections include employee health clinics, college health clinics, or perhaps the pharmacy where the prescription is filled. Self-administration may become an appropriate option for some users of injectable contraception.

Religious Correlates of Male Sexual Behavior and Contraceptive Use.

ERIC Educational Resources Information Center

Young, Michael

1985-01-01

This study sought to determine whether religious beliefs could distinguish between older adolescent males of differing sexual experience and to determine whether such beliefs could distinguish between older adolescent males differing in frequency of contraceptive use. Results are discussed and implications for health educators are set forth. (MT)

Sexual and contraceptive behavior among female university students in Sweden - repeated surveys over a 25-year period.

PubMed

Stenhammar, Christina; Ehrsson, Ylva Tiblom; Åkerud, Helena; Larsson, Margareta; Tydén, Tanja

2015-03-01

To study female students' sexual and contraceptive behavior and compare these results with earlier surveys. Comparative, repeated cross-sectional surveys, started in 1989 and repeated every fifth year. Contraceptive counseling delivered at a Student Health Center in Sweden. Female university students (n = 359). Multiple-choice waiting-room questionnaire. Sexual and contraceptive behavior. In 1989, age at first intercourse was 17.6 years vs. 16.7 years in 2014, number of lifetime sexual partners was 4.0 vs. 12.1 in 2014, and number of sexual partners during the previous 12 months was 1.0 vs. 2.8 in 2014. Condom use during first intercourse with the latest partner decreased from 49% to 41% (n = 172 in 2009 vs. n = 148 in 2014: p < 0.001), and experience of anal sex increased from 39% to 46% (n = 136 in 2009 vs. n = 165 in 2014: p = 0.038), and 25% (n = 41 in 2014) always used a condom during anal sex. A total of 70% (n = 251) made use of pornography, and 48% (n = 121) considered their sexual behavior affected by pornography. Eighty-nine percent (n = 291) wanted two to three children and 9% (n = 33) had thought about freezing eggs for the future. The female students' knowledge about increasing age being correlated with decreased fertility varied. Sexual behavior among female university students has gradually changed during the last 25 years and behavior appears more risky today. As this may have consequences on future reproductive health, it is vital to inform women about consistent and correct condom use and about the limitations of the fertile window. © 2015 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).

Findings from the use of a narrative story and leaflet to influence shifts along the behavior change continuum toward postpartum contraceptive uptake in Sylhet District, Bangladesh.

PubMed

Cooper, Chelsea M; Ahmed, Salahuddin; Winch, Peter J; Pfitzer, Anne; McKaig, Catharine; Baqui, Abdullah H

2014-12-01

Postpartum women face uncertainty about timing of return to fecundity. Many women wait to use contraception until menses return, resulting in unintended pregnancies. This study explored the use of behavior change communication to address perceptions of postpartum return to fecundity and contraceptive adoption. This study, which took place in Sylhet District in Bangladesh, explored knowledge and perceptions about postpartum return to fecundity and used the Steps to Behavior Change framework to assess the reported influence of a leaflet and fictional story ("Asma's Story") incorporated within community health activities. The study relied on in- depth interviews and focus group discussions. The study revealed nearly universal exposure to Asma's Story. Reported shifts in perceived susceptibility to pregnancy, benefits of pregnancy spacing, and increased social support for postpartum family planning (PPFP) were noted. However, only approximately one third of women were using a modern contraceptive method. Using a fictional story offers a promising approach for motivating shifts along the continuum. It is recommended that Asma's Story be incorporated within future efforts to scale up PPFP in Bangladesh, and that similar approaches be tailored and tested in other countries. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

State variations in women's socioeconomic status and use of modern contraceptives in Nigeria.

PubMed

Lamidi, Esther O

2015-01-01

According to the 2014 World Population Data Sheet, Nigeria has one of the highest fertility and lowest contraceptive prevalence rates around the world. However, research suggests that national contraceptive prevalence rate overshadows enormous spatial variations in reproductive behavior in the country. I examined the variations in women's socioeconomic status and modern contraceptive use across states in Nigeria. Using the 2013 Nigeria Demographic and Health Survey data (n = 18,910), I estimated the odds of modern contraceptive use among sexually active married and cohabiting women in a series of multilevel logistic regression models. The share of sexually active, married and cohabiting women using modern contraceptives widely varied, from less than one percent in Kano, Yobe, and Jigawa states, to 40 percent in Osun state. Most of the states with low contraceptive prevalence rates also ranked low on women's socioeconomic attributes. Results of multilevel logistic regression analyses showed that women residing in states with greater shares of women with secondary or higher education, higher female labor force participation rates, and more women with health care decision-making power, had significantly higher odds of using modern contraceptives. Differences in women's participation in health care decisions across states remained significantly associated with modern contraceptive use, net of individual-level socioeconomic status and other covariates of modern contraceptive use. Understanding of state variations in contraceptive use is crucial to the design and implementation of family planning programs. The findings reinforce the need for state-specific family planning programs in Nigeria.

Access to Emergency Contraception and its Impact on Fertility and Sexual Behavior.

PubMed

Mulligan, Karen

2016-04-01

Half of all pregnancies in the USA are unintended, suggesting a high incidence of either improper or nonuse of contraceptives. Emergency birth control (EBC) provides individuals with additional insurance against unplanned pregnancy in the presence of contraception failure. This study is the first to estimate the impact of switching EBC from prescription to nonprescription status in the USA on abortions and risky sexual behavior as measured by STD rates. Utilizing state-level variation in access to EBC, we find that providing individuals with over-the-counter access to EBC leads to increase STD rates and has no effect on abortion rates. Moreover, individual-level analysis using the National Longitudinal Survey of Youth indicates that risky sexual behavior such as engaging in unprotected sex and number of sexual encounters increases as a result of over-the-counter access to EBC, which is consistent with the state-level STD findings. Copyright © 2015 John Wiley & Sons, Ltd.

Pharmacy staff perceptions and self-reported behaviors related to providing contraceptive information and counseling.

PubMed

Batra, Peter; Aquilino, Mary L; Farris, Karen B

2015-01-01

To evaluate pharmacy staff perspectives of a 2-year pharmacy intervention aimed at reducing unintended pregnancy in 18- to 30-year-old women. Pharmacy staff completed a 48-item, self-administered paper survey consisting of scaled and open-ended questions. 55 community pharmacies in 12 Iowa counties. All pharmacy staff participated, including pharmacists, pharmacy technicians, and other pharmacy employees. Online continuing education (CE) training was made available to all pharmacy staff. Promotional materials including posters, brochures, and shelf talkers were displayed in all of the pharmacies. Pharmacy staff perceptions and self-reported behaviors related to displaying posters, brochures, and shelf talkers in their pharmacies and providing contraceptive information and counseling to patients/customers. A total of 192 (43% return rate) pharmacy staff responded. Only 44% of respondents consistently provided contraceptive information and counseling, yet more than 90% felt that talking with patients/customers about contraceptives was easy, and more than 50% could do so privately. The study showed increased pharmacy staff desire to make this topic a priority. Community pharmacy staff can play a key role in educating and counseling young adult women about contraceptive health and pregnancy planning. This study indicates that staff are comfortable providing this service and that patients/customers are open to receiving guidance from pharmacists. However, pharmacy staff are missing additional opportunities to provide information and counseling. There is also a need for greater attention to provision of nonprescription contraceptive education.

Sexual initiation, contraceptive use, and pregnancy among young adolescents.

PubMed

Finer, Lawrence B; Philbin, Jesse M

2013-05-01

To present new data on sexual initiation, contraceptive use, and pregnancy among US adolescents aged 10 to 19, and to compare the youngest adolescents' behaviors with those of older adolescents. Using nationally representative data from several rounds of the National Survey of Family Growth, we performed event history (ie, survival) analyses to examine timing of sexual initiation and contraceptive use. We calculated adolescent pregnancy rates by single year of age using data from the National Center for Health Statistics, the Guttmacher Institute, and the US Census Bureau. Sexual activity is and has long been rare among those 12 and younger; most is nonconsensual. By contrast, most older teens (aged 17-19) are sexually active. Approximately 30% of those aged 15 to 16 have had sex. Pregnancy rates among the youngest teens are exceedingly low, for example, ∼1 per 10 000 girls aged 12. Contraceptive uptake among girls as young as 15 is similar to that of their older counterparts, whereas girls who start having sex at 14 or younger are less likely to have used a method at first sex and take longer to begin using contraception. Sexual activity and pregnancy are rare among the youngest adolescents, whose behavior represents a different public health concern than the broader issue of pregnancies to older teens. Health professionals can improve outcomes for teenagers by recognizing the higher likelihood of nonconsensual sex among younger teens and by teaching and making contraceptive methods available to teen patients before they become sexually active.

[Factor analysis of sexual behavior in migratory adolescent and choice of contraceptive measures].

PubMed

Guo, Li-na; Yu, Xiao-ming; Gao, Su-hong

2012-06-18

To comprehend the young migrants' sexual behavior and contraceptive status, and to provide the scientific basis for the health education regarding sex and reproduction for the young migrants in cities. An anonymous self-designed structured questionnaire was used to survey 4 389 young migrants in Beijing, Guangzhou and Ji'nan. In the study, 33.4%(1 453/4 354) of the migrant adolescents reported had sexual activity, with the unmarried sex rate of 27.5%(1 066/3 880), and the males accounting for 37.8%(579/1 533) and the females 20.7%(487/2 347); contraception was 44.8%(642/1 432); condoms were the preferred contraceptive measures for floating adolescents; but 31.1%(322/1 034) of the unmarried persons reported experienced pregnancy, and 29.7%(307/1 034) of the unmarried people reported had a history of abortion. Education backgrounds (OR=1.555), marital status (OR=0.432), sex partner number (OR=0.683), knowledge of venereal disease prevention (OR=1.758) were the influence factors. Higher sexual and lower birth control utilization rates have triggered young migrants' reproductive health problems. We should promote the floating people' s reproductive health education and make better choices for effective contraceptive measures.

Young women's contraceptive microbicide preferences: associations with contraceptive behavior and sexual relationship characteristics.

PubMed

Best, Candace; Tanner, Amanda E; Hensel, Devon J; Fortenberry, J Dennis; Zimet, Gregory D

2014-03-01

In time, microbicides may provide women with dual prevention against pregnancy and STDs. Although several microbicide dimensions have been evaluated, little is known about women's preferences for contraceptive microbicides and correlates of these preferences. Acceptability of a hypothetical contraceptive microbicide cream or jelly was examined among a -clinic-based sample of 266 women in Indianapolis from 2004 (when participants were aged 14-22) to 2008. Group conjoint analyses and individual conjoint analyses were used to compare preferences with respect to four microbicide -dimensions: contraceptive ability, efficacy in relation to condoms, timing of use and texture. Pearson's product moment correlations were used to examine the relationship between preferences for a contraceptive microbicide and selected characteristics of the women. Overall, the top-rated microbicide dimensions were efficacy in relation to that of condoms and contraceptive ability (importance scores, 40.0 and 35.4 out of 100.0, respectively). When all dimension levels were compared, contraceptive ability was the most strongly preferred (part-worth utility score, 8.9), and lower efficacy than that of -condoms was the least strongly preferred (-11.9). Preference for contraceptive microbicides was positively -associated with current contraceptive use, sexual agency, partner communication, commitment to avoiding pregnancy and -perceived partner agreement about avoiding pregnancy (coefficients, 0.07-0.18). It was negatively associated with current or past nonuse of contraceptives, seeking pregnancy and perceived partner agreement about seeking -pregnancy (-0.08 to -0.14). Microbicides with dual prevention properties may be attractive to young women. Microbicide development and subsequent clinical trials should incorporate contraceptive microbicides. Copyright © 2013 by the Guttmacher Institute.

HIV/AIDS and contraceptive use: factors associated with contraceptive use among sexually active HIV-positive women in Kenya.

PubMed

Magadi, Monica A; Magadi, Winnie A

2017-03-01

With increased availability of antiretroviral therapy and improved survival for people living with HIV, more HIV-positive women are leading full reproductive lives. However, HIV-positive women have special contraceptive needs/concerns. This paper examines the individual and community-level HIV/AIDS factors associated with contraceptive use and compares predictors of contraceptive uptake between HIV-positive and HIV-negative women in Kenya. The study is based on secondary analysis of cross-sectional data of a sample of 9132 sexually active women of reproductive age from the Kenya Demographic and Health Surveys collected in 2003 and 2008. Multilevel logistic regression models are used to examine individual and contextual community-level factors associated with current contraceptive use. The study provides evidence of lower contraceptive uptake among women living in high HIV-prevalence communities. It further reveals striking differences in factors associated with contraceptive uptake between HIV-positive and HIV-negative women. Education and the desire to stop childbearing are strongly associated with contraceptive uptake among uninfected women, but both factors are not significant among HIV-positive women for whom wealth is the most important factor. While HIV-negative women in the richest wealth quintile are about twice as likely to use contraceptives as their counterparts of similar characteristics in the poorest quintile, this gap is about sevenfold among HIV-positive women. These findings suggest that having the desire and relevant knowledge to use contraceptives does not necessarily translate into expected contraceptive behavior for HIV-positive women in Kenya and that poor HIV-positive women may be particularly in need of increased access to contraceptive services. • Study provides evidence of lower contraceptive uptake among women living in high HIV-prevalence communities in Kenya. • Results reveal striking differences in factors associated with contraceptive use between HIV-positive and HIV-negative women. • Poverty may be an impediment to contraceptive uptake among HIV-positive women in Kenya. Copyright © 2016 Elsevier Inc. All rights reserved.

Peer-driven contraceptive choices and preferences for contraceptive methods among students of tertiary educational institutions in Enugu, Nigeria.

PubMed

Iyoke, Ca; Ezugwu, Fo; Lawani, Ol; Ugwu, Go; Ajah, Lo; Mba, Sg

2014-01-01

To describe the methods preferred for contraception, evaluate preferences and adherence to modern contraceptive methods, and determine the factors associated with contraceptive choices among tertiary students in South East Nigeria. A questionnaire-based cross-sectional study of sexual habits, knowledge of contraceptive methods, and patterns of contraceptive choices among a pooled sample of unmarried students from the three largest tertiary educational institutions in Enugu city, Nigeria was done. Statistical analysis involved descriptive and inferential statistics at the 95% level of confidence. A total of 313 unmarried students were studied (194 males; 119 females). Their mean age was 22.5±5.1 years. Over 98% of males and 85% of females made their contraceptive choices based on information from peers. Preferences for contraceptive methods among female students were 49.2% for traditional methods of contraception, 28% for modern methods, 10% for nonpharmacological agents, and 8% for off-label drugs. Adherence to modern contraceptives among female students was 35%. Among male students, the preference for the male condom was 45.2% and the adherence to condom use was 21.7%. Multivariate analysis showed that receiving information from health personnel/media/workshops (odds ratio 9.54, 95% confidence interval 3.5-26.3), health science-related course of study (odds ratio 3.5, 95% confidence interval 1.3-9.6), and previous sexual exposure prior to university admission (odds ratio 3.48, 95% confidence interval 1.5-8.0) all increased the likelihood of adherence to modern contraceptive methods. An overwhelming reliance on peers for contraceptive information in the context of poor knowledge of modern methods of contraception among young people could have contributed to the low preferences and adherence to modern contraceptive methods among students in tertiary educational institutions. Programs to reduce risky sexual behavior among these students may need to focus on increasing the content and adequacy of contraceptive information held by people through regular health worker-led, on-campus workshops.

Characteristics of Females Who Use Contraception at Coitarche: An Analysis of the National Survey of Family Growth 2006-2010 Database.

PubMed

Lee, Jinhyung; Berenson, Abbey B; Patel, Pooja R

2015-12-01

To determine demographical and behavioral characteristics associated with contraceptive use at coitarche, or first sexual experience, to determine which populations are at greatest risk of contraceptive nonuse during early sexual experiences. Cross-sectional study. We used the National Survey of Family Growth 2006-2010 database to abstract pertinent variables, including race, highest education, annual family income, parental living situation, importance of religion, age at coitarche, number of sexual partners, type of first contraception, and source of first contraception. Generalized linear models with logit link and binomial distribution were applied to examine the association between use of contraceptive methods at coitarche and the variables abstracted. Of the 5931 female participants included in the study, 1071 (18%) did not use contraceptive methods at coitarche. Only 199 (2%) of the female participants included in this study used the more reliable hormonal contraceptive methods at coitarche. Black females were significantly more likely than white females to use contraceptive methods at coitarche (p < 0.01). Females who initiated coitarche from 16 to 20 years of age were significantly more likely to use contraception at coitarche than females who had their first sexual experience at less than 16 years of age (p < 0.001). Females with greater educational background and greater family income were also significantly more likely to use contraception at coitarche (p < 0.001). Finally, females who obtained their first contraceptive methods from a spouse, partner, or friend were more likely to use contraception at coitarche than females who obtained their first method from a medical facility (p < 0.001). This study highlights several key differences between females who use contraceptive methods at coitarche versus those who do not. Greater effort needs to be focused on increasing access to more reliable contraceptive methods for young females, as females who obtain methods from nonmedical facilities are more likely to use contraceptive methods at coitarche.

Partner communication, discordant fertility goals, and contraceptive use in urban Kenya

PubMed Central

Tumlinson, Katherine; Speizer, Ilene S.; Davis, Joshua T.; Fotso, Jean Christophe; Kuria, Paul; Archer, Linda

2013-01-01

This study assesses the degree of partner communication and perceived partner concordance and their association with contraceptive use among 2,891 women and 1,362 men in urban Kenya. Twenty-three percent of men and 30% of women report never discussing FP with their partner. Approximately 70% of participants perceive their partner to have concordant fertility desires. Multivariate analyses revealed that both male (AOR = 7.7 [95% CI = 5.5–10.7]) and female (AOR = 2.8 [95% CI = 2.3–3.3]) participants were more likely to use contraception if they report discussing FP with their partner. Participants who perceive that their partner wants fewer children also were more likely to use contraception (AOR, females = 1.8 [95% CI = 1.2–2.8]), (AOR, males = 1.9 [95% CI = 1.2–3.1]). Discussion of FP is a key determinant of contraceptive use; in couples with discordant fertility goals, pro-natalist males do not always dictate contraceptive behavior in urban Kenya. PMID:24069770

An Intervention Delivered by App Instant Messaging to Increase Acceptability and Use of Effective Contraception Among Young Women in Bolivia: Protocol of a Randomized Controlled Trial.

PubMed

McCarthy, Ona L; Osorio Calderon, Veronica; Makleff, Shelly; Huaynoca, Silvia; Leurent, Baptiste; Edwards, Phil; Lopez Gallardo, Jhonny; Free, Caroline

2017-12-18

Unintended pregnancy is associated with numerous poorer health outcomes for both women and their children. Fulfilling unmet need for contraception is essential in avoiding unintended pregnancies, yet millions of women in low- and middle-income countries continue to face obstacles in realizing their fertility desires. In Bolivia, family planning progress has improved in recent decades but lags behind other countries in the region. Unmet need for contraception among women aged 15 to 19 years is estimated to be 38%, with the adolescent fertility rate at 70 per 1000 women. Mobile phones are an established and popular mode in which to deliver health behavior support. The London School of Hygiene & Tropical Medicine and the Centro de Investigación, Educación y Servicios in Bolivia have partnered to develop and evaluate a contraceptive behavioral intervention for Bolivian young women delivered by mobile phone. The intervention was developed guided by behavioral science and consists of short instant messages sent through an app over 4 months. The objective of this study is to evaluate the effect of the intervention on young women's use of and attitudes toward the most effective contraceptive methods. We will allocate 1310 women aged 16 to 24 years with an unmet need for contraception in a 1:1 ratio to receive the intervention messages or the control messages about trial participation. The messages are sent through the Tú decides app, which contains standard family planning information. Coprimary outcomes are use and acceptability of at least one effective contraceptive method, both measured at 4 months. Recruitment commenced on March 1, 2017 and was completed on July 29, 2017. We estimate that the follow-up period will end in January 2018. This trial will evaluate the effect of the intervention on young women's use of and attitudes toward the (nonpermanent) effective contraception methods available in Bolivia. ClinicalTrials.gov NCT02905526; https://clinicaltrials.gov/ct2/show/NCT02905526 (Archived by WebCite at http://www.webcitation.org/6vT0yIFfN). ©Ona L McCarthy, Veronica Osorio Calderon, Shelly Makleff, Silvia Huaynoca, Baptiste Leurent, Phil Edwards, Jhonny Lopez Gallardo, Caroline Free. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 18.12.2017.

Contraception determinants in youths of Sierra Leone are largely behavioral.

PubMed

Labat, Aline; Medina, Marta; Elhassein, Mohammed; Karim, Afrina; Jalloh, Mohammad B; Dramaix, Michèle; Zhang, Wei-Hong; Alexander, Sophie; Dickson, Kim E

2018-04-19

Sexual initiation occurs early in Sierra Leone. This study aims to analyze the determinants of condom and/or contraceptive use among a representative sample of young persons (10 to 24 years) in Sierra Leone. This is a secondary analysis of data from a study conducted to monitor the implementation of a UNFPA package of interventions directed to improve SRH in young people of Sierra Leone. This assessment was conducted in 2016 at the end of the Ebola outbreak. In consequence, determinants linked to healthy lifestyle behaviors and UNFPA interventions were explored in addition to the usual determinants: socio demographic and sexual lifestyle. This study is a household quantitative survey with open ended questions used to illustrate and complete the analysis. A total of 1409 young people were interviewed: of these, 216 boys and 381 girls were sexually active. Those who were pregnant or wished for pregnancy were excluded, leaving 194 boys and 268 girls for the analysis of determinants. The proportion of young people using neither condom nor other contraception at their last sexual intercourse in the whole sample was 40.5% and there was no statistically significant difference between boys and girls (42.3 vs 39.2; P = 0.504). Determinants were assessed and, after multivariable analysis, results differed between boys and girls and showed the importance of behavioral aspects. Four determinants were common to boys and girls: literacy, distance, negotiation capacity and hand washing. However, the distance factor for girls was to the health facility and for boys it was to school. Three more determinants remained in the boy's model: sleeping under a bednet, number of sexual partners and knowledge of contraceptive methods. Opinions about condoms and contraception revealed important barriers; opposition to contraceptive use was the main reason for non-use for both boys and girls, while lack of access was an important reason for boys. There is a need to reach out to the 40% of young people who are sexually active and neither pregnant nor with pregnancy desire, and are not using condom or contraception.

Postpartum contraceptive use in Gondar town, Northwest Ethiopia: a community based cross-sectional study.

PubMed

Abera, Yeshewas; Mengesha, Zelalem Birhanu; Tessema, Gizachew Assefa

2015-01-01

Addressing family planning in the postpartum period is crucial for better maternal, neonatal and child survival because it enables women to achieve healthy interval between births. The contraceptive behavior of women in the postpartum period is usually different from other times in a woman's life cycle due to the additional roles and presence of emotional changes. Therefore, this study is conducted with the aim of assessing the contraceptive behavior of women in the postpartum period. A community-based cross-sectional study was conducted in August 2013 among women who gave birth one year before the study period in Gondar town, Northwest Ethiopia. Multistage cluster sampling technique was employed to recruit a total of 703 study participants. For data collection, a structured and pretested questionnaire was used. Descriptive statistics were done to characterize the study population using different variables. Bivariate and multiple logistic regression models were fitted. Odds ratios with 95% confidence intervals were computed to identify factors associated with contraceptive use. Nearly half (48.4%) of the postpartum women were using different types of contraceptives. The most commonly used method was injectable (68.5%). Resumption of mensus [Adjusted Odds Ratio (AOR) = 8.32 95% Confidence Interval (CI): (5.27, 13.14)], age ≤24 years [AOR = 2.36, 95% CI: (1.19, 4.69), duration of 7-9 months after delivery [AOR = 2.26 95% CI: (1.12, 4.54)], and having antenatal care [AOR = 5.76, 95% CI: (2.18, 15.2)] were the factors positively associated with contraceptive use in the extended postpartum period. Postpartum contraceptive practice was lower as compared to the Ethiopian demographic and health survey 2011 report for urban areas. Strengthening family planning counseling during antenatal care visit and postnatal care would improve contraceptive use in the postpartum period.

Sexual behavior among university students in Nigera.

PubMed

Soyinka, F

1979-01-01

Sexual behavior patterns among Nigerian university students and factors influencing them were studied. While permarital cohabitation is common, a large percentage (48%) had their first coital experience between the ages of 22 and 27. Religion does not appear to have a strong inhibiting influence on premarital sex, although it does affect the frequency of changing partners. Contraceptives, although known to almost all the respondents, are not widely used. The use of contraceptives had little influence on premarital cohabitation. Oral-genital, male-male, and female-female sexual practices are very uncommon.

Men's attitudes on gender equality and their contraceptive use in Uttar Pradesh India.

PubMed

Mishra, Anurag; Nanda, Priya; Speizer, Ilene S; Calhoun, Lisa M; Zimmerman, Allison; Bhardwaj, Rochak

2014-06-04

Men play crucial role in contraceptive decision-making, particularly in highly gender-stratified populations. Past research examined men's attitudes toward fertility and contraception and the association with actual contraceptive practices. More research is needed on whether men's attitudes on gender equality are associated with contraceptive behaviors; this is the objective of this study. This study uses baseline data of the Measurement, Learning, and Evaluation (MLE) Project for the Urban Health Initiative in Uttar Pradesh, India. Data were collected from a representative sample of 6,431 currently married men in four cities of the state. Outcomes are current use of contraception and contraceptive method choice. Key independent variables are three gender measures: men's attitudes toward gender equality, gender sensitive decision making, and restrictions on wife's mobility. Multivariate analyses are used to identify the association between the gender measures and contraceptive use. Most men have high or moderate levels of gender sensitive decision-making, have low to moderate levels of restrictions on wife's mobility, and have moderate to high levels of gender equitable attitudes in all four cities. Gender sensitive decision making and equitable attitudes show significant positive association and restrictions on wife's mobility showed significant negative relationship with current contraceptive use. The study demonstrates that contraceptive programs need to engage men and address gender equitable attitudes; this can be done through peer outreach (interpersonal communication) or via mass media. Engaging men to be more gender equal may have an influence beyond contraceptive use in contexts where men play a crucial role in household decision-making.

Contraception Delivery in Pediatric and Specialist Pediatric Practices.

PubMed

Kaskowitz, Alexa; Quint, Elisabeth; Zochowski, Melissa; Caldwell, Amy; Vinekar, Kavita; Dalton, Vanessa K

2017-04-01

To characterize pediatricians' knowledge, attitudes, and self-efficacy around contraception. Cross-sectional survey. United States. National sample of pediatricians. Assessment of behaviors of providing contraception. Reproductive health practice score. Two hundred twenty-three usable surveys were received, from 163 contraceptive prescribers and 60 nonprescribers. The mean reproductive health practice score was 43.1 (SD, 8.2; total possible score, 84). Prescribers differed in their mean reproductive health score (46.0; SD, 7.0) from nonprescribers (34.0; SD, 4.5; P < .001). Prescribers vs nonprescribers differed in their attitude and efficacy in providing contraception. More prescribers believed it was their responsibility to ask about patients' need for birth control, were confident in their ability to prescribe contraception options, and provided contraception to minors despite parental disapproval. Neither group was confident in their ability to place intrauterine devices or believed that the literature supports intrauterine device placement in adolescents. Only efficacy was related to prescribing contraception in a multivariate regression analysis (odds ratio, 1.7; P < .001). In this study, we showed that most pediatricians are contraception prescribers but the overall reproductive health score was low for prescribers and nonprescribers. The odds of prescribing contraception increased with higher self-efficacy scores rather than knowledge alone. Many prescribers and nonprescribers would not prescribe birth control if parents disapproved and do not believe it is their responsibility to assess patients' need for birth control. In addition very few pediatricians have training in long-acting reversible contraception, despite being the recommended method for adolescents. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Contraceptive services for adolescents in Latin America: facts, problems and perspectives.

PubMed

Pons, J E

1999-12-01

This review presents facts about sexual and contraceptive behavior of Latin American adolescents, analyzes barriers to contraception, and summarizes present perspectives. Between 13 and 30% of Latin American adolescent women live in union before their 20th birthday and between 46 and 63% have had sexual relations. The prevalence of contraceptive use among adolescents at risk of pregnancy remains very low. The pill is the best known contraceptive method. When sexual activity becomes a permanent practice, contraceptive use increases but remains low. Barriers to contraception can be identified as: (1) arising from adolescents themselves (moral objections, alleged medical reasons, lack of confidence in adults and in the health system, promiscuity; (2) arising from the sexual partner (partner's opposition, masculine irresponsibility); (3) arising from adults (moral objections, fear of sex education, adult control and power of decision-making); (4) arising from the health system (inappropriateness of services, regulatory barriers, gender inequality); (5) arising from health professionals (medical barriers to contraceptive use, discomfort with sexual matters); (6) arising from the educational system (educational failure, teachers' reluctance); and (7) arising from other social agents (religious opposition, media ambivalent messages, fund restraints). There have been improvements in recent years, including the achievements of groups working for and with adolescents, and the support from distinguished personalities.

A randomized controlled trial to promote long-term contraceptive use among HIV-serodiscordant and concordant positive couples in Zambia.

PubMed

Stephenson, Rob; Vwalika, Bellington; Greenberg, Lauren; Ahmed, Yusuf; Vwalika, Cheswa; Chomba, Elwyn; Kilembe, William; Tichacek, Amanda; Allen, Susan

2011-04-01

Countries facing high HIV prevalence often also experience high levels of fertility and low contraceptive use, suggesting high levels of unmet need for contraceptive services. In particular, the unique needs of couples with one or both partners HIV positive are largely missing from many current family planning efforts, which focus on the prevention of pregnancies in the absence of reduction of the risk of HIV and other sexually transmitted infections (STIs). This article presents an examination of contraceptive method uptake among a cohort of HIV serodiscordant and concordant positive study participants in Zambia. Baseline contraceptive use was low; however, exposure to a video-based intervention that provided information on contraceptive methods and modeled desirable future planning behaviors dramatically increased the uptake of modern contraceptive methods. Including information on family planning in voluntary counseling and testing (VCT) services in addition to tailoring the delivery of family planning information to meet the needs and concerns of HIV-positive women or those with HIV-positive partners is an essential step in the delivery of services and prevention efforts to reduce the transmission of HIV. Family planning and HIV prevention programs should integrate counseling on dual method use, combining condoms for HIV/STI prevention with a long-acting contraceptive for added protection against unplanned pregnancy.

[Some signs of women applying for abortion].

PubMed

Simonová, D; Fait, T; Weiss, P

2010-05-01

To discover the motivation of women for abortion. Prospective questionary study. Department of Obstetrics and Gynecology, 1st Faculty of Medicine Charles University and General Faculty Hospital Prague. Special questionnaire centered on the social situation, sexual behavior, knowledge about contraception and the use of contraception, and a motivation for abortion was given to one hundred women attending our clinic for abortion for non-medical reasons. Results were discussed in comparison with population survey data. Although education and acces to modern contraceptive methods have induced the great progress in the area of family planning, abortion is still an important psychosocial problem. In our sample an earlier start of sexual intercourse, higher number of sexual partners, and substantialy lower number of hormonal contraception users were found.

Association of the quality of interpersonal care during family planning counseling with contraceptive use.

PubMed

Dehlendorf, Christine; Henderson, Jillian T; Vittinghoff, Eric; Grumbach, Kevin; Levy, Kira; Schmittdiel, Julie; Lee, Jennifer; Schillinger, Dean; Steinauer, Jody

2016-07-01

Health communication and interpersonal skills are increasingly emphasized in the measurement of health care quality, yet there is limited research on the association of interpersonal care with health outcomes. As approximately 50% of pregnancies in the United States are unintended, whether interpersonal communication influences contraceptive use is of public health importance. The aim of this study was to determine whether the quality of interpersonal care during contraceptive counseling is associated with contraceptive use over time. The Patient-Provider Communication about Contraception study is a prospective cohort study of 348 English-speaking women seen for contraceptive care, conducted between 2009 and 2012 in the San Francisco Bay Area. Quality of communication was assessed using a patient-reported interpersonal quality in family planning care measure based on the dimensions of patient-centered care. In addition, the clinical visit was audio recorded and its content coded according to the validated Four Habits Coding Scheme to assess interpersonal communication behaviors of clinicians. The outcome measures were 6-month continuation of the selected contraceptive method and use of a highly or moderately effective method at 6 months. Results were analyzed using mixed effect logistic regression models controlling for patient demographics, the clinic and the provider at which the visit occurred, and the method selected. Patient participants had a mean age of 26.8 years (SD 6.9 years); 46% were white, 26% Latina, and 28% black. Almost two-thirds of participants had an income of <200% of the Federal Poverty Level. Most of the women (73%) were making visits to a provider whom they had not seen before. Of the patient participants, 41% were still using their chosen contraceptive method at 6-month follow-up. Patients who reported high interpersonal quality of family planning care were more likely to maintain use of their chosen contraceptive method (adjusted odds ratio [aOR], 1.8; 95% CI, 1.1-3.0) and to be using a highly or moderately effective method at 6 months (aOR, 2.0; 95% CI, 1.2-3.5). In addition, 2 of the Four Habits were associated with contraceptive continuation; "invests in the beginning" (aOR, 2.3; 95% CI, 1.2-4.3) and "elicits the patient's perspective" (aOR, 1.8; 95% CI, 1.0-3.2). Our study provides evidence that the quality of interpersonal care, measured using both patient report and observation of provider behaviors, influences contraceptive use. These results provide support for ongoing attention to interpersonal communication as an important aspect of health care quality. The associations of establishing rapport and eliciting the patient perspective with contraceptive continuation are suggestive of areas of focus for provider communication skills training for contraceptive care. Copyright © 2016 Elsevier Inc. All rights reserved.

Noncontracepting behavior in women at risk for unintended pregnancy: what's religion got to do with it?

PubMed

Kramer, Michael R; Hogue, Carol J Rowland; Gaydos, Laura M D

2007-05-01

In the United States, 49% of all pregnancies are unintended. Part of this high rate has been attributed to the negative effects of higher levels of personal and community-level religiosity in this country. To explore the impacts of individual-level religiosity on unintended pregnancy, we used 2002 National Survey of Family Growth (NSFG) data to model the relationship between religion and noncontracepting behavior, a crucial precursor to unintended pregnancies. We tested logistic models with current and childhood religious affiliation as primary exposures and recent noncontracepting behavior as the outcome, controlling for demographic covariates, religious service importance, and attendance frequency. An estimated 32.7 million women are at risk for unintended pregnancy, 14 % of whom use no contraception. Proportions of noncontraceptors were 15.5 % among Catholics, 10.3% among mainstream Protestants, and 15.0% among fundamentalist Protestants. In multivariate modeling, religion was significantly related to not contracepting in teens, but noncontributory for women from 20 to 44 years of age. Variables associated with contraceptive behavior included marital status, age, education, and income. Among women, current and childhood religious affiliations modify odds ratio for noncontracepting behavior only among teenage girls. For adults, odds ratio vary widely by marital status, education, and income, but not by religious affiliation.

Encouraging contraceptive uptake by motivating men to communicate about family planning: the Malawi Male Motivator project.

PubMed

Shattuck, Dominick; Kerner, Brad; Gilles, Kate; Hartmann, Miriam; Ng'ombe, Thokozani; Guest, Greg

2011-06-01

We examined the effect of a peer-delivered educational intervention, the Malawi Male Motivator intervention, on couples' contraceptive uptake. We based the intervention design on the information-motivation-behavioral skills (IMB) model. In 2008 we recruited 400 men from Malawi's Mangochi province who reported not using any method of contraception. We randomized them into an intervention arm and a control arm, and administered surveys on contraceptive use at baseline and after the intervention. We also conducted in-depth interviews with a subset of intervention participants. After the intervention, contraceptive use increased significantly within both arms (P < .01), and this increase was significantly greater in the intervention arm than it was in the control arm (P < .01). Quantitative and qualitative data indicated that increased ease and frequency of communication within couples were the only significant predictors of uptake (P < .01). Our findings indicate that men facilitated contraceptive use for their partners. Although the IMB model does not fully explain our findings, our results show that the intervention's content and its training in communication skills are essential mechanisms for successfully enabling men to help couples use a contraceptive.

State Variation in Rates of Adolescent Pregnancy and Childbearing. Final Report [and] Executive Summary.

ERIC Educational Resources Information Center

Moore, Kristin A.; Blumenthal, Connie; Sugland, Barbara W.; Hyatt, Byoung-gi; Snyder, Nancy O.; Morrison, Donna Ruane

Recent declines in funding for contraceptive services have led to questions regarding the role of contraceptive services and social policy in shaping adolescent reproductive behavior. This 2-year study examined the impact of state-level policies on adolescent pregnancy and fertility. Data were obtained from a variety of sources, including the…

Teenagers: fertility control behavior and attitudes before and after abortion, childbearing or negative pregnancy test.

PubMed

Evans, J R; Selstad, G; Welcher, W H

1976-01-01

Following abortion or delivery, teenagers' knowledge and use of effective contraception improved markedly; but those who had negative pregnancy tests continued to take risks--and to get pregnant--subsequently. Most sexually active teenagers were poorly educated on the facts of reproduction, and began to have intercourse before seeking contraception.

Impact of Counseling on Repeated Unplanned Pregnancy and Contraceptive Behavior in Low SES Abortion Population.

ERIC Educational Resources Information Center

Burnhill, Michael S.; And Others

High numbers of repeat abortions at a medical school clinic prompted clinic personnel to develop an experimental fertility control counseling program. Counseling objectives included the following: (1) to engender rapport and trust; (2) to assess the patient's past contraceptive use and psychosocial history; (3) to improve patient's knowledge of…

Predictors of Men's Acceptance of Modern Contraceptive Practice: Study in Rural Vietnam

ERIC Educational Resources Information Center

Ha, Bui Thi Thu; Jayasuriya, Rohan; Owen, Neville

2005-01-01

Studies have shown family planning adoption is likely to be more effective for women when men are actively involved. The transtheoretical model of behavior change was used to examine men's involvement in general contraception and intrauterine device (IUD) use by their wives. The study was carried out in rural Vietnam with 651 eligible…

Multilevel Effects of Wealth on Women's Contraceptive Use in Mozambique

PubMed Central

Dias, José G.; de Oliveira, Isabel Tiago

2015-01-01

Objective This paper analyzes the impact of wealth on the use of contraception in Mozambique unmixing the contextual effects due to community wealth from the individual effects associated with the women's situation within the community of residence. Methods Data from the 2011 Mozambican Demographic and Health Survey on women who are married or living together are analyzed for the entire country and also for the rural and urban areas separately. We used single level and multilevel probit regression models. Findings A single level probit regression reveals that region, religion, age, previous fertility, education, and wealth impact contraceptive behavior. The multilevel analysis shows that average community wealth and the women’s relative socioeconomic position within the community have significant positive effects on the use of modern contraceptives. The multilevel framework proved to be necessary in rural settings but not relevant in urban areas. Moreover, the contextual effects due to community wealth are greater in rural than in urban areas and this feature is associated with the higher socioeconomic heterogeneity within the richest communities. Conclusion This analysis highlights the need for the studies on contraceptive behavior to specifically address the individual and contextual effects arising from the poverty-wealth dimension in rural and urban areas separately. The inclusion in a particular community of residence is not relevant in urban areas, but it is an important feature in rural areas. Although the women's individual position within the community of residence has a similar effect on contraceptive adoption in rural and urban settings, the impact of community wealth is greater in rural areas and smaller in urban areas. PMID:25786228

Sexual Esteem in Emerging Adulthood: Associations with Sexual Behavior, Contraception Use, and Romantic Relationships

PubMed Central

Maas, Megan; Lefkowitz, Eva

2014-01-01

Sexual esteem is an integral psychological aspect of sexual health (Snell & Papini, 1989), yet it is unclear if sexual esteem is associated with sexual health behavior among heterosexual men and women. The current analysis uses a normative framework for sexual development (Lefkowitz & Gillen, 2006; Tolman & McClelland, 2011) by examining the association of sexual esteem with sexual behavior, contraception use, and romantic relationship characteristics. Participants (N = 518; 56.0% female; mean age = 18.43 years; 26.8% identified as Hispanic/Latino; among non-Hispanic/Latinos, 27.2% of the full sample identified as European American, 22.4% Asian American, 14.9% African American, and 8.7% multiracial) completed web-based surveys at a large northeastern university. Participants who had oral sex more frequently, recently had more oral and penetrative sex partners (particularly for male participants), and spent more college semesters in romantic relationships, tended to have higher sexual esteem than those who had sex less frequently, with fewer partners, or spent more semesters without romantic partners. Sexually active male emerging adults who never used contraception during recent penetrative sex tended to have higher sexual esteem than those who did use it, whereas female emerging adults who never used contraception tended to have lower sexual esteem than those who did use it. Implications of these results for the development of a healthy sexual self-concept in emerging adulthood are discussed. PMID:25210789

Sexual Esteem in Emerging Adulthood: Associations with Sexual Behavior, Contraception Use, and Romantic Relationships.

PubMed

Maas, Megan K; Lefkowitz, Eva S

2015-01-01

Sexual esteem is an integral psychological aspect of sexual health (Snell & Papini, 1989 ), yet it is unclear whether sexual esteem is associated with sexual health behavior among heterosexual men and women. The current analysis used a normative framework for sexual development (Lefkowitz & Gillen, 2006 ; Tolman & McClelland, 2011 ) by examining the association of sexual esteem with sexual behavior, contraception use, and romantic relationship characteristics. Participants (N = 518; 56.0% female; mean age = 20.43 years; 26.8% identified as Hispanic/Latino; among non-Hispanic/Latinos, 27.2% of the full sample identified as European American, 22.4% Asian American, 14.9% African American, and 8.7% multiracial) completed Web-based surveys at a large Northeastern university. Participants who had oral sex more frequently, recently had more oral and penetrative sex partners (particularly for male participants), and spent more college semesters in romantic relationships tended to have higher sexual esteem than those who had sex less frequently, with fewer partners, or spent more semesters without romantic partners. Sexually active male emerging adults who never used contraception during recent penetrative sex tended to have higher sexual esteem than those who did use it, whereas female emerging adults who never used contraception tended to have lower sexual esteem than those who did use it. Implications of these results for the development of a healthy sexual self-concept in emerging adulthood are discussed.

[Effects of a Customized Birth Control Program for Married Immigrant Postpartum Mothers].

PubMed

Kim, So Young; Choi, So Young

2016-12-01

This study was conducted to develop a customized birth control program and identify its effects on attitude, subjective norm, behavioral control, intention, and behavior of contraception among immigrant postpartum mothers. In this experimental study, Vietnamese, Filipino or Cambodian married immigrant postpartum mothers were recruited. They were assigned to the experiment group (n=21) or control group (n=21). The customized birth control program was provided to the experimental group for 4 weeks. The experimental group showed a significant increase in the score of attitude, subjective norm, behavioral control, intention, and behavior of contraception. Findings in this study indicate that the customized postpartum birth control program, a systematic and integrative intervention program composed of customized health education, counseling and telephone monitoring, is able to provide effective planning for postpartum health promotion and birth control behavior practice in married immigrant women.

The association between estradiol levels, hormonal contraceptive use, and responsiveness to one-session-treatment for spider phobia in women.

PubMed

Graham, Bronwyn M; Li, Sophie H; Black, Melissa J; Öst, Lars-Göran

2018-04-01

Preclinical studies have demonstrated that conditioned fear extinction is impaired in females with low endogenous levels of the sex hormone estradiol, due to menstrual fluctuations or hormonal contraceptive use. As fear extinction is a laboratory model of exposure therapy for anxiety and trauma disorders, here we assessed the hypothesis that treatment outcomes may be diminished when exposure therapy occurs during periods of low estradiol. 90 women with spider phobia (60 cycling and 30 using hormonal contraceptives) underwent a one-session exposure treatment for spider phobia, following which, serum estradiol levels were assessed. A median split in estradiol level was used to divide cycling participants into two groups; lower and higher estradiol. Behavioral avoidance and self-reported fear of spiders were measured pre-treatment, post-treatment, and at a 12 week follow-up assessment. Women using hormonal contraceptives exhibited a significantly slower rate of improvement across treatment, greater behavioral avoidance at post-treatment and follow-up, and fewer self-initiated post-treatment exposure tasks, relative to both groups of cycling women, who did not differ. No group differences in self-reported fear were evident. Correlational analyses revealed that across the whole sample, lower estradiol levels were associated with slower rates of improvement across treatment, and greater self-reported fear and behavioral avoidance at post-treatment, but not follow-up. These results provide the first evidence of an association between endogenous estradiol, hormonal contraceptive use, and exposure therapy outcomes in spider phobic women. Hormonal profile may partly account for variability in responsiveness to psychological treatments for anxiety and trauma disorders in women. Copyright © 2018 Elsevier Ltd. All rights reserved.

How Oral Contraceptives Impact Social-Emotional Behavior and Brain Function.

PubMed

Montoya, Estrella R; Bos, Peter A

2017-02-01

Millions of women worldwide use oral contraceptives ('the pill'; OCs), often starting at a pubertal age when their brains are in a crucial developmental stage. Research into the social-emotional effects of OCs is of utmost importance. In this review, we provide an overview of studies that have emerged over the past decade investigating how OCs, and their main ingredients estradiol (E) and progesterone (P), influence social-emotional behaviors and underlying brain functions. Based on this overview, we present a heuristic model that postulates that OCs modulate core social-emotional behaviors and brain systems. Research domains and challenges for the future, as well as implications, are discussed. Copyright © 2016 Elsevier Ltd. All rights reserved.

Sex education and adolescent sexual behavior: do community characteristics matter?

PubMed

Kraft, Joan Marie; Kulkarni, Aniket; Hsia, Jason; Jamieson, Denise J; Warner, Lee

2012-09-01

Studies point to variation in the effects of formal sex education on sexual behavior and contraceptive use by individual and community characteristics. Using the 2002 National Survey of Family Growth, we explored associations between receipt of sex education and intercourse by age 15, intercourse by the time of the interview and use of effective contraception at first sex among 15-19-year-olds, stratified by quartiles of three community characteristics and adjusted for demographics. Across all quartiles of community characteristics, sex education reduced the odds of having sex by age 15. Sex education resulted in reduced odds of having sex by the date of the interview and increased odds of using contraception in the middle quartiles of community characteristics. Variation in the effects of sex education should be explored. Research might focus on programmatic differences by community type and programmatic needs in various types of communities. Published by Elsevier Inc.

Family planning and contraceptive decision-making by economically disadvantaged, African-American women

PubMed Central

Hodgson, Eric J.; Collier, Charlene; Hayes, Laura; Curry, Leslie; Fraenkel, Liana

2013-01-01

Background Significant racial disparities exist in the US unplanned pregnancy rate. We conducted a qualitative study using the theory of planned behavior as a framework to describe how low-income, African-American women approach family planning. Study Design Structured focus groups were held with adult, low-income, non-pregnant, African-American women in Connecticut. Data were collected using a standardized discussion guide, and audio-taped and transcribed. Four, independent researchers coded the transcripts using the constant comparative method. Codes were organized into over-arching themes. Results Contraceptive knowledge was limited with formal education often occurring after sexual debut. Attitudes about contraception were overtly negative with method effectiveness being judged by the experience of side effects. Family and friends strongly influence contraceptive decisions while male partners are primarily seen as a barrier. Contraceptive pills are perceived as readily accessible although compliance is considered a barrier. Conclusions Contraception education should occur before sexual debut, should involve trusted family and community members, and should positively frame issues in terms of achieving life goals. PMID:23177266

Assessment of dietary choices of young women in the contexts of hormonal contraceptives

PubMed

Friedrich, Mariola; Junak, Magdalena

Metabolic changes caused by hormonal contraception combined with unbalanced diet may pose many threats, and deficiency or excess of nutrients may increase the risk of using such contraceptives. The purpose of the survey was to assess the dietary choices of young women using hormonal contraceptives, taking into account their general knowledge about the contraception and its impact on their bodies. The survey comprised 67 women aged from 18 to 25 years. In of three-day menus (201 daily food rations) of the women under research the content of energy and most of nutritious ingredients wandered away from recommended values in Poland. Each respondent additionally filled in a questionnaire concerning her: anthropometric data, education, place of residence; the type, name and time of taking contraceptives; purpose for using hormonal contraception along with its determinants; duration of use, breaks in contraceptive practice; occurrence of side effects during contraceptive use; stimulants used; physical activity, incidence of diarrhoea and vomiting, and dietary supplements use. The assessment of nutritional status of young women taking hormonal contraceptives has shown a number of nonconformities. The survey has revealed insufficient energy value of the menus, and incorrect proportions of basic nutrients, from recommended values, what was reflected in insufficient intake of vitamins (A, D, E, C, B1, B3, B6, and folates) and minerals (K, Ca, Mg, Fe). An excessive consumption of proteins, animal-based in particular, and insufficient consumption of lipids and carbohydrates, polysaccharides in particular, what resulted in insufficient consumption of dietary fibre. Nutritional choices of the respondents were typical to their gender and age, but were not adjusted to the use of hormonal contraceptives. Side effects observed by the respondents, mainly weight gain, may have been a summary result of improper eating behaviors that facilitated accumulation of body fat and water.

Varying family planning strategies across age categories: differences in factors associated with current modern contraceptive use among youth and adult women in Luanda, Angola.

PubMed

Prata, Ndola; Bell, Suzanne; Weidert, Karen; Nieto-Andrade, Benjamin; Carvalho, Adelaide; Neves, Isilda

2016-01-01

The objective of this study is to identify factors associated with current modern contraceptive use among Angolan women. By differentiating according to age groups (15-24 and 25-49 years), this study aimed to help family planning program planners better tailor interventions to improve utilization of modern contraception. A household survey was used to collect data from 1,545 women of reproductive age living in Luanda Province, Angola. Data on sociodemographic characteristics, reproductive behavior and intentions, contraceptive knowledge and use, and attitudes and beliefs regarding contraception and abortion were collected. The analyses were stratified based on age: 15-24 years (youth) and 25-49 years (adult). Multivariate logistic regression models were built for each age group, adding different subsets of variables in groups to see how relationships changed across the models. Common factors associated with modern contraceptive use among all ages include education level, perceived contraceptive accessibility, contraceptive knowledge, communication with partner about family planning in last year, and self-efficacy. Exposure to family planning information in the media in the last few months, perceived partner approval of family planning, and marital status were all positively associated with current modern contraceptive use among women aged 15-24 years. Meanwhile, receiving information about family planning from a pharmacy in the last year was uniquely associated with current modern contraceptive use among women aged 25-49 years. Young women in Luanda, Angola seem to have a unique set of factors affecting their contraceptive use. These findings highlight the need for family planning programs to cater services and messages toward specific age groups.

Men’s attitudes on gender equality and their contraceptive use in Uttar Pradesh India

PubMed Central

2014-01-01

Background Men play crucial role in contraceptive decision-making, particularly in highly gender-stratified populations. Past research examined men’s attitudes toward fertility and contraception and the association with actual contraceptive practices. More research is needed on whether men’s attitudes on gender equality are associated with contraceptive behaviors; this is the objective of this study. Methods This study uses baseline data of the Measurement, Learning, and Evaluation (MLE) Project for the Urban Health Initiative in Uttar Pradesh, India. Data were collected from a representative sample of 6,431 currently married men in four cities of the state. Outcomes are current use of contraception and contraceptive method choice. Key independent variables are three gender measures: men’s attitudes toward gender equality, gender sensitive decision making, and restrictions on wife’s mobility. Multivariate analyses are used to identify the association between the gender measures and contraceptive use. Results Most men have high or moderate levels of gender sensitive decision-making, have low to moderate levels of restrictions on wife’s mobility, and have moderate to high levels of gender equitable attitudes in all four cities. Gender sensitive decision making and equitable attitudes show significant positive association and restrictions on wife’s mobility showed significant negative relationship with current contraceptive use. Conclusion The study demonstrates that contraceptive programs need to engage men and address gender equitable attitudes; this can be done through peer outreach (interpersonal communication) or via mass media. Engaging men to be more gender equal may have an influence beyond contraceptive use in contexts where men play a crucial role in household decision-making. PMID:24894376

The antecedents and prevention of unwanted pregnancy.

PubMed

Gerrard, M; McCann, L; Geis, B D

1983-01-01

Much of the research on the antecedents and consequences of birth control has focused on teenagers and members of racial minority groups, but the trends in contraceptive use indicate that the danger of unwanted pregnancy exists for most women throughout the childbearing ages of 14-45, for white and middle class women as well as minority women and women from the lower socioeconomic status levels. There are basically 4 choices open to the unmarried woman who conceives: giving the child up for adoption, keeping the child without marrying, and marriage. There are little data on the mental health consequences of giving a child up for adoption, but there is no question that the experience at the very least upsetting and may cause longterm trauma. Induced abortion is less traumatic, both physically and psychologically, than carrying a pregnancy to term, however, many women suffer from longterm depression following the procedure. The social, economic, and psychological consequences of single motherhood are clearly documented for both teenagers and older women. The most frequently cited problems are delayed or truncated emotional and social activities, unemployment, and role overload resulting from the responsibility of caring for a child without the support of a spouse. The pregnant teenager who does marry has a 50% probability of divorce within 4 years, and even if the couple does stay married they suffer some adverse consequences. In 1978 Zelnick and Kantner estimated that it would be possible to reduce the number of premarital pregnancies and presumably their psychological and economic consequences by at least 40% if all sexually active young women were to use a contraceptive method and to use it consistently. If the majority of all sexually active women were to use the most reliable methods of contraception, the unwanted pregnancy rate would be reduced even more markedly. Yet, reliable contraceptive behavior involves a complex sequence of psychological and behavioral events including awareness of the risk of becoming pregnant, obtaining adequate information about contraception, making decisions about contraceptive use, acquiring contraception, and regular and consistent use of a reliable contraceptive method. The literature on the psychological antecedents of contraceptive behavior clearly characterize ineffective female contraceptors as being unaccepting of their own sexuality and having negative attitudes toward most matters pertaining to sex. Their attitudes and emotions include irrational fears about specific contraceptives, conflicting attitude and belief systems about birth control in general, and guilt. Implicit in this profile is an inability to think rationally about the high probability that unprotected sex will result in conception and an inability to engage in rational decision making about birth control. Yet, review of the prevention programs currently available reveals that the vast majority are designed to serve the self-motivated women. Given that these programs already have been demonstrated to be effective, it is time to direct attention to exploring ways to reach those women who will not adequate precautions without first experiencing changes in their attitudinal and emotional responses to sex.

Committee Opinion No 699: Adolescent Pregnancy, Contraception, and Sexual Activity.

PubMed

2017-05-01

In 2015, the birth rate among U.S. adolescents and young adults (aged 15-19 years) reached a historic low at 22.3 per 1,000 women. Despite positive trends, the United States continues to have the highest adolescent pregnancy rate among industrialized countries with data. Racial and ethnic disparities in adolescent pregnancy rates continue to exist, as do state-based differences in pregnancy, birth, and abortion rates. The American College of Obstetricians and Gynecologists supports access for adolescents to all contraceptive methods approved by the U.S. Food and Drug Administration. In the absence of contraindications, patient choice should be the principal factor in prescribing one method of contraception over another. Dual method use-the use of condoms in combination with more effective contraceptive methods to protect against sexually transmitted infections and unwanted pregnancy-is the ideal contraceptive practice for adolescents. Just as adolescents should have access to the full range of contraceptives, including long-acting reversible contraceptive methods, they should be able to decline and discontinue any method on their own, without barriers. A reproductive justice framework for contraceptive counseling and access is essential to providing equitable health care, accessing and having coverage for contraceptive methods, and resisting potential coercion by health care providers. Successful programs that resulted in measurable changes in adolescent contraceptive practices and sexual behavior have been described, but not implemented uniformly nor supported by policy improvements. More research is needed to determine which programs are most effective and which programs do not work. Continued efforts are integral to further advance positive trends.

Committee Opinion No. 699: Adolescent Pregnancy, Contraception, and Sexual Activity.

PubMed

2017-05-01

In 2015, the birth rate among U.S. adolescents and young adults (aged 15-19 years) reached a historic low at 22.3 per 1,000 women. Despite positive trends, the United States continues to have the highest adolescent pregnancy rate among industrialized countries with data. Racial and ethnic disparities in adolescent pregnancy rates continue to exist, as do state-based differences in pregnancy, birth, and abortion rates. The American College of Obstetricians and Gynecologists supports access for adolescents to all contraceptive methods approved by the U.S. Food and Drug Administration. In the absence of contraindications, patient choice should be the principal factor in prescribing one method of contraception over another. Dual method use-the use of condoms in combination with more effective contraceptive methods to protect against sexually transmitted infections and unwanted pregnancy-is the ideal contraceptive practice for adolescents. Just as adolescents should have access to the full range of contraceptives, including long-acting reversible contraceptive methods, they should be able to decline and discontinue any method on their own, without barriers. A reproductive justice framework for contraceptive counseling and access is essential to providing equitable health care, accessing and having coverage for contraceptive methods, and resisting potential coercion by health care providers. Successful programs that resulted in measurable changes in adolescent contraceptive practices and sexual behavior have been described, but not implemented uniformly nor supported by policy improvements. More research is needed to determine which programs are most effective and which programs do not work. Continued efforts are integral to further advance positive trends.

Pregnancy Prevention and Termination of Pregnancy in Adolescence: Facts, Ethics, Law and Politics.

PubMed

Fisher, Menachem; Ben Shlomo, Izhar; Solt, Ido; Burke, Yechiel Z

2015-11-01

We present an overview of the current sexual behavior of adolescents in Israel, including the related social and moral issues, and compare it to that in Western countries. An important factor is the existence of liberal versus conservative views regarding the use of contraception and termination of pregnancy in these young subjects. We describe the current situation where in most cases the medical providers do not provide adequate contraceptive advice to adolescent girls, resulting ultimately in a high rate of unintended pregnancy. In our opinion, it is essential to make effective contraception more accessible to this vulnerable group.

First intercourse, contraception and first pregnancy in Flanders: changes during the past 30 years.

PubMed

Lodewijckx, E

1987-10-01

The investigation of women in Flanders born between 1931 and 1962 shows that premarital sexual intercourse has become almost general and that the age at the onset of sexual intercourse is steadily declining. Until the 1970s in spite of the improving contraceptive behavior of youngsters, the number of women experiencing premarital pregnancy increased and 1st conceptions occurred at an increasingly younger age. The 1970s marked a turning point: fewer women became pregnant before marriage or in adolescnece. From that time, the contraceptive revolution kept pace with the sexual revolution.

Preventing Unintended Pregnancy and HIV Transmission: Effects of the HIV Treatment Cascade on Contraceptive Use and Choice in Rural KwaZulu-Natal

PubMed Central

Raifman, Julia; Chetty, Terusha; Tanser, Frank; Mutevedzi, Tinofa; Matthews, Philippa; Herbst, Kobus; Pillay, Deenan

2014-01-01

Background: For women living with HIV, contraception using condoms is recommended because it prevents not only unintended pregnancy but also acquisition of other sexually transmitted infections and onward transmission of HIV. Dual-method dual-protection contraception (condoms with other contraceptive methods) is preferable over single-method dual-protection contraception (condoms alone) because of its higher contraceptive effectiveness. We estimate the effect of progression through the HIV treatment cascade on contraceptive use and choice among HIV-infected women in rural South Africa. Methods: We linked population-based surveillance data on contraception collected by the Wellcome Trust Africa Centre for Health and Population Studies to data from the local antiretroviral treatment (ART) program in Hlabisa subdistrict, KwaZulu-Natal. In bivariate probit regression, we estimated the effects of progressing through the cascade on contraceptive choice among HIV-infected sexually active women aged 15–49 years (N = 3169), controlling for a wide range of potential confounders. Findings: Contraception use increased across the cascade from <40% among HIV-infected women who did not know their status to >70% among women who have been on ART for 4–7 years. Holding other factors equal (1) awareness of HIV status, (2) ART initiation, and (3) being on ART for 4–7 years increased the likelihood of single-method/dual-method dual protection by the following percentage points (pp), compared with women who were unaware of their HIV status: (1) 4.6 pp (P = 0.030)/3.5 pp (P = 0.001), (2) 10.3 pp (P = 0.003)/5.2 pp (P = 0.007), and (3) 21.6 pp (P < 0.001)/11.2 pp (P < 0.001). Conclusions: Progression through the HIV treatment cascade significantly increased the likelihood of contraception in general and contraception with condoms in particular. ART programs are likely to contribute to HIV prevention through the behavioral pathway of changing contraception use and choice. PMID:25436821

Preventing unintended pregnancy and HIV transmission: effects of the HIV treatment cascade on contraceptive use and choice in rural KwaZulu-Natal.

PubMed

Raifman, Julia; Chetty, Terusha; Tanser, Frank; Mutevedzi, Tinofa; Matthews, Philippa; Herbst, Kobus; Pillay, Deenan; Bärnighausen, Till

2014-12-01

For women living with HIV, contraception using condoms is recommended because it prevents not only unintended pregnancy but also acquisition of other sexually transmitted infections and onward transmission of HIV. Dual-method dual-protection contraception (condoms with other contraceptive methods) is preferable over single-method dual-protection contraception (condoms alone) because of its higher contraceptive effectiveness. We estimate the effect of progression through the HIV treatment cascade on contraceptive use and choice among HIV-infected women in rural South Africa. We linked population-based surveillance data on contraception collected by the Wellcome Trust Africa Centre for Health and Population Studies to data from the local antiretroviral treatment (ART) program in Hlabisa subdistrict, KwaZulu-Natal. In bivariate probit regression, we estimated the effects of progressing through the cascade on contraceptive choice among HIV-infected sexually active women aged 15-49 years (N = 3169), controlling for a wide range of potential confounders. Contraception use increased across the cascade from <40% among HIV-infected women who did not know their status to >70% among women who have been on ART for 4-7 years. Holding other factors equal (1) awareness of HIV status, (2) ART initiation, and (3) being on ART for 4-7 years increased the likelihood of single-method/dual-method dual protection by the following percentage points (pp), compared with women who were unaware of their HIV status: (1) 4.6 pp (P = 0.030)/3.5 pp (P = 0.001), (2) 10.3 pp (P = 0.003)/5.2 pp (P = 0.007), and (3) 21.6 pp (P < 0.001)/11.2 pp (P < 0.001). Progression through the HIV treatment cascade significantly increased the likelihood of contraception in general and contraception with condoms in particular. ART programs are likely to contribute to HIV prevention through the behavioral pathway of changing contraception use and choice.

[Emergency contraception with levonorgestrel].

PubMed

Saraví, Fernando D

2007-01-01

Emergency contraception may avoid pregnancy after unprotected intercourse or when regular contraceptive measures fail. Levonorgestrel, a synthetic gestagen, is recommended for emergency contraception as a single 1.5-mg dose or, alternatively, two 0.75-mg doses taken 12 h apart. Its efficacy is moderate, preventing about 80% of pregnancies. Efficacy is higher the earlier after unprotected intercourse the drug is taken, but it may be administered up to 5 days post-coitum. Tolerance is similar to, or better than, those of other oral emergency contraceptives. Adverse effects include nausea, vomiting, headache, breast tenderness and transient alteration of menstrual bleeding pattern. It is not known whether levonogestrel increases the risk of ectopic pregnancy when the treatment fails. Its use as an ongoing contraceptive method is discouraged. When given before the preovulatory LH peak, levonorgestrel blocks or delays ovulation. It may also affect sperm migration in the female reproductive tract and have an effect on fertilization. Although it has been often postulated, there is no evidence for an anti-implantatory effect. Acquaintance with the method is quite variable among different societies, but it remains underutilized even where it is well known. Advance provision of the drug has been proposed as a way to promote its use. In clinical trials, advance provision did not adversely modify sexual or regular contraceptive behavior, but it did not reduce pregnancy or abortion rate either. Therefore, emergency contraception with levonorgestrel should be regarded as a backup method which is not a substitute for the continued use of more effective contraceptive methods.

Sexual and contraceptive behavior among female university students in Sweden – repeated surveys over a 25-year period

PubMed Central

Stenhammar, Christina; Ehrsson, Ylva Tiblom; Åkerud, Helena; Larsson, Margareta; Tydén, Tanja

2015-01-01

Objective To study female students’ sexual and contraceptive behavior and compare these results with earlier surveys. Design Comparative, repeated cross-sectional surveys, started in 1989 and repeated every fifth year. Setting Contraceptive counseling delivered at a Student Health Center in Sweden. Population Female university students (n = 359). Methods Multiple-choice waiting-room questionnaire. Main outcome measures Sexual and contraceptive behavior. Results In 1989, age at first intercourse was 17.6 years vs. 16.7 years in 2014, number of lifetime sexual partners was 4.0 vs. 12.1 in 2014, and number of sexual partners during the previous 12 months was 1.0 vs. 2.8 in 2014. Condom use during first intercourse with the latest partner decreased from 49% to 41% (n = 172 in 2009 vs. n = 148 in 2014: p < 0.001), and experience of anal sex increased from 39% to 46% (n = 136 in 2009 vs. n = 165 in 2014: p = 0.038), and 25% (n = 41 in 2014) always used a condom during anal sex. A total of 70% (n = 251) made use of pornography, and 48% (n = 121) considered their sexual behavior affected by pornography. Eighty-nine percent (n = 291) wanted two to three children and 9% (n = 33) had thought about freezing eggs for the future. The female students’ knowledge about increasing age being correlated with decreased fertility varied. Conclusions Sexual behavior among female university students has gradually changed during the last 25 years and behavior appears more risky today. As this may have consequences on future reproductive health, it is vital to inform women about consistent and correct condom use and about the limitations of the fertile window. PMID:25619646

Effective Contraceptive Use: An Exploration of Theory-Based Influences

ERIC Educational Resources Information Center

Peyman, N.; Oakley, D.

2009-01-01

The purpose of this study was to explore factors that influence oral contraceptive (OC) use among women in Iran using the Theory of Planned Behavior (TPB) and concept of self-efficacy (SE). The study sample consisted of 360 married OC users, aged 18-49 years recruited at public health centers of Mashhad, 900 km east of Tehran. SE had the strongest…

Black South African freshmen's experience of first coitus and contraception.

PubMed

Nicholas, L

1994-01-01

An anonymous questionnaire investigating Black South African first-year college students' experience of first intercourse and contraception was administered during the February 1993 orientation at a Black university. 754 females and 959 males of mean age 20.4 years in an age range of 16-50 years participated. 96.5% of the respondents were single. The study findings relate to the 894 single students who reported having experienced sexual intercourse. Male and female respondents' mean ages at first intercourse were, respectively, 15.5 and 17.8 years. 35.7% of males and 32.8% of females reported not using contraception during first intercourse, 12.3% of males and 7.1% of females were unsure, and 6.2% reported using withdrawal. 36.8% reported not using a condom because first sexual intercourse was unplanned, while 38.1% simply did not think about contraception at the time. Peers were reported as the primary first source of learning about sexual intercourse as well as the preferred source. These findings lend support to the need to target safer sex messages to college freshmen in this setting. In so doing, safer sex behavior can be encouraged and possibly adopted before high-risk sex behavior patterns develop.

A Randomized Controlled Trial to Promote Long-Term Contraceptive Use Among HIV-Serodiscordant and Concordant Positive Couples in Zambia

PubMed Central

Vwalika, Bellington; Greenberg, Lauren; Ahmed, Yusuf; Vwalika, Cheswa; Chomba, Elwyn; Kilembe, William; Tichacek, Amanda; Allen, Susan

2011-01-01

Abstract Background Countries facing high HIV prevalence often also experience high levels of fertility and low contraceptive use, suggesting high levels of unmet need for contraceptive services. In particular, the unique needs of couples with one or both partners HIV positive are largely missing from many current family planning efforts, which focus on the prevention of pregnancies in the absence of reduction of the risk of HIV and other sexually transmitted infections (STIs). Methods This article presents an examination of contraceptive method uptake among a cohort of HIV serodiscordant and concordant positive study participants in Zambia. Results Baseline contraceptive use was low; however, exposure to a video-based intervention that provided information on contraceptive methods and modeled desirable future planning behaviors dramatically increased the uptake of modern contraceptive methods. Conclusions Including information on family planning in voluntary counseling and testing (VCT) services in addition to tailoring the delivery of family planning information to meet the needs and concerns of HIV-positive women or those with HIV-positive partners is an essential step in the delivery of services and prevention efforts to reduce the transmission of HIV. Family planning and HIV prevention programs should integrate counseling on dual method use, combining condoms for HIV/STI prevention with a long-acting contraceptive for added protection against unplanned pregnancy. PMID:21410332

Contraceptive use among hairdressers in South-west Nigeria.

PubMed

Omokhodion, F O; Onadeko, M O; Balogun, O O

2007-08-01

Hairdressers and their apprentices are mostly women in their reproductive years. The social environment in hairdressing salons provides the opportunity to discuss sexual exploits among peers and may influence decisions on sexual behavior. This study was designed to assess the knowledge and use of contraceptives among hairdressers. A structured questionnaire was used to collect information on demographic characteristics and knowledge and use of contraceptive methods among hairdressers in Ibadan, South-west Nigeria. A total of 355 hairdressers were interviewed: 60 apprentices (17%) and 295 qualified hairdressers (83%); 110 (31%) single and 240 (67%) married. They were females aged 15 - 49 years (mean 29 +/- 6.9 years). Some 70% of single women had regular sexual partners. A total of 24 single women (21%) had been pregnant and 20 (18%) had abortions. Some 121 (34%) of the study population were currently using contraceptives: 27 single and 94 married respondents. The prevalence of contraceptive use among sexually active single women was 34%. The condom was the most known and used contraceptive method. The major reasons for non-use of contraceptives were fear of side-effects (23%); need for more children (16%); or respondents were not engaged in sexual activity (12%). Contraceptive use among sexually active single hairdressers is lower than the national average. Workplace educational intervention is needed to prevent unwanted pregnancies and sexually transmitted infections among these young women.

Family planning policy in the United States: the converging politics of abortion and contraception.

PubMed

Aiken, Abigail R A; Scott, James G

2016-05-01

Following decades of mainstream bipartisan support, contraception has reemerged as a controversial political issue in the United States. At the same time, opposition to abortion has intensified. State legislatures across the country have enacted highly visible policies limiting access to family planning. Perhaps the most striking example occurred in 2011 in Texas, when legislators instituted unprecedented requirements on abortion providers and cut public funding for contraception by two thirds. Yet, despite popular interpretations of this phenomenon as a simple byproduct of increasing partisan divisions, little is understood about the factors underlying such policy shifts. We fit Bayesian ideal-point models to analyze correlation patterns in record-vote data in the Texas House of Representatives in the 2003 and 2011 Legislatures. Both sessions had large Republican majorities and saw the passage of restrictive abortion bills, but they differed markedly with respect to public funding for contraception. We demonstrate that variation in voting on family-planning issues cannot be fully attributed to partisanship in either session. However, the politics of abortion and contraception have converged over time, and - at least for Democrats - the correlation between constituency characteristics and voting behavior on family-planning legislation is markedly higher in 2011 than in 2003. These shifts have been partly driven by legislators from high-poverty, majority Latino districts near the US-Mexico border. Recent dramatic shifts in family-planning policy go beyond simple partisan divisions. As the politics of abortion and contraception have converged, policies that are increasingly hostile to reproductive health and that disproportionately affect low-income minority women have emerged. Recent shifts in family-planning policy restrict women's access to contraception and abortion, yet little research has examined why such shifts are occurring. This paper analyzes factors underlying voting behavior on restrictive policies in Texas. Identification of these factors helps us to better understand the current political climate surrounding our field. Copyright © 2016 Elsevier Inc. All rights reserved.

Motivational interviewing with computer assistance as an intervention to empower women to make contraceptive choices while incarcerated: study protocol for randomized controlled trial.

PubMed

Clarke, Jennifer; Gold, Melanie A; Simon, Rachel E; Roberts, Mary B; Stein, Lar

2012-07-02

Unplanned pregnancies and sexually transmitted infections (STIs) are important and costly public health problems in the United States resulting from unprotected sexual intercourse. Risk factors for unplanned pregnancies and STIs (poverty, low educational attainment, homelessness, substance abuse, lack of health insurance, history of an abusive environment, and practice of commercial sex work) are especially high among women with a history of incarceration. Project CARE (Contraceptive Awareness and Reproductive Education) is designed to evaluate an innovative intervention, motivational interviewing with computer assistance (MICA), aimed at enhancing contraceptive initiation and maintenance among incarcerated women who do not want a pregnancy within the next year and who are anticipated to be released back to the community. This study aims to: (1) increase the initiation of highly effective contraceptives while incarcerated; (2) increase the continuation of highly effective contraceptive use at 3, 6, 9, and 12  months after release; and (3) decrease unsafe sexual activity. This randomized controlled trial will recruit 400 women from the Rhode Island Department of Corrections (RI DOC) women's jail at risk for an unplanned pregnancy (that is, sexually active with men and not planning/wanting to become pregnant in the next year). They will be randomized to two interventions: a control group who receive two educational videos (on contraception, STIs, and pre-conception counseling) or a treatment group who receive two sessions of personalized MICA. MICA is based on the principles of the Transtheoretical Model (TTM) and on Motivational Interviewing (MI), an empirically supported counseling technique designed to enhance readiness to change targeted behaviors. Women will be followed at 3, 6, 9, and 12  months post release and assessed for STIs, pregnancy, and reported condom use. Results from this study are expected to enhance our understanding of the efficacy of MICA to enhance contraceptive initiation and maintenance and reduce sexual risk-taking behaviors among incarcerated women who have re-entered the community. NCT01132950.

Ambivalence, communication and past use: understanding what influences women's intentions to use contraceptives.

PubMed

Campo, Shelly; Askelson, Natoshia M; Spies, Erica L; Losch, Mary

2012-01-01

Unintended pregnancy among women in the 18-30 age group is a public health concern. The Extended Parallel Process Model (EPPM) provides a framework for exploring how women's perceptions of threat, efficacy, and fear influence intentions to use contraceptives. Past use and communication with best friends and partners were also considered. A telephone survey of 18-30-year-old women (N = 599) was completed. After univariate and bivariate analyses were conducted, the variables were entered into a hierarchal, multi-variate linear regression with three steps consistent with the EPPM to predict behavioral intention. The first step included the demographic variables of relationship status and income. The constructs for the EPPM were entered into step 2. Step 3 contained the fear measure. The model for the third step was significant, F(10,471) = 36.40, p < 0.001 and the variance explained by this complete model was 0.42. Results suggest that perceived severity of the consequences of an unintended pregnancy (p < 0.01), communication with friends (p < 0.01) and last sexual partner (p < 0.05), relationship status (p < 0.01), and past use (p < 0.001) were associated with women's intentions to use contraceptives. A woman's perception of the severity was related to her intention to use contraceptives. Half of the women (50.3%) reported ambivalence about the severity of an unintended pregnancy. In our study, talking with their last sexual partner had a positive effect on intentions to use contraceptives, while talking with friends influenced intentions in a negative direction. These results reconfirm the need for public health practitioners and health care providers to consider level of ambivalence toward unintended pregnancy, communication with partner, and relationship status when trying to improve women's contraceptive behaviors. Implications for effective communication interventions are discussed.

Amygdala reactivity to negative stimuli is influenced by oral contraceptive use.

PubMed

Petersen, Nicole; Cahill, Larry

2015-09-01

The amygdala is a highly interconnected region of the brain that is critically important to emotional processing and affective networks. Previous studies have shown that the response of the amygdala to emotionally arousing stimuli can be modulated by sex hormones. Because oral contraceptive pills dramatically lower circulating sex hormone levels with potent analogs of those hormones, we performed a functional magnetic resonance imaging experiment to measure amygdala reactivity in response to emotional stimuli in women using oral contraceptives, and compared their amygdala reactivity with that of naturally cycling women. Here, we show that women who use oral contraceptive pills have significantly decreased bilateral amygdala reactivity in response to negatively valenced, emotionally arousing stimuli compared with naturally cycling women. We suggest that by modulating amygdala reactivity, oral contraceptive pills may influence behaviors that have previously been shown to be amygdala dependent-in particular, emotional memory. © The Author (2015). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

The Complexity of Multiple Contraceptive Method Use and the Anxiety That Informs It: Implications for Theory and Practice.

PubMed

Frohwirth, Lori; Blades, Nakeisha; Moore, Ann M; Wurtz, Heather

2016-11-01

Despite clinical guidelines and national data describing the use of one contraceptive method as the best and most common way to prevent unintended pregnancy, limited evidence indicates a more complex picture of actual contraceptive practice. Face-to-face in-depth interviews were conducted in November of 2013 with a sample of women from two cities in the United States (n = 52). The interviews explored the ways participants used contraception to protect themselves from unintended pregnancy over the past 12 months. Most respondents reported using multiple methods, many of which are considered to be less-effective, within this timeframe. The practice of combining methods in order to increase one's level of protection from pregnancy was prevalent, and was mainly enacted in two ways: by backing up inconsistent method use with other methods and by "buttressing" methods. These practices were found to be more common, and more complex, than previously described in the literature. These behaviors were mainly informed by a deep anxiety about both the efficacy of contraceptive methods, and about respondents' own perceived ability to prevent pregnancy. These findings challenge prevailing assumptions about women's contraceptive method use and have implications for clinical contraceptive counseling practice.

Contraceptive Method Choice Among Young Adults: Influence of Individual and Relationship Factors.

PubMed

Harvey, S Marie; Oakley, Lisa P; Washburn, Isaac; Agnew, Christopher R

2018-01-26

Because decisions related to contraceptive behavior are often made by young adults in the context of specific relationships, the relational context likely influences use of contraceptives. Data presented here are from in-person structured interviews with 536 Black, Hispanic, and White young adults from East Los Angeles, California. We collected partner-specific relational and contraceptive data on all sexual partnerships for each individual, on four occasions, over one year. Using three-level multinomial logistic regression models, we examined individual and relationship factors predictive of contraceptive use. Results indicated that both individual and relationship factors predicted contraceptive use, but factors varied by method. Participants reporting greater perceived partner exclusivity and relationship commitment were more likely to use hormonal/long-acting methods only or a less effective method/no method versus condoms only. Those with greater participation in sexual decision making were more likely to use any method over a less effective method/no method and were more likely to use condoms only or dual methods versus a hormonal/long-acting method only. In addition, for women only, those who reported greater relationship commitment were more likely to use hormonal/long-acting methods or a less effective method/no method versus a dual method. In summary, interactive relationship qualities and dynamics (commitment and sexual decision making) significantly predicted contraceptive use.

Contraceptive use at last intercourse among reproductive-aged women with disabilities: an analysis of population-based data from seven states.

PubMed

Haynes, Renee Monique; Boulet, Sheree L; Fox, Michael H; Carroll, Dianna D; Courtney-Long, Elizabeth; Warner, Lee

2018-06-01

To assess patterns of contraceptive use at last intercourse among women with physical or cognitive disabilities compared to women without disabilities. We analyzed responses to 12 reproductive health questions added by seven states to their 2013 Behavioral Risk Factor Surveillance System questionnaire. Using responses from female respondents 18-50 years of age, we performed multinomial regression to calculate estimates of contraceptive use among women at risk for unintended pregnancy by disability status and type, adjusted for age, race/ethnicity, marital status, education, health insurance status, and parity. Women with disabilities had similar rates of sexual activity as women without disabilities (90.0% vs. 90.6%, p=.76). Of 5995 reproductive-aged women at risk for unintended pregnancy, 1025 (17.1%) reported one or more disabilities. Contraceptive use at last intercourse was reported by 744 (70.1%) of women with disabilities compared with 3805 (74.3%) of those without disabilities (p=.22). Among women using contraception, women with disabilities used male or female permanent contraception more often than women without disabilities (333 [29.6%] versus 1337 [23.1%], p<.05). Moderately effective contraceptive (injection, oral contraceptive, patch, or ring) use occurred less frequently among women with cognitive (13.1%, n=89) or independent living (13.9%, n=40) disabilities compared to women without disabilities (22.2%, n=946, p<.05). The overall prevalence of sexual activity and contraceptive use was similar for women with and without physical or cognitive disabilities. Method use at last intercourse varied based on presence and type of disability, especially for use of permanent contraception. Although women with disabilities were sexually active and used contraception at similar rates as women without disabilities, contraception use varied by disability type, suggesting the importance of this factor in reproductive health decision-making among patients and providers, and the value of further research to identify reasons why this occurs. Published by Elsevier Inc.

Current hormonal contraceptive use predicts female extra-pair and dyadic sexual behavior: evidence based on Czech National Survey data.

PubMed

Klapilová, Kateřina; Cobey, Kelly D; Wells, Timothy; Roberts, S Craig; Weiss, Petr; Havlíček, Jan

2014-01-10

Data from 1155 Czech women (493 using oral contraception, 662 non-users), obtained from the Czech National Survey of Sexual Behavior, were used to investigate evolutionary-based hypotheses concerning the predictive value of current oral contraceptive (OC) use on extra-pair and dyadic (in-pair) sexual behavior of coupled women. Specifically, the aim was to determine whether current OC use was associated with lower extra-pair and higher in-pair sexual interest and behavior, because OC use suppresses cyclical shifts in mating psychology that occur in normally cycling women. Zero-inflated Poisson (ZIP) regression and negative binomial models were used to test associations between OC use and these sexual measures, controlling for other relevant predictors (e.g., age, parity, in-pair sexual satisfaction, relationship length). The overall incidence of having had an extra-pair partner or one-night stand in the previous year was not related to current OC use (the majority of the sample had not). However, among the women who had engaged in extra-pair sexual behavior, OC users had fewer one-night stands than non-users, and tended to have fewer partners, than non-users. OC users also had more frequent dyadic intercourse than non-users, potentially indicating higher commitment to their current relationship. These results suggest that suppression of fertility through OC use may alter important aspects of female sexual behavior, with potential implications for relationship functioning and stability.

The Impact of Female Schooling on Fertility and Contraceptive Use: A Study of Fourteen Sub-Saharan Countries. Living Standards Measurement Study Working Paper No. 110.

ERIC Educational Resources Information Center

Ainsworth, Martha; And Others

This paper examines the relationship between female schooling and two behaviors--cumulative fertility and contraceptive use--in 14 Sub-Saharan African countries where Demographic and Health Surveys (DHS) have been conducted since the mid-1980s. Using multivariate regression analysis, the paper compares the effect of schooling across countries, in…

Adolescent and Young Women's Contraceptive Decision-Making Processes: Choosing "The Best Method for Her".

PubMed

Melo, Juliana; Peters, Marissa; Teal, Stephanie; Guiahi, Maryam

2015-08-01

To evaluate influences on adolescent and young women's contraceptive decision-making processes. We conducted 21 individual interviews with women who presented to an adolescent-focused Title X family planning clinic seeking a new contraceptive method. Data were collected using a semi-structured interview guide, audio-taped and transcribed. Three researchers independently coded the transcripts using grounded theory; codes were organized into overarching themes and discrepancies were resolved. After identification of themes, we organized the conceptual framework of the decision-making process using the transtheoretical model of behavior change in which participants move through 4 stages: (1) contemplation, (2) preparation, (3) action, and (4) maintenance. When contemplating contraception, most of our participants were highly motivated to avoid pregnancy. During preparation, participants gathered information related to their contraceptive concerns. Participants cited peers as primary informants and healthcare providers as experts in the field. Participants integrated information received with their personal concerns about contraception initiation; the most common concerns were effectiveness, method duration, convenience, and side effects. When participants acted on choosing a contraceptive method they described how it fit their individual needs. They considered their contraceptive experiences unique and not necessarily applicable to others. During maintenance, they acted as informants for other peers, but most commonly expressed that each individual must choose "the best method for her." When adolescent and young women select a contraceptive method they balance the benefits and risks of available methods portrayed by peers and provider in the context of their personal concerns. Peer influence appeared to be greatest when participants shared contraceptive concerns and goals. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Factors influencing the contraceptive method choice: a university hospital experience

PubMed Central

Kahraman, Korhan; Göç, Göksu; Taşkın, Salih; Haznedar, Pınar; Karagözlü, Selen; Kale, Burak; Kurtipek, Zeynep; Özmen, Batuhan

2012-01-01

Objective To analyze the factors influencing behavior of women in choosing contraceptive methods. Material and Methods A total of 4022 women who were admitted to our clinic in a year, were the subjects in this current study for contraception choices. Relationship between the current contraceptive choice and the age, marital status, educational level, gravidity and induced abortions were evaluated. Results Current users of any contraceptive methods were found to make up thirty-three percent of the entire study population. The most preferred method of contraception was an intrauterine device (46.4%), followed by, condom (19.2%), coitus interruptus (16.4%), tubal sterilization (11%), oral contraceptives (5.7%) and lastly the “other methods” that consisted of depot injectables and implants (1.2%). Among other contraceptive methods, the condom was found to be used mostly by the younger age group (OR:0.956, 95% CI:0.936–0.976, p<0.001), while tubal sterilization was preferred mainly by the elderly population (p<0.001, OR:1.091, 95% CI:1.062–1.122). Women that have a higher educational level, were found to use OC (76.3%, OR:5.970, 95% CI:3.233–11.022), tubal sterilization (59.6%, OR:4.110, 95% CI:2.694–6.271) and other methods (62.5%, OR:3.279, 95% CI:1.033–10.402) more commonly than the low educational group (p<0.001). Conclusion These results demonstrated that the rates of both contraception utilization and the usage of more effective methods of contraception need to be increased by providing better family planning systems and counselling opportunities. PMID:24592017

Facts of life for adults.

PubMed

Paxman, J M

1991-04-01

The editorial commentary reflects the desire for openness in providing contraceptive services for adolescents, rather than pretending that the emperor has new clothes. The simile is used to expose the coverup intended by adults who desire adolescent sexual behavior that does not exist. Examples of 4 European countries, (Sweden, Netherlands, France, and England and Wales) who support contraceptive use for teenagers are given. Lessons can be learned from these countries which have a 3 times lower teenage pregnancy rate than the US. In the Netherlands contraceptives are used by 90% of sexually active teenagers. The birth rate of 14/1000 and the abortion rate of 10/1000 is the lowest of the 4 countries. Swedish contraceptive, birth, and abortion rates are similar, but the age of the 1st sexual experience is the earliest. England and Wales has a similar contraception rate but the birth rate is also 45/1000 and the abortion rate is slightly higher. All countries provide teenage contraceptive services free or at low cost as well as sex education. The debate over contraception in other countries links access to sexual activity, when the facts of life are that teenagers become sexually active before contraception. In Sweden to curb abortions, contraception was increased between 1974-1981 with a concomitant decline of 27% in the abortion rate. In the US, it rose 59%. The experience of all 4 countries has been to reduce abortion, but still provide access to abortion services. The formula for successful management of teenage sexuality such as sex education, low cost contraceptive services, and access to early safe abortion services may not meet the needs of the AIDS pandemic. Many questions arise and Europe may provide the answers.

Contraception and Unintended Pregnancy among Unmarried Female University Students: A Cross-sectional Study from China.

PubMed

Wang, Hongjing; Long, Lu; Cai, Hui; Wu, Yue; Xu, Jing; Shu, Chang; Wang, Peng; Li, Bo; Wei, Qinyu; Shang, Xuejun; Wang, Xueyi; Zhang, Meimei; Xiong, Chengliang; Yin, Ping

2015-01-01

This study aims to understand the level of contraceptive knowledge and attitudes towards contraception, and then to explore the association between the contraceptive behavior and unintended pregnancy in unmarried female university students in China. A cross-sectional study was conducted of university students in 49 universities across 7 cities in China from September 2007 to January 2008. We distributed 74,800 questionnaires, of which 69,842 were returned. In this paper, the data from 35,383 unmarried female university students were analyzed. The prevalence of sexual intercourse in unmarried female university students was 10.2%. The prevalence of unintended pregnancy in those sexually active female university students, was 31.8%. Among students with pregnancy, 53.5% experienced two or more pregnancies. 28.3% of the students with sexual intercourse reported that they always adopted contraceptive methods, and of those 82.9% chose to use male condoms. The majority (83.9%) of students with unintended pregnancy chose to terminate the latest pregnancy by surgical abortion or medical abortion. The contraceptive knowledge level of students who experienced unintended pregnancy was lower than those who did not. In China, about one third of unmarried female students with sexual intercourse experience unintended pregnancy. A variety of contraceptive methods are adopted, but the frequency of contraceptive use is low. Most of unmarried female students who experienced unintended pregnancy would choose to terminate the pregnancy with surgical or medical abortion. University students, especially the ones who have experienced unintended pregnancy, lack contraceptive and reproductive health knowledge.

Contraceptive use among clients of the Atlanta Feminist Women's Health Center at three to five weeks post-abortion.

PubMed

Moslin, Trisha A; Rochat, Roger W

2011-08-01

Little is known about women's contraceptive use and sexual activity in the immediate post-abortion period although effective contraceptive use is paramount during this time because fertility returns almost immediately. This study sought to learn more about women's contraceptive use and sexual behaviors to inform abortion providers and help them serve their clients better, potentially leading to a decline in the rates of unintended pregnancy and repeat abortion. Abortion clients of an Atlanta, GA clinic were surveyed over the telephone 3-5 weeks post-abortion. Background information was collected from clinic medical charts. Simple and stratified frequencies and logistic regression were used to describe women's sexual activity and contraceptive use in the immediate post-abortion period and to determine if variables known at the time of the abortion could predict contraceptive use 3-5 weeks post-abortion. 54.2% (n = 39) of women had engaged in sexual intercourse in the immediate post-abortion period. Of these, 30.8% (n = 12) were not using a contraceptive method or were not using it effectively. Women who said they did not want or need information about birth control on their medical history form were less likely to be using contraception 3-5 weeks post abortion. Emphasizing the rapid return of fertility and risk of conception in pre-abortion counseling sessions could prevent future unintended pregnancies among abortion clients. Further research could explore the interaction between a willingness to talk about contraceptive methods at the time of abortion and method use post-abortion.

Contraception and Unintended Pregnancy among Unmarried Female University Students: A Cross-sectional Study from China

PubMed Central

Wang, Hongjing; Long, Lu; Cai, Hui; Wu, Yue; Xu, Jing; Shu, Chang; Wang, Peng; Li, Bo; Wei, Qinyu; Shang, Xuejun; Wang, Xueyi; Zhang, Meimei; Xiong, Chengliang; Yin, Ping

2015-01-01

This study aims to understand the level of contraceptive knowledge and attitudes towards contraception, and then to explore the association between the contraceptive behavior and unintended pregnancy in unmarried female university students in China. A cross-sectional study was conducted of university students in 49 universities across 7 cities in China from September 2007 to January 2008. We distributed 74,800 questionnaires, of which 69,842 were returned. In this paper, the data from 35,383 unmarried female university students were analyzed. The prevalence of sexual intercourse in unmarried female university students was 10.2%. The prevalence of unintended pregnancy in those sexually active female university students, was 31.8%. Among students with pregnancy, 53.5% experienced two or more pregnancies. 28.3% of the students with sexual intercourse reported that they always adopted contraceptive methods, and of those 82.9% chose to use male condoms. The majority (83.9%) of students with unintended pregnancy chose to terminate the latest pregnancy by surgical abortion or medical abortion. The contraceptive knowledge level of students who experienced unintended pregnancy was lower than those who did not. In China, about one third of unmarried female students with sexual intercourse experience unintended pregnancy. A variety of contraceptive methods are adopted, but the frequency of contraceptive use is low. Most of unmarried female students who experienced unintended pregnancy would choose to terminate the pregnancy with surgical or medical abortion. University students, especially the ones who have experienced unintended pregnancy, lack contraceptive and reproductive health knowledge. PMID:26091505

Beyond Denomination: The Relationship between Religion and Family Planning in Rural Malawi

PubMed Central

Yeatman, Sara E.; Trinitapoli, Jenny

2010-01-01

Despite the centrality of religion and fertility to life in rural Africa, the relationship between the two remains poorly understood. The study presented here uses unique integrated individual and congregational level data from rural Malawi to examine religious influences on contraceptive use. In this religiously diverse population, we find evidence that the particular characteristics of a congregation—leader’s positive attitudes toward family planning and discussion of sexual morality, which do not fall along broad denominational lines—are more relevant than denominational categories for predicting women’s contraceptive use. We further find evidence for a relationship between religious socialization and contraceptive behavior. PMID:20463916

Contraceptive effect and potential side-effects of deslorelin acetate implants in rats (Rattus norvegicus): Preliminary observations

PubMed Central

Grosset, Claire; Peters, Stijn; Peron, Franck; Figuéra, Joëlle; Navarro, Christelle

2012-01-01

During the last ten years, numerous species have been treated with deslorelin implants to induce contraception. The aims of the study were 1) to assess contraceptive efficacy of 4.7 mg subcutaneous deslorelin implants in rats, 2) to determine the latency of contraceptive effect, and 3) to determine potential side effects. Three experimental females were implanted and their estrous cycle was studied by vaginal smear. Two weeks after implantation, a male whose fertility was previously assessed with a control female, was introduced into their cage. No female conceived during the 4 mo following implantation. Additionally, 38 pet rats were recruited from clients in practice to test for potential side effects, including 6 males and 32 females with a mean age of 14 mo. Local reaction and transient weight gain during the first 2 wk, as well as behavioral changes were recorded. According to this pilot study, deslorelin implant could be used as a contraceptive method in female rats. The latency period is about 2 wk. Nevertheless, it might be possible to refine the treatment further using hormonal measurements. The duration of contraceptive effect is to be determined in an upcoming study. PMID:23277700

Microcredit, family planning programs, and contraceptive behavior: evidence from a field experiment in Ethiopia.

PubMed

Desai, Jaikishan; Tarozzi, Alessandro

2011-05-01

The impact of community-based family planning programs and access to credit on contraceptive use, fertility, and family size preferences has not been established conclusively in the literature. We provide additional evidence on the possible effect of such programs by describing the results of a randomized field experiment whose main purpose was to increase the use of contraceptive methods in rural areas of Ethiopia. In the experiment, administrative areas were randomly allocated to one of three intervention groups or to a fourth control group. In the first intervention group, both credit and family planning services were provided and the credit officers also provided information on family planning. Only credit or family planning services, but not both, were provided in the other two intervention groups, while areas in the control group received neither type of service. Using pre- and post-intervention surveys, we find that neither type of program, combined or in isolation, led to an increase in contraceptive use that is significantly greater than that observed in the control group. We conjecture that the lack of impact has much to do with the mismatch between women's preferred contraceptive method (injectibles) and the contraceptives provided by community-based agents (pills and condoms).

Son Preference and Family Limitation in Pakistan: A Parity- and Contraceptive Method-Specific Analysis.

PubMed

Channon, Melanie Dawn

2017-09-01

Son preference exerts a strong influence over contraceptive and fertility decisions in many South Asian countries. In Pakistan, where fertility remains high and contraceptive use low, research on son preference has been limited. Data from Pakistan Demographic and Health Surveys conducted in 1990-1991, 2006-2007 and 2012-2013 were used to examine potential indicators and outcomes of son preference. Descriptive analyses looked at sex composition preferences of men and women, as well as the sex ratio at last birth. Multivariate logistic regression analyses examined parity progression by birth order, while multinomial logistic regression was used to identify associations between sex composition and use of permanent, temporary and traditional contraceptive methods. Parity progression and choice of contraceptive method are increasingly associated with the sex composition of children. Many respondents wanted at least two sons, though most also wanted at least one daughter. Analyses suggest that the prevalence of modern contraceptive use among parous women would have been 19% higher in 2012-2013 in the absence of son preference. Permanent method use was extremely low among women with no sons and increased significantly with number of sons. The association between number of sons and use of temporary methods was weaker, while son preference had little relationship with traditional method use. The association of son preference with parity progression and modern contraceptive use has become stronger in Pakistan. Continuation of the fertility transition may be difficult unless the degrees of differential stopping behavior and differential contraceptive use decline.

[Sexual behavior and emergency contraception among adolescents from public schools in Pernambuco State, Brazil].

PubMed

Araújo, Maria Suely Peixoto de; Costa, Laura Olinda Bregieiro Fernandes

2009-03-01

This study focused on knowledge and use of emergency contraception among 4,210 adolescents (14-19 years) enrolled in public schools in Pernambuco State, Brazil. Information was collected using the Global School-Based Student Health Survey, previously validated. Knowledge, frequency, and form of use of emergency contraception were investigated. Independent variables were classified as socio-demographic and those related to sexual behavior. Most adolescents reported knowing and having received information about the method, but among those who had already used it, only 22.1% had done so correctly. Adjusted regression analysis showed greater likelihood of knowledge about the method among girls (OR = 5.03; 95%CI: 1.72-14.69) and the sexually initiated (OR = 1.52; 95%CI: 1.34-1.75), while rural residents were 68% less knowledgeable. Rural residents showed 1.68 times higher odds (CI95%: 1.09-2.25) of incorrect use, while girls showed 71% lower likelihood of incorrect use. Sexual and reproductive education is necessary, especially among male and rural adolescents.

Parent-adolescent sexual communication and its association with adolescent sexual behaviors: a nationally representative analysis in the Netherlands.

PubMed

de Looze, Margaretha; Constantine, Norman A; Jerman, Petra; Vermeulen-Smit, Evelien; ter Bogt, Tom

2015-01-01

Sexual communication is a principal means of transmitting sexual values, beliefs, expectations, and knowledge from parents to children. Although this area has received considerable research attention, more studies with representative samples are needed to assure that findings are reflective of populations of interest. A nationally representative sample of parent-adolescent dyads (N = 2,965; mean adolescent age = 13.8 years) in the Netherlands was employed to examine the frequency of parent-adolescent sexual communication and its association with adolescent sexual behaviors (defined as sexual initiation, condom use, and contraceptive pill use). Nine communication topics in the areas of anatomy, relationships and rights, and protection and contraception were examined. In all, 75%of parents reported having discussed at least one topic multiple times with their adolescents. Romantic relationships were discussed most frequently. Hierarchical logistic regression analyses indicated that parent-adolescent sexual communication on protection and contraception was positively associated with adolescent sexual initiation and contraceptive pill use but not condom use. This may reflect that adolescents, when they become sexually active, are more likely to discuss sexuality with their parents. Findings are interpreted within the context of Dutch culture, which is generally accepting of adolescent sexuality and characterized by open sexual communication.

Women's Limited Choice and Availability of Modern Contraception at Retail Outlets and Public-Sector Facilities in Luanda, Angola, 2012-2015.

PubMed

Nieto-Andrade, Benjamin; Fidel, Eva; Simmons, Rebecca; Sievers, Dana; Fedorova, Anya; Bell, Suzanne; Weidert, Karen; Prata, Ndola

2017-03-24

In Angola, many women want to use family planning but lack access to affordable and preferred methods. This article assesses the link between women's choice and availability of contraceptive methods in Luanda, Angola, drawing on data from 3 surveys: a 2012 survey among women ages 15-49 and 2 retail surveys conducted in 2014 and 2015 among outlets and facilities offering contraceptive methods. Descriptive statistics for women's contraceptive knowledge, use, and preferred methods were stratified by age group. We report the percentage of establishments offering different methods and brands of modern contraception, and the mean price, volume of units sold, and value (Angolan Kwanzas) for each brand. Data from the 2 retail surveys are compared to measure changes in availability over time. Results show that 51% of women reported having an unwanted pregnancy. Less than 40% of women knew about long-acting reversible contraceptives (LARCs). Overall, the method most commonly used was male condoms (32.1%), with a substantial proportion (17.3%) of women not using their preferred contraceptive. Trends in contraceptive use mirror availability: in 2015, condoms were available in 73.6% of outlets/facilities, while LARC methods were available in less than 10%. The availability of different methods also dropped significantly between 2014 and 2015-by up to 15 percentage points-with a subsequent price increase in many brands. To meet women's needs for contraception and make informed choice possible, Angola should reinforce demand creation and contraceptive supply in both the public and private sectors through behavior change programs aimed at both women and providers, improved quality of services, training of health personnel on method options and delivery, and improved supply chain distribution of contraceptives. This will allow women to find the methods and brands that best suit their needs, preferences, and ability to pay. © Nieto-Andrade et al.

Women's Limited Choice and Availability of Modern Contraception at Retail Outlets and Public-Sector Facilities in Luanda, Angola, 2012–2015

PubMed Central

Nieto-Andrade, Benjamin; Fidel, Eva; Simmons, Rebecca; Sievers, Dana; Fedorova, Anya; Bell, Suzanne; Weidert, Karen; Prata, Ndola

2017-01-01

ABSTRACT In Angola, many women want to use family planning but lack access to affordable and preferred methods. This article assesses the link between women's choice and availability of contraceptive methods in Luanda, Angola, drawing on data from 3 surveys: a 2012 survey among women ages 15–49 and 2 retail surveys conducted in 2014 and 2015 among outlets and facilities offering contraceptive methods. Descriptive statistics for women's contraceptive knowledge, use, and preferred methods were stratified by age group. We report the percentage of establishments offering different methods and brands of modern contraception, and the mean price, volume of units sold, and value (Angolan Kwanzas) for each brand. Data from the 2 retail surveys are compared to measure changes in availability over time. Results show that 51% of women reported having an unwanted pregnancy. Less than 40% of women knew about long-acting reversible contraceptives (LARCs). Overall, the method most commonly used was male condoms (32.1%), with a substantial proportion (17.3%) of women not using their preferred contraceptive. Trends in contraceptive use mirror availability: in 2015, condoms were available in 73.6% of outlets/facilities, while LARC methods were available in less than 10%. The availability of different methods also dropped significantly between 2014 and 2015—by up to 15 percentage points—with a subsequent price increase in many brands. To meet women's needs for contraception and make informed choice possible, Angola should reinforce demand creation and contraceptive supply in both the public and private sectors through behavior change programs aimed at both women and providers, improved quality of services, training of health personnel on method options and delivery, and improved supply chain distribution of contraceptives. This will allow women to find the methods and brands that best suit their needs, preferences, and ability to pay. PMID:28193721

[Contraceptive use among adolescents at public schools in Brazil].

PubMed

de Almeida, Maria da Conceição Chagas; de Aquino, Estela Maria Leão; Gaffikin, Lynne; Magnani, Robert J

2003-10-01

There has been a growing interest in patterns of contraceptive use among adolescents, due, in particular, to the social relevance attached to pregnancy in this age group. Therefore, the objective of the study was to investigate factors associated with the use of contraceptive methods among female and male adolescent students. A cross-sectional study was conducted, by means of self-applied questionnaires, among 4,774 students ranging from 11 to 19 years of age. Prevalence with respect to the use of contraceptive methods during the first experience of sexual intercourse as well as the most recent one was calculated both separately, that is, for each of these events, and in conjunction as a measure of consistent use. Logistic regression was carried out for simultaneous analysis of factors associated with the use of contraceptive methods and in order to calculate adjusted measures. Among the 1,664 students who reported being sexually active, the factors positively associated with the consistent use of contraceptive methods among male students included a) postponing their first experience of sexual intercourse and interaction with a stable partner, b) the family as a potential supplier of contraceptive methods, and c) access to health services. On the other hand, among female students factors positively associated with the consistent use of contraceptive methods included a) recent sexual initiation, and b) having a father as their source of information regarding sexuality, contraception and STD/AIDS prevention. Pregnancy was reported by 6.4% of the boys and 18.1% of the girls, its absence was associated with the consistent use of contraceptives by them (the girls) (Odds Ratio=3.83; 2.06-7.15). The results confirm the complexity of determining contraceptive behavior among adolescents and therefore reinforce the need to include multi-dimensional aspects of this theme in order to ensure the efficacy of sex education programs.

Intentions to use contraceptives in Pakistan: implications for behavior change campaigns

PubMed Central

2010-01-01

Background Since 1990-91, traditional method use has increased at a faster rate in Pakistan than modern method use. The importance of hormonal methods or the IUD has diminished and that of traditional methods has increased in the method mix. There is a need to identify factors motivating and deterring the adoption of specific family planning methods among married men and women in Pakistan. Methods In addition to social and demographic characteristics of respondents, a representative household survey collected information on psychological correlates of family planning behavior from 1,788 non-pregnant wives and 1,805 husbands with not-pregnant wives. Males and females were from separate households. Principal components analysis was conducted to identify the underlying constructs that were important for each gender. Multinomial logistic regression analysis was conducted to determine the correlates of male and female intentions to use contraceptive methods. Results Amongst women, the perception that her in-laws support family planning use was the strongest determinant of her intentions to use contraceptive methods. A woman's belief in the importance of spacing children and her perception that a choice of methods and facilities with competent staff were available were also powerful drivers of her intentions to use contraceptive methods. The strongest obstacle to a woman's forming an intention to use contraceptive methods was her belief that family planning decisions were made by the husband and fertility was determined by God's will. Fears that family planning would harm a woman's womb lowered a woman's intentions to use methods requiring procedures, such as the IUD and female sterilization. The perception that a responsible, caring, husband uses family planning to improve the standard of living of his family and to protect his wife's health was the most important determinant of a man's intention to use condoms. A husband's lack of self-efficacy in being able to discuss family planning with his wife was the strongest driver of the intention to use withdrawal. A man's fear that contraceptives would make a woman sterile and harm her womb lowered his intention to use modern contraceptive methods. Conclusions These findings highlight the importance of having secondary target audiences such as mothers-in-law and husbands in family planning behavior change campaigns implemented in Pakistan. Campaigns that stress the importance of child spacing are likely to have an impact. Client perceptions of the quality of care are important determinants of intentions to use contraceptive methods in Pakistan. Client concerns that the IUD and sterilization procedures might harm a woman's womb and cause sterility should be addressed. The findings suggest that there is a need to assess the actual quality of service delivery in Pakistan. PMID:20673374

Bundles of Norms About Teen Sex and Pregnancy.

PubMed

Mollborn, Stefanie; Sennott, Christie

2015-09-01

Teen pregnancy is a cultural battleground in struggles over morality, education, and family. At its heart are norms about teen sex, contraception, pregnancy, and abortion. Analyzing 57 interviews with college students, we found that "bundles" of related norms shaped the messages teens hear. Teens did not think their communities encouraged teen sex or pregnancy, but normative messages differed greatly, with either moral or practical rationalizations. Teens readily identified multiple norms intended to regulate teen sex, contraception, abortion, childbearing, and the sanctioning of teen parents. Beyond influencing teens' behavior, norms shaped teenagers' public portrayals and post hoc justifications of their behavior. Although norm bundles are complex to measure, participants could summarize them succinctly. These bundles and their conflicting behavioral prescriptions create space for human agency in negotiating normative pressures. The norm bundles concept has implications for teen pregnancy prevention policies and can help revitalize social norms for understanding health behaviors. © The Author(s) 2014.

Using the theory of reasoned action to explain physician intention to prescribe emergency contraception.

PubMed

Sable, Marjorie R; Schwartz, Lisa R; Kelly, Patricia J; Lisbon, Eleanor; Hall, Matthew A

2006-03-01

Although research has examined providers' knowledge, attitudes and prescribing behaviors with regard to emergency contraception, none has used a theory-based approach to understanding the interplay of these factors. A cross-sectional survey of 96 faculty physicians from one Southern and three Midwestern universities was conducted in 2004 to assess factors associated with intention to prescribe emergency contraception. The theory of reasoned action guided the study hypotheses and survey design. Correlation and regression analyses were used to examine the data. Only 42% of respondents strongly intended to prescribe emergency contraception for teenagers, but 65-77% intended to do so for all other specified groups (women who ask for the method, who have had a method problem, who have experienced rape or incest, and who have had unprotected sex). Consistent with the theory of reasoned action, high intention to prescribe emergency contraception was associated with positive attitudes toward doing so and with the perception that specific colleagues or professional groups support prescribing it; however, the perception of support by colleagues or professional groups in general did not predict intention. Also consistent with the theory, physicians' knowledge about emergency contraception and their demographic characteristics were not significant. Interventions to encourage physicians to provide emergency contraception should take into account their attitudes toward the method and the components of those attitudes.

Norms and stigma around unintended pregnancy in Alabama: Associations with recent contraceptive use and dual method use among young women.

PubMed

Rice, Whitney S; Turan, Bulent; White, Kari; Turan, Janet M

2017-12-14

The role of unintended pregnancy norms and stigma in contraceptive use among young women is understudied. This study investigated relationships between anticipated reactions from others, perceived stigma, and endorsed stigma concerning unintended pregnancy, with any and dual contraceptive use in this population. From November 2014 to October 2015, young women aged 18-24 years (n = 390) and at risk for unintended pregnancy and sexually transmitted infections participated in a survey at a university and public health clinics in Alabama. Multivariable regression models examined associations of unintended pregnancy norms and stigma with contraceptive use, adjusted for demographic and psychosocial characteristics. Compared to nonusers, more any and dual method users, were White, nulliparous, and from the university and had higher income. In adjusted models, anticipated disapproval of unintended pregnancy by close others was associated with greater contraceptive use (adjusted Odds Ratio [aOR] = 1.54, 95 percent confidence interval [CI] = 1.03-2.30), and endorsement of stigma concerning unintended pregnancy was associated with lower odds of dual method use (aOR = 0.71, 95 percent CI = 0.51-1.00). Unintended pregnancy norms and stigma were associated with contraceptive behavior among young women in Alabama. Findings suggest the potential to promote effective contraceptive use in this population by leveraging close relationships and addressing endorsed stigma.

Adolescent reproductive behavior: an international comparison of developed countries.

PubMed

Forrest, J D

1990-01-01

A comparative study of adolescent reproductive behavior in the 1980s examined difference in pregnancy, birth, and abortion levels among teenagers in developed countries especially in the US, Canada, the UK, France, the Netherlands, and Sweden. Only 6 of 37 countries with total fertility rates 3.5 and per capita income US$2000/year, and at least 1 million people had adolescent birth rates higher than the US (Bulgaria, Cuba, Puerto Rico, Romania, Hungary, and Chile). The US had the highest abortion rate (42/1000) followed by Hungary (27/1000). Thus the US had the highest adolescent pregnancy rate (96/1000) as well as Hungary (96/1000). The 6 country analysis showed that reducing the level of sexual activity among teenagers is not necessarily needed to achieve lower pregnancy rates. For example, Sweden had the highest levels of sexual activity but its pregnancy rate were 33% as high as those of the US. The rates of sexual activity among teenagers in the Netherlands equaled those of the US, but its pregnancy rates were 14% as high as those of the US. All countries had earlier, more extensive, and better contraceptive use among sexually active teenagers than the US which accounted for their lower pregnancy rates. The more realistic acceptance of sexual activity among teenagers and provision of contraceptives in all the countries except the US differed from the societal ambivalence in the US. Thus ambivalence about sexuality and the appropriateness of contraceptive use results in lower contraceptive use and greater adolescent pregnancy rates. US adolescents constantly receive conflicting messages that sex is romantic, thrilling, and arousing but it is also immoral to have premarital sex. Thus adults need to be more candid about sexuality so they can clearly convey to adolescents their expectations for responsible behavior and to provide the information and services needed to make effective use of contraceptives when sexually active.

Experiencing sexuality in youth living in Greece: contraceptive practices, risk taking, and psychosocial status.

PubMed

Tsitsika, Artemis; Andrie, Elisabeth; Deligeoroglou, Efthymios; Tzavara, Chara; Sakou, Irene; Greydanus, Donald; Papaevangelou, Vassiliki; Tsolia, Mariza; Creatsas, George; Bakoula, Chryssa

2014-08-01

To assess initiation of sexual activity and contraception methods used among Greek adolescents. To determine the association of adolescents' emotional and behavioral status with their sexual activity. A descriptive cross-sectional survey was conducted. The population (N = 1074, age 14-16) consisted of a random sample, stratified according to locality and population density, of 20 public junior high and high schools located in the urban district of Athens, Greece. Anonymous self-reported questionnaires were used to assess sexual activity choices and contraception methods. The Youth Self-Report questionnaire was used to evaluate the psychosocial competencies and difficulties of Greek adolescents. Analyses included frequencies with chi-square tests and multivariate logistic regression analysis. Factors that may influence sexual engagement of Greek adolescents were assessed. Of the adolescents who completed the questionnaire 21.8% reported having experienced sexual intercourse. The male/female ratio was 3/1 (P < .001) and the mean age of sexual debut was 14.5 ± 0.9 years. Condoms were the most preferred contraceptive method (79.9%), followed by withdrawal (38.9%). Emergency contraception was used by 9.6% of participants. Adolescents with separated, divorced or with a deceased parent, and non-Greek nationality have higher possibility of being sexually active. Adolescents who reported sexual intercourse had significantly higher score of thought problems (β = 1.07, SE = 0.35, P = .002), attention difficulties (β = 0.67, SE = 0.29, P = .022), delinquent behavior problems (β = 2.37, SE = 0.34, P < .001), aggressive behavior (β = 1.97, SE = 0.48, P < .001), and externalizing problems (β = 4.18, SE = 0.78, P < .001). Engagement in sexual activities was significantly associated with psychosocial difficulties among adolescents living in Greece. Copyright © 2014. Published by Elsevier Inc.

Abnormal Papanicolaou smears, genital tract infections, and contraception.

PubMed

Hawkins, J W; Matteson, P S; Mersha, G

1999-01-01

Cervical cancer ranks second among all cancers in women world-wide, and the rate of invasive cervical cancer among women under 50 is rising in the United States. Risk factors for abnormal Papanicolaou (Pap) smears and invasive cervical cancer include genital tract infections. This study was designed to compare the rates of genital tract infections and the contraceptive choices of a random sample of 800 women, using an ex post facto design. The Pap positive women had a significantly higher rate of genital tract infections than did the Pap negative women but did not differ significantly in use of contraceptive methods. Findings support those of other researchers suggesting genital tract infections as risk factors for abnormal Pap smears and are consistent with the literature in suggesting a role for oral contraceptive pills (OCPs) in acquisition of the human papillomavirus (HPV). Caregivers can help empower women to reduce their risks through informed choices about protection and sexual behaviors.

Predictors of men's acceptance of modern contraceptive practice: study in rural Vietnam.

PubMed

Ha, Bui Thi Thu; Jayasuriya, Rohan; Owen, Neville

2005-12-01

Studies have shown family planning adoption is likely to be more effective for women when men are actively involved. The transtheoretical model of behavior change was used to examine men's involvement in general contraception and intrauterine device (IUD) use by their wives. The study was carried out in rural Vietnam with 651 eligible participants. Cons of IUD use for men in precontemplation and contemplation/preparation were significantly higher than those in the action/maintenance stages, whereas the reverse was true for pros of IUD. The self-efficacy for convincing wife to have IUD in precontemplation was significantly lower than for those in higher stages. Women's education and ages, spontaneous recall of modern contraceptive method, cons for IUD, and self-efficacy for contraception and for convincing wives to get IUD inserted (or continue use) were significant predictors of men's readiness to accept IUD. Interventions are targeted to reduce cons and increase self-efficacy for IUD use.

Myths about oral contraceptives. Does OC availability result in increased sexual activity among teens?

PubMed

Chaney

1993-11-01

Parents, educators, public health officials, health-care providers, religious organizations, and advocacy groups are very concerned about the rise in teenage pregnancy and the increase in sexually transmitted diseases among the young. Some say the increased availability and acceptance of oral contraceptives is directly related to an increase in sexual activity among teens. Less than 50% of women use a contraceptive method at first intercourse. Use is much lower in Hispanic and African-American women than among White women; women with low socioeconomic status, living in one-parent households, or having sex at an early age are the least likely to use a contraceptive method at first intercourse. According to the National Survey of Family Growth, teens engaging in sexual intercourse for the first time, who use a contraceptive method, typically choose the condom. Oral contraceptive use is very low and use at first intercourse has not increased over time. It is only after the establishment of routine sexual intercourse that the pill becomes the preferred method. The use of a condom has more than doubled for the period from 1982 to 1988. Adolescents under age 16 are at greatest risk for unintended pregnancies because this group is the least likely to use any method of contraception. The increase in teen sexual activity over the years does not coincide with an increase in pill use. Education must begin in elementary schools, stressing abstinence, but also include facts about sex, contraception, and disease prevention, because 40% of teens are sexually active by 9th grade. Skills can focus on changing behavior, such as learning to delay intercourse, building self-esteem as well as proper use of contraceptives. Easy, nonthreatening access to medical care can prevent many unintended pregnancies and the spread of sexually transmitted diseases.

Social Media Use and Sexual Risk Reduction Behavior Among Minority Youth: Seeking Safe Sex Information.

PubMed

Stevens, Robin; Gilliard-Matthews, Stacia; Dunaev, Jamie; Todhunter-Reid, Abigail; Brawner, Bridgette; Stewart, Jennifer

Sexual health is an important area of study-particularly for minority youth and youth living in disadvantaged neighborhoods. The purpose of the research was to examine the sources of sexual health information associated with youth adopting sexual risk reduction behaviors. Data collection took place in a small city in the Northeastern United States using cross-sectional behavioral surveys and modified venue-based sampling. Participants included 249 African American and Latino youth aged 13-24. Participants reported their sources of information about contraception and human immunodeficiency virus/sexually transmitted disease, such as TV/movies, parents, social media; their intentions to have sex; and condom and contraception use during their last sexual activity. Social media use, past pregnancy experience, past sexual history, age, and gender were also measured. Standard tests of bivariate association (chi-square and F tests) were used to examine initial associations between sexual risk reduction behavior and exposure to sexual risk reduction information on social media. Logistic regression models were used to test multivariate relationships between information sources and sexual risk reduction behavior. Youth who were exposed to sexual health messages on social media were 2.69 times (p < .05) and 2.49 times (p < .08) more likely to have used contraception or a condom at last intercourse, respectively. Parents, schools, or traditional media as information sources were not significantly associated with contractive use or condom use at last intercourse. Youth sexual behavior is increasingly informed by social media messages. Health practitioners should utilize social media as an important health promotion tool.

The Relation of Gender-Role Orientation to Sexual Experience among College Students.

ERIC Educational Resources Information Center

Whitley, Bernard E., Jr.

1988-01-01

Examines the relations of gender role self concept, behavior, and sexual attitudes to sexual experience, reasons for intercourse, and contraceptive behavior. Finds that gender is strongly related to all three aspects of sexual behavior for a group of 185 female and 163 male college students. (FMW)

Psychological Aspects of Contraception, Unintended Pregnancy, and Abortion.

PubMed

Steinberg, Julia R; Rubin, Lisa R

2014-10-01

The knowledge of important biopsychosocial factors linking women's reproductive health and mental health is increasing. This review focuses on psychological aspects of contraception, unintended pregnancy, and abortion because these are common reproductive health experiences in U.S. women's lives. This review addresses the mental-health antecedents and consequences of these experiences, mostly focusing on depression and depressive symptoms before and after unintended pregnancy and contraception. As mental-health antecedents, depressive symptoms predict contraceptive behaviors that lead to unintended pregnancy, and mental-health disorders have been associated with having subsequent abortions. In examining the mental-health consequences, most sound research does not find abortion or contraceptive use to cause mental-health problems. Consequently, evidence does not support policies based on the notion that abortion harms women's mental health. Nevertheless, the abortion-care setting may be a place to integrate mental-health services. In contrast, women who have births resulting from unintended pregnancies may be at higher risk of postpartum depression. Social policies (e.g., paid maternity leave, subsidized child care) may protect women from mental-health problems and stress of unplanned children interrupting employment, education, and pre-existing family care responsibilities.

Premarital sexual activity and contraceptive use in Santiago, Chile.

PubMed

Herold, J M; Valenzuela, M S; Morris, L

1992-01-01

The Santiago Young Adult Reproductive Health Survey was conducted in 1988 to examine the sexual behavior of and contraceptive use among young adults in Chile. The survey was based on multistage household probability samples of 865 women and 800 men aged 15-24 who were living in Santiago in 1988. Findings show that 35 percent of females and 65 percent of males had had premarital intercourse. Among those who had done so, the median age at first experience was 18.4 years for women and 16.4 years for men. Only 20 percent of females and 19 percent of males used contraceptives at first premarital intercourse. Use of contraceptives increased with age at the time of that event. Fertility data reveal that 70 percent of first births were premaritally conceived, and more than one-third of these were born prior to union. The high rates of premarital and unintended pregnancy among young women and the low prevalence of effective contraceptive use indicate a need for greater emphasis on sex education and family planning services directed at adolescents and unmarried young adults in Santiago.

Negative opinions about cancer screening and contraceptive measures by female emergency department patients.

PubMed

Merchant, Roland C; Gee, Erin M; Bock, Beth C; Becker, Bruce M; Clark, Melissa A

2008-11-01

We sought to determine the extent to which adult female emergency department participants viewed two women's cancer screening and two contraceptive measures negatively. The study also explored the relationship between having a negative opinion about these measures and participant demography, lack of knowledge, and lack of usage of these measures. Few women expressed negative opinions about these measures. Lack of knowledge about and lack of use of these measures were associated with having negative opinions on these cancer screening and contraceptive measures. Having any negative opinion about one cancer screening or contraceptive measure was associated with a higher risk of having any negative opinion on another measure. The results suggest that influencing opinion and knowledge about these measures might impact the success of emergency department-based cancer screening and contraceptive health programs. Editors' Strategic Implications: Emergency departments (and primary care settings) provide key opportunities for prevention. Replication is needed, but the authors present important data on knowledge, attitudes, and characteristics that might influence women's receptivity to consent to and engage in behaviors consistent with prevention, screening, and health promotion.

Rural development and family planning behavior in Bangladesh Villages.

PubMed

Alauddin, M

1979-01-01

Variarion in knowledge and usage of contraceptive methods was examined across Bangladesh villages. It was hypothesized that the variation can be explained by 3 sets of factors measured at the village level: development programs, family planning program efforts, and given environmental and socioeconomic conditions. The data were drawn from the Bangladesh Fertility Survey and the 1974 Bangladesh Population Census. The 3 sets of factors taken together explained a greater proportion of the variance in knowledge and contraceptive usage than each of the sets taken either singly or in paired combination. Knowledge of clinical contraceptive methods was found to be affected more by development programs than by either family planning or environmental and socioeconomic conditions. Despite the fact that both development and family planning variables have independent and about equal effects on ever use of contraception, each of them separately is not likely to produce as much contraceptive usage as would both of them jointly. In terms of policy, if both development and family planning programs are provided to the villages, the effect on fertility may be maximized.

Change in sexual behavior with provision of no-cost contraception.

PubMed

Secura, Gina M; Adams, Tiffany; Buckel, Christina M; Zhao, Qiuhong; Peipert, Jeffrey F

2014-04-01

To estimate whether providing no-cost contraception is associated with the number of sexual partners and frequency of intercourse over time. This was an analysis of the Contraceptive CHOICE Project, a prospective cohort study of 9,256 adolescents and women at risk for unintended pregnancy. Participants were provided reversible contraception of their choice at no cost and were followed-up with telephone interviews at 6 and 12 months. We examined the number of male sexual partners and coital frequency reported during the previous 30 days at baseline compared with 6-month and 12-month time points. From our total cohort, 7,751 (84%) women and adolescents completed both 6-month and 12-month surveys and were included in this analysis. We observed a statistically significant decrease in the fraction of women and adolescents who reported more than one sexual partner during the past 30 days from baseline to 12 months (5.2% to 3.3%; P<.01). Most participants (70-71%) reported no change in their number of sexual partners at 6 and 12 months, whereas 13% reported a decrease and 16% reported an increase (P<.01). More than 80% of participants who reported an increase in the number of partners experienced an increase from zero to one partner. Frequency of intercourse increased during the past 30 days from baseline (median, 4) to 6 and 12 months (median, 6; P<.01). However, greater coital frequency did not result in greater sexually transmitted infection incidence at 12 months. We found little evidence to support concerns of increased sexual risk-taking behavior subsequent to greater access to no-cost contraception.

Contraceptive use, knowledge, attitude, perceptions and sexual behavior among female University students in Uganda: a cross-sectional survey.

PubMed

Nsubuga, Henry; Sekandi, Juliet N; Sempeera, Hassard; Makumbi, Fredrick E

2016-01-27

In Uganda, the risk of unintended pregnancies and unsafe abortions remains high due to relatively low contraceptive use. There is paucity of data on knowledge, attitudes, perceptions and practices towards modern contraceptives and, sexual and reproductive health especially among the young female university students. A survey was conducted at Makerere University main campus in Kampala, Uganda during April 2014. A team of well-trained and experienced research assistants interviewed female undergraduate students who provided data on socio-demographic characteristics, knowledge, perceptions and attitudes and use of contraceptives, as well as other sexual and reproductive health practices. Users of any contraceptive method in the past 12 months were coded as '1' and none users as '0'. The prevalence of contraceptive use was determined as the number of users divided by all female participants. Prevalence ratios (PRs) with their corresponding 95 % confidence intervals were used as measures of association between contraceptive use and associated factors. The PRs were obtained via a modified Poisson regression model using a generalized linear model with Poisson as family and a log link without an offset but including robust standard errors. All analyses were conducted with Stata version 13. A total of 1,008 females responded to the survey; median (IQR) age was 21(20, 21) years, 38.6% in year 2 of study, and nearly three quarters (72.3%) were of Christian faith. Knowledge of any contraceptives was almost universal (99.6%) but only 22.1% knew about female condoms. Perceived acceptability of contraceptive use at the university (93%) or being beneficial to male partners too (97.8%) were high. Nearly 70% had ever engaged in sexual intercourse and 62.1% reported sexual intercourse in the past 12 months. Overall, 46.6% reported current contraceptive use, with male condoms (34.5%) being the commonest methods. Factors associated with higher contraceptive use were being in year 2, consensual union or perception that contraceptives are for females only. However, being evangelical/SDA or perception that contraceptive use is wrong was associated with lower contraceptive use. Overall, 9% reported ever being pregnant, 2% were pregnant at the time of the survey and a third (33.8%) knew of a pregnant friend. About 40% of ever pregnant respondents reported ever trying to terminate the pregnancy. Knowledge, perceived acceptability and benefits of contraceptive use were nearly universal, but contraceptive use was suboptimal in this setting. Ever trying to terminate a pregnancy was common and a clear indicator of unintended pregnancies.

Contraception and condom use among Bolivian female sex workers: relationship-specific associations between disease prevention and family planning behaviors.

PubMed

Yam, Eileen A; Tinajeros, Freddy; Revollo, Rita; Richmond, Kara; Kerrigan, Deanna L; Garcia, Sandra G

2013-01-01

We examined data from a clinic-based survey of 1,222 Bolivian female sex workers (FSWs) to assess whether use of nonbarrier modern contraception is associated with less consistent condom use with clients and noncommercial partners. Women who were using nonbarrier modern contraception were less likely than nonusers to consistently use condoms with noncommercial partners (AOR 0.393, 95% CI 0.203-0.759, p = .005). With clients, this inverse association did not hold. Public health professionals must consider both disease prevention and pregnancy prevention needs in this vulnerable population, and messages should be tailored to encourage dual method use with all partners.

Theory-based interventions for contraception.

PubMed

Lopez, Laureen M; Tolley, Elizabeth E; Grimes, David A; Chen-Mok, Mario

2009-01-21

The explicit use of theory in research helps expand the knowledge base. Theories and models have been used extensively in HIV-prevention research and in interventions for preventing sexually transmitted infections (STIs). The health behavior field uses many theories or models of change. However, educational interventions addressing contraception often have no stated theoretical base. Review randomized controlled trials that tested a theoretical approach to inform contraceptive choice; encourage contraceptive use; or promote adherence to, or continuation of, a contraceptive regimen. We searched computerized databases for trials that tested a theory-based intervention for improving contraceptive use (MEDLINE, POPLINE, CENTRAL, PsycINFO, EMBASE, ClinicalTrials.gov, and ICTRP). We also wrote to researchers to find other trials. Trials tested a theory-based intervention for improving contraceptive use. We excluded trials focused on high-risk groups. Interventions addressed the use of one or more contraceptive methods. The reports provided evidence that the intervention was based on a specific theory or model. The primary outcomes were pregnancy, contraceptive choice, initiating or changing contraceptive use, contraceptive regimen adherence, and contraception continuation. The primary author evaluated abstracts for eligibility. Two authors extracted data from included studies. We calculated the odds ratio for dichotomous outcomes and the mean difference for continuous data. No meta-analysis was conducted due to intervention differences. Of 26 trials, 12 interventions addressed contraception (other than condoms), while 14 focused on condom use for preventing HIV or STIs. In 2 of 10 trials with pregnancy or birth data, a theory-based group showed better results. Four of nine trials with contraceptive use (other than condoms) showed better outcomes in an experimental group. For condom use, a theory-based group had favorable results in 14 of 20 trials, but the number was halved in a subgroup analysis. Social Cognitive Theory was the main theoretical basis for 12 trials, and 10 showed positive results. Of the other 14 trials, favorable results were shown for other social cognition models (N=2), motivational interviewing (N=5), and the AIDS Risk Reduction Model (N=2). No major patterns were detected by type of theory, intervention, or target population. Family planning researchers and practitioners could apply the relevant theories and effective interventions from HIV and STI prevention. More thorough use of single theories would help inform the field about what works. Better reporting is needed on research design and intervention implementation.

Sex steroids, sexual behavior, and selection attention for erotic stimuli in women using oral contraceptives.

PubMed

Alexander, G M; Sherwin, B B

1993-01-01

The relationship between sex steroids and sexual behavior was examined in 19 oral contraceptive users. Retrospective assessment of sexual attitudes were obtained and women completed daily ratings of sexual behavior and well-being for 28 days. Plasma levels of free testosterone (T), estradiol, and progesterone were measured at weekly intervals. In addition, women performed a novel selective attention task designed to measure the strength of the tendency to be distracted by sexual stimuli. Multiple regression analyses using average sexual behavior variables as dependent variables, and hormone levels sexual attitudes and well-being as predictor variables, showed that free T was strongly and positively associated with sexual desire, sexual thoughts, and anticipation of sexual activity. A role for T in attention to sexual stimuli was also supported by the positive correlation between free T and the bias for sexual stimuli in a subgroup of women. These results are consistent with the hypothesis that T may enhance cognitive aspects of women's sexual behavior.

Community resources and reproductive behaviour in rural Bangladesh.

PubMed

Saha, T D

1994-03-01

Local community impact on contraceptive usage is illustrated in this logistic model of contraceptive behavior in 1986 in rural Bangladesh. Variables include an index of accessibility and availability of family planning (FP) at the "thana" level, age of respondent, respondent's educational level, desire to have a child, distance from the district, rural electrification, an index of agricultural wages and percentage of small farm households, and presence of a mosque. Community-level variables are found to be significant in separate equations and in equations with individual level variables. Contraceptive use is more likely to occur in a rural situation where there are commercial places such as market places and post offices. Contraceptive use is enhanced by "thana" closeness to district headquarters. Reduced contraceptive use is related to rural areas with many small farm households and a high agricultural wage rate. Access to FP provides a positive environment for improving motivation to use contraception and for improving use of modern methods. The degree of rural isolation negatively impacts on contraceptive use. Bangladesh is one of the few countries with a comprehensive development program at the sub-district level or "thana." Health centers and family welfare centers are established but are unevenly distributed spatially. Data for this study were obtained from the 1985 Bangladesh Contraceptive Prevalence Survey of 7681 rural women aged under 50 years, from the 1983 Agricultural Census on farm land, and from other statistical publications. Information was obtained on 120 "thanas." Contraceptive use status is measured as use, nonuse, modern use, traditional use, intention to use, and nonintention to use. The religious variable is negative, as expected, but not significant for contraceptive use and intention to use. The sign is positive for modern contraceptive use. Closer examination reveals that respondents with no education and with no household land are more frequent users of modern methods, including sterilization which incurs a religious moral and social stigma. Other data support the notion that religious beliefs are not an important factor in nonuse of contraceptives in Bangladesh. The FP index has a significant impact on use and intention to use but has a positive and insignificant effect on modern methods, which may indicate measurement error.

Meeting Contraceptive Needs: Long-Term Associations of the PRACHAR Project with Married Women's Awareness and Behavior in Bihar.

PubMed

Jejeebhoy, Shireen J; Prakash, Ravi; Acharya, Rajib; Singh, Santosh K; Daniel, Elkan

2015-09-01

Although interventions such as the PRACHAR project in Bihar, India, have been associated with increased contraceptive knowledge and use in the short term, less is known about whether such gains are sustained years later. Survey data, collected in 2013 from 2,846 married women aged 15-34, were used to compare contraceptive awareness and use between those who lived in areas where the PRACHAR project had been implemented in 2002-2009 and those who lived in matched comparison areas. Multivariate analyses assessed whether, after adjustment for covariates, outcomes differed between women in comparison and intervention areas, as well as between women directly exposed to the program and those who lived in intervention areas but had been only indirectly exposed. Compared with women in comparison areas, those in intervention areas were more likely to have method-specific knowledge of oral contraceptives, IUDs, condoms and the Standard Days Method (odds ratios, 1.4-1.7); to know that oral contraceptives and condoms are appropriate for delaying first pregnancy (2.3 for each) and IUDs and injectables are appropriate for spacing births (1.4 for each); to have ever used contraceptives (2.1) or be using a modern method (1.5); and to have initiated contraception within three months of their first birth (1.8). Levels of awareness and use were elevated not only among women directly exposed to the intervention but also, for many measures, among indirectly exposed women. The association of multipronged reproductive health programs like PRACHAR with contraceptive awareness and practices may last for years beyond the project's conclusion.

Motivational Interviewing with computer assistance as an intervention to empower women to make contraceptive choices while incarcerated: study protocol for randomized controlled trial

PubMed Central

2012-01-01

Background Unplanned pregnancies and sexually transmitted infections (STIs) are important and costly public health problems in the United States resulting from unprotected sexual intercourse. Risk factors for unplanned pregnancies and STIs (poverty, low educational attainment, homelessness, substance abuse, lack of health insurance, history of an abusive environment, and practice of commercial sex work) are especially high among women with a history of incarceration. Project CARE (Contraceptive Awareness and Reproductive Education) is designed to evaluate an innovative intervention, Motivational Interviewing with Computer Assistance (MICA), aimed at enhancing contraceptive initiation and maintenance among incarcerated women who do not want a pregnancy within the next year and who are anticipated to be released back to the community. This study aims to: (1) increase the initiation of highly effective contraceptives while incarcerated; (2) increase the continuation of highly effective contraceptive use at 3, 6, 9, and 12 months after release; and (3) decrease unsafe sexual activity. Methods/Design This randomized controlled trial will recruit 400 women from the Rhode Island Department of Corrections (RI DOC) women’s jail at risk for an unplanned pregnancy (that is, sexually active with men and not planning/wanting to become pregnant in the next year). They will be randomized to two interventions: a control group who receive two educational videos (on contraception, STIs, and pre-conception counseling) or a treatment group who receive two sessions of personalized MICA. MICA is based on the principles of the Transtheoretical Model (TTM) and on Motivational Interviewing (MI), an empirically supported counseling technique designed to enhance readiness to change targeted behaviors. Women will be followed at 3, 6, 9, and 12 months post release and assessed for STIs, pregnancy, and reported condom use. Discussion Results from this study are expected to enhance our understanding of the efficacy of MICA to enhance contraceptive initiation and maintenance and reduce sexual risk-taking behaviors among incarcerated women who have re-entered the community. Trial registration NCT01132950 PMID:22747705

Impact of family planning health talks by lay health workers on contraceptive knowledge and attitudes among HIV-infected patients in rural Kenya

PubMed Central

Onono, Maricianah; Blat, Cinthia; Miles, Sondra; Steinfeld, Rachel; Wekesa, Pauline; Bukusi, Elizabeth A.; Owuor, Kevin; Grossman, Daniel; Cohen, Craig R.; Newmann, Sara J.

2015-01-01

Objective To determine if a health talk on family planning (FP) by community clinic health assistants (CCHAs) will improve knowledge, attitudes and behavioral intentions about contraception in HIV-infected individuals. Methods A 15-min FP health talk was given by CCHAs in six rural HIV clinics to a sample of 49 HIV-infected men and women. Effects of the health talk were assessed through a questionnaire administered before the health talk and after completion of the participant's clinic visit. Results Following the health talk, there was a significant increase in knowledge about contraceptives (p < .0001), side-effects (p < .0001), and method-specific knowledge about IUCDs (p < .001), implants (p < .0001), and injectables (p < .05). Out of 31 women and 18 men enrolled, 14 (45%) women and 6 (33%) men intended to try a new contraceptive. Participant attitudes toward FP were high before and after the health talk (median 4 of 4). Conclusion A health talk delivered by CCHAs can increase knowledge of contraception and promote the intention to try new more effective contraception among HIV-infected individuals. Practice implications FP health talks administered by lay-health providers to HIV-infected individuals as they wait for HIV services can influence FP knowledge and intention to use FP. PMID:24316053

Impact of family planning health talks by lay health workers on contraceptive knowledge and attitudes among HIV-infected patients in rural Kenya.

PubMed

Onono, Maricianah; Blat, Cinthia; Miles, Sondra; Steinfeld, Rachel; Wekesa, Pauline; Bukusi, Elizabeth A; Owuor, Kevin; Grossman, Daniel; Cohen, Craig R; Newmann, Sara J

2014-03-01

To determine if a health talk on family planning (FP) by community clinic health assistants (CCHAs) will improve knowledge, attitudes and behavioral intentions about contraception in HIV-infected individuals. A 15-min FP health talk was given by CCHAs in six rural HIV clinics to a sample of 49 HIV-infected men and women. Effects of the health talk were assessed through a questionnaire administered before the health talk and after completion of the participant's clinic visit. Following the health talk, there was a significant increase in knowledge about contraceptives (p<.0001), side-effects (p<.0001), and method-specific knowledge about IUCDs (p<.001), implants (p<.0001), and injectables (p<.05). Out of 31 women and 18 men enrolled, 14 (45%) women and 6 (33%) men intended to try a new contraceptive. Participant attitudes toward FP were high before and after the health talk (median 4 of 4). A health talk delivered by CCHAs can increase knowledge of contraception and promote the intention to try new more effective contraception among HIV-infected individuals. FP health talks administered by lay-health providers to HIV-infected individuals as they wait for HIV services can influence FP knowledge and intention to use FP. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Sex education and contraceptive use at coital debut in the United States: results from Cycle 6 of the National Survey of Family Growth.

PubMed

Isley, Michelle M; Edelman, Alison; Kaneshiro, Bliss; Peters, Dawn; Nichols, Mark D; Jensen, Jeffrey T

2010-09-01

The study was conducted to characterize the relationship between formal sex education and the use and type of contraceptive method used at coital debut among female adolescents. This study employed a cross-sectional, nationally representative database (2002 National Survey of Family Growth). Contraceptive use and type used were compared among sex education groups [abstinence only (AO), birth control methods only (MO) and comprehensive (AM)]. Analyses also evaluated the association between demographic, socioeconomic, behavioral variables and sex education. Multiple logistic regression with adjustment for sampling design was used to measure associations of interest. Of 1150 adolescent females aged 15-19 years, 91% reported formal sex education (AO 20.4%, MO 4.9%, AM 65.1%). The overall use of contraception at coitarche did not differ between groups. Compared to the AO and AM groups, the proportion who used a reliable method in the MO group (37%) was significantly higher (p=.03) (vs. 15.8% and 14.8%, respectively). Data from the 2002 NSFG do not support an association between type of formal sex education and contraceptive use at coitarche but do support an association between abstinence-only messaging and decreased reliable contraceptive method use at coitarche. Copyright 2010 Elsevier Inc. All rights reserved.

Cluster Randomized Controlled Trial Evaluation of a Gender Equity and Family Planning Intervention for Married Men and Couples in Rural India

PubMed Central

Raj, Anita; Ghule, Mohan; Ritter, Julie; Battala, Madhusudana; Gajanan, Velhal; Nair, Saritha; Dasgupta, Anindita; Silverman, Jay G.; Balaiah, Donta; Saggurti, Niranjan

2016-01-01

Background Despite ongoing recommendations to increase male engagement and gender-equity (GE) counseling in family planning (FP) services, few such programs have been implemented and rigorously evaluated. This study evaluates the impact of CHARM, a three-session GE+FP counseling intervention delivered by male health care providers to married men, alone (sessions 1&2) and with their wives (session 3) in India. Methods and Findings A two-armed cluster randomized controlled trial was conducted with young married couples (N = 1081 couples) recruited from 50 geographic clusters (25 clusters randomized to CHARM and a control condition, respectively) in rural Maharashtra, India. Couples were surveyed on demographics, contraceptive behaviors, and intimate partner violence (IPV) attitudes and behaviors at baseline and 9 &18-month follow-ups, with pregnancy testing at baseline and 18-month follow-up. Outcome effects on contraceptive use and incident pregnancy, and secondarily, on contraceptive communication and men’s IPV attitudes and behaviors, were assessed using logistic generalized linear mixed models. Most men recruited from CHARM communities (91.3%) received at least one CHARM intervention session; 52.5% received the couple’s session with their wife. Findings document that women from the CHARM condition, relative to controls, were more likely to report contraceptive communication at 9-month follow-up (AOR = 1.77, p = 0.04) and modern contraceptive use at 9 and 18-month follow-ups (AORs = 1.57–1.58, p = 0.05), and they were less likely to report sexual IPV at 18-month follow-up (AOR = 0.48, p = 0.01). Men in the CHARM condition were less likely than those in the control clusters to report attitudes accepting of sexual IPV at 9-month (AOR = 0.64, p = 0.03) and 18-month (AOR = 0.51, p = 0.004) follow-up, and attitudes accepting of physical IPV at 18-month follow-up (AOR = 0.64, p = 0.02). No significant effect on pregnancy was seen. Conclusions Findings demonstrate that men can be engaged in FP programming in rural India, and that such an approach inclusive of GE counseling can improve contraceptive practices and reduce sexual IPV in married couples. Trial Registration ClinicalTrials.gov NCT01593943 PMID:27167981

Gender, Self-Monitoring, Alcohol Consumption, and Sexual Behavior: A Survey.

ERIC Educational Resources Information Center

Harnish, Richard J.; Abbey, Antonia

For this study, college students were asked to describe their sexual histories and how their sexual behavior related to alcohol consumption, contraceptive use, and concern over Acquired Immune Deficiency Syndrome (AIDS) so that more could be learned about gender and self-monitoring differences in sexual behavior. College undergraduates (N=94)…

Female status and fertility in Pakistan.

PubMed

Syed, S H

1978-01-01

The roles of education and labor force participation in the reproductive behavior of women (aged 20-29 and 30-39) were analyzed using data from the 1975 Pakistan Fertility Survey. Analysis shows that urban women of both age groups fare better than rural women with respect to overall literacy and educational achievement. No significant differentials were observed between urban and rural women as regards labor force participation. The difficulty in presenting a true picture of the work status of Pakistani women is attributed to the difficulty of defining the concept of female labor force participation, not to mention biases in response and enumeration during the survey. Nevertheless, it is suggested that most urban and rural women are either not economically active or are engaged in traditional activities which do not provide stimulus for changes in their fertility behavior. With respect to education, the data shows that the effect of education on contraceptive use is statistically significant for urban women, but not for rural women, urban women being 3 times greater users of contraceptives than rural women. Work status did not significantly affect ever contraceptive use. The findings lend support to the hypothesis that education reduces female vulnerability to unwanted pregnancies by increasing age at 1st marriage, by becoming more aware of available contraceptive methods, and by limiting family size. Thus, policy should be geared towards providing educational opportunities for both rural and urban women.

Determinants of oral contraceptive pill use and its discontinuation among rural women in Bangladesh

PubMed Central

HUMBLE, MORAG ELIZABETH

2006-01-01

Oral contraceptive pills (OCP) contribute a major share in the current method‐mix in Bangladesh. However, multiple studies show high discontinuation rates of OCP. The present study examines the behavior and attitude towards OCP use, and investigates the determinants of its discontinuation among the rural married women of Bangladesh. The present study is based on critical analyses of the data from 24 focus group discussions and 135 in‐depth‐interviews with women, their husbands and key informants conducted over the period of 1 year. The present study shows that more than two‐thirds of married women have at one time or another used OCP as a method of family planning. However, many women did not take the pills regularly and about one‐quarter of ever users had taken, at one stage or another, a ‘short break’ from OCP use. Although nearly half of them took a break because of side effects, interestingly, 16% took a break as the result of fear of health problems that were related to ‘folk stories’ and other misconceptions. The individual assessment by users of the national family planning service delivery, perceived side effects, misconceptions about continuous use of pills, quality of counseling and information, and contraceptive behavior of the OCP users considerably influenced the decisions on contraceptive use or non‐use. (Reprod Med Biol 2006; 5: 111–121) PMID:29699243

Cognitive-Behavioral Prevention of Adolescent Pregnancy.

ERIC Educational Resources Information Center

Schinke, Steven Paul; And Others

1981-01-01

Studied high-school sophmores, who through group training, were given contraceptive information, steps for solving problems, and practice in communicating decisions about sexual behavior. Compared with untrained, control-condition teenagers, trained teenagers had more positive postest scores on measures of sexual knowledge, interpersonal problem…

Sex Role Development and Teenage Fertility-Related Behavior

ERIC Educational Resources Information Center

Cvetkovich, George; And Others

1978-01-01

Presents some data bearing on the relationship between the psychological development or maturity of adolescent women and their sexual behavior and contraceptive use. Data were collected through the American Public Health Association in 1975 from 369 females and 325 males. (Author/RK)

Adolescent sexual behavior in the eighties.

PubMed

Bigler, M O

1989-10-01

This paper summarizes what is known about adolescent sexual behavior in the 1980s. One study found that 85% of American teens have had a boyfriend or girlfriend. Overall, 43% of teens have participated in vaginal play and 40% have experienced penile manipulation. A significant number of teenagers report having participated in oral sex. Many adolescents also report that they masturbate. Surveys of American adolescents have found that, on the whole, average age at 1st intercourse ranges from 16 to 16.9 years, but some teenagers begin to have intercourse shortly after puberty. The proportion of sexually-experienced teens increases with age. Many adolescents see their 1st experience sexual intercourse as a conscious, personal choice. At all ages, males are more likely to report having had intercourse than are females. Many adolescents who have had intercourse report regular contraceptive use. More than 1/3 (33%-39%) report contraceptive use every time they engage in intercourse. However, a large number of sexually experienced teenagers use contraception irregularly. Teenagers who have had intercourse express a preference for birth control pills over condoms as their primary means of contraception. Inconsistent contraceptive use among teens is reflected in the number of adolescent pregnancies in the US each year. In 1984, there were 233 adolescent pregnancies/1000 sexually active 15-19-year-old females. A large share of adolescent pregnancies end in abortion. 1 in 7 teens contracts a sexually transmitted disease each year. Many believe that teens are at high risk of infection with Human Immunodeficiency Virus (HIV) because of poorly protected sexual experimentation and intravenous drug use. Healthy adult sexuality may depend a great deal on the earlier years of sexual development.

Adolescent sexual behavior during periods of increase and decrease in the abortion rate.

PubMed

Falah-Hassani, Kobra; Kosunen, Elise; Shiri, Rahman; Jokela, Jukka; Liinamo, Arja; Rimpelä, Arja

2009-07-01

To study changes in adolescent sexual behavior in periods of increase (1994-2000) and decrease (2001-2007) in the abortion rate. School surveys with self-administered questionnaires were carried out annually among eighth graders (mean age 14.8 years) and ninth graders (mean age 15.8 years) (N=286,665) in 1996/1997 and 2006/2007. Schools participated biennially. The proportions of respondents reporting noncoital (kissing, light petting, heavy petting) and coital (ever had sexual intercourse, intercourse at least 10 times, at least three partners) sexual experience and nonuse of contraception were studied. Among adolescents, both coital and noncoital sexual experiences and the proportion of those not using contraception increased between 1996-1997 and 2000-2001 (P for trend <.01, all) and decreased from 2000-2001 onward (P<.001, all), except the proportion of at least 10 coital events, which did not decrease. Among sexually experienced adolescents, a similar increase in coital experiences (intercourse at least 10 times from 38.2% to 41.5%, at least three partners from 27.8% to 30.7%, P<.001) and in not using contraception (from 17.2% to 19.1%, P=.002) was seen before 2000-2001, but after that the only significant change was a further increase in the proportion of those reporting intercourse at least 10 times (from 41.5% to 47.8%, P<.001). The proportion of adolescents reporting noncoital sexual experiences, intercourse, or not using contraception increased in the 1990s and decreased in the 2000s, reflecting the changes in the abortion rate. However, as the abortion rate decreased, the intensity of sexual activity further increased among sexually experienced adolescents, suggesting that the fall in the abortion rate may be due to contraception and more effective sexual education. : III.

Perceived Dual Method Responsibilities by Relationship Type Among African-American Male Adolescents.

PubMed

Gilliam, Melissa; Woodhams, Elisabeth; Sipsma, Heather; Hill, Brandon

2017-03-01

To describe the extent to which African-American male adolescents perceive responsibility for contraception and condom use and to understand the perceived importance of dual method use for respondents in casual versus committed relationships. Data were collected using surveys informed by formative focus group sessions. Participants included African-American male high-school students aged 14-19 years from the Chicago's South Side. Respondents were surveyed regarding contraceptive behavioral intentions and perceived importance of dual method use. Responses were compared by relationship type. Logistic regression modeling was used to determine the association between contraception responsibility and perceiving dual method protection as important for each sexual relationship type. Sample included 348 young men (mean age: 16.1 years; mean age at first sex: 13.8 years). Among those who had heard of condoms (99.4%) and withdrawal (90.4%), most reported liking these methods (83.7% and 53.9%). Participants were more likely to report greater responsibility within a committed relationship for all perceived contraceptive responsibilities (e.g., going with partner to get contraception). Participants were more likely to engage in conversation about pregnancy prevention with a committed partner. Among sexually active respondents, perceived contraceptive responsibility was associated with perceiving dual protection as very important (odds ratio = 1.58; 95% confidence interval = 1.05-2.38). Respondents felt partially responsible for pregnancy prevention, particularly within committed relationships, and were open to using dual protection. However, many respondents had low levels of contraception knowledge. These findings indicate that male African-American adolescents might benefit from increased education and support around contraception methods and condom use. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Recasting image of contraceptives.

PubMed

Rimon Jg; Kiragu, K

1993-03-01

Even though contraceptives are linked to sex which, along with sensuality and peer acceptance, is used to market consumer goods, contraceptives are promoted in a hygienic, clinical way. Glamorous images which divert from adverse health effects are used to sell unhealthy goods, e.g., alcohol and cigarettes, but technical and intimidating promotion techniques centering on risks are used to promote family planning (FP) products and services which actually save the lives of mothers and children and improve their health. Until recently, only the medical system provided FP products and services so consumers identified them with illness and a help-seeking behavior. The image of contraceptives must be remolded to gain people's attention. To avoid instilling mistrust of a method in consumers, even those who believe in birth spacing, it is important for images to be positive and to reflect accurate information. In Indonesia, the Dualima condom has been linked to responsible fatherhood thereby creating a positive image and removing the negative image of a condom being linked to illicit sex. In the US, condom adds show the user in control, especially in reference to AIDS. Prior to promotion of any contraceptive, complete, clear communication and marketing plans are needed to identify and to focus on consumers' perceived needs. A survey in Egypt shows that the most important attributes of a contraceptive are ease of use, healthiness, and effectiveness and that Egyptians considered IUDs to best fit these attributes. Images of contraceptive users often determine whether potential users do choose to use contraceptives. For example, in Cameroon and the Philippines, female users are considered to be smart, rich, educated, confident and in control of their lives. In the Philippines, male users are perceived to be loving, caring, and considerate husbands. The mass medias can improve providers' public image as was the case in Turkey and Egypt.

Increasing literate and illiterate women's met need for contraception via empowerment: a quasi-experiment in rural India.

PubMed

León, Federico R; Lundgren, Rebecka; Sinai, Irit; Sinha, Ragini; Jennings, Victoria

2014-10-21

Virtually all the evidence on the relationship between women's empowerment and use of contraception comes from cross-sectional studies that have emphasized macrosocial factors.This analysis tested whether literate and illiterate women are empowered by an intervention designed to provide information addressing technical and gender concerns and expand contraceptive choice, and evaluated the effects of women's decision-making power on contraceptive behavior. The data came from a three-year quasi-experiment conducted in two comparable, yet not equivalent, rural blocks in Jharkhand, India. At the intervention block, a new contraceptive method was introduced at Ministry of Health health centers, providers were trained to offer family planning information and services which took into consideration gender power dynamics, and promotional messages and information about contraception were disseminated community-wide. Married women ages 15-49 who lived in the intervention and control blocks were sampled and interviewed before and after the intervention by a professional research firm. Data analyses included generalized linear models with interactions and covariate control. Women's normative beliefs concerning wives' power in decisions regarding money earned and visits to relatives and friends vis-à-vis their husbands' power were increased by the intervention; similar was the case among illiterate, but not literate, women regarding decisions related to childbearing. Concerning met need for contraception, the change for women with relatively more power who were illiterate was greater in the intervention than in the control area. The findings suggest that women were empowered by outreach visits that addressed gender dynamics and that their empowerment contributed to their met need for contraception. Generalizations to other settings, however, may be limited by cultural differences.

Barriers to Modern Contraceptive Use in Kinshasa, DRC.

PubMed

Muanda, Mbadu; Gahungu Ndongo, Parfait; Taub, Leah D; Bertrand, Jane T

2016-01-01

Recent research from Kinshasa, DRC, has shown that only one in five married women uses modern contraception; over one quarter have an unmet need for family planning; and almost 400 health facilities across Kinshasa report that they provide modern contraception. This study addresses the question: with reasonable physical access and relatively high unmet need, why is modern contraceptive prevalence so low? To this end, the research team conducted 6 focus groups of women (non-users of any method, users of traditional methods, and users of modern methods) and 4 of husbands (of users of traditional methods and in non-user unions) in health zones with relatively strong physical access to FP services. Five key barriers emerged from the focus group discussions: fear of side effects (especially sterility), costs of the method, sociocultural norms (especially the dominant position of the male in family decision-making), pressure from family members to avoid modern contraception, and lack of information/misinformation. These findings are very similar to those from 12 other studies of sociocultural barriers to family planning in sub-Saharan Africa. Moreover, they have strong programmatic implications for the training of FP workers to counsel future clients and for the content of behavior change communication interventions.

The Role of Public-Sector Family Planning Programs in Meeting the Demand for Contraception in Sub-Saharan Africa.

PubMed

Bongaarts, John; Hardee, Karen

2017-06-01

Commonly used indicators of contraceptive behavior in a population-modern contraceptive prevalence (mCPR), unmet need for contraception, demand for contraception and demand satisfied-are not well-suited for evaluating the progress made by government family planning programs in helping women and men achieve their reproductive goals. Trends in these measures in 26 Sub-Saharan African countries between 1990 and 2014 were examined. Trends in a proposed new indicator, the public-sector family planning program impact score (PFPI), and its relationship to mCPR and the family planning effort score were also assessed. Case studies were used to review public family planning program development and implementation in four countries (Nigeria, Ethiopia, Rwanda and Kenya). The four commonly used indicators capture the extent to which women use family planning and to which demand is satisfied, but shed no direct light on the role of family planning programs. PFPI provides evidence that can be used to hold governments accountable for meeting the demand for family planning, and was closely related to policy developments in the four case-study countries. PFPI provides a useful addition to the indicators currently used to assess progress in reproductive health and family planning programs.

A Health Belief Model-Social Learning Theory approach to adolescents' fertility control: findings from a controlled field trial.

PubMed

Eisen, M; Zellman, G L; McAlister, A L

1992-01-01

We evaluated an 8- to 12-hour Health Belief Model-Social Learning Theory (HBM-SLT)-based sex education program against several community- and school-based interventions in a controlled field experiment. Data on sexual and contraceptive behavior were collected from 1,444 adolescents unselected for gender, race/ethnicity, or virginity status in a pretest-posttest design. Over 60% completed the one-year follow-up. Multivariate analyses were conducted separately for each preintervention virginity status by gender grouping. The results revealed differential program impacts. First, for preintervention virgins, there were no gender or intervention differences in abstinence maintenance over the follow-up year. Second, female preintervention Comparison program virgins used effective contraceptive methods more consistently than those who attended the HBM-SLT program (p less than 0.01); among males, the intervention programs were equally effective. Third, both interventions significantly increased contraceptive efficiency for teenagers who were sexually active before attending the programs. For males, the HBM-SLT program led to significantly greater follow-up contraceptive efficiency than the Comparison program with preintervention contraceptive efficiency controlled (p less than 0.05); for females, the programs produced equivalent improvement. Implications for program planning and evaluation are discussed.

A prospective study of the sexual, emotional and behavioral correlates associated with young women’s first and usual coital events

PubMed Central

Tanner, Amanda E.; Hansel, Devon J.; Fortenberry, J. Dennis

2010-01-01

Context First coitus is considered a major transitional event imbued with cultural relevance. Research has focused on classifying women as virgins with the primary interest in pregnancy and STI prevention and less on sexuality. This study prospectively explored young women’s sexual interest and love at first and subsequent coitus. Methods Daily diary data were collected during a longitudinal study of young women’s sexual health (N=387; 14–17 years at enrollment). Variables of interest included sexual interest, love, and contraceptive and disease prevention behaviors. ANOVA and bootstrapping analytic techniques were utilized. Results For first coital events, love and sexual interest were reported about ‘half of the day’ with sexual interest significantly higher on the day of first coitus. Condom use was nine times more likely than no method at first compared to later coital events. For subsequent coitus, feeling in love was significantly higher compared to first coitus with average sexual interest and love significantly higher with use of no contraceptive method over condoms. Condoms were associated with higher feelings of being in love, but lower sexual interest compared to hormonal contraception. Conclusions The results indicated that sexual interest and love are independent components of coital behavior. Yet the results also suggest that young women’s first coitus does not fully capture the expected significance of ‘losing one’s virginity.’ Thus, at first coitus women can actively engage in protective behaviors and focus on pleasure. PMID:20547288

[Difficulties in psychology and sexual behavior].

PubMed

1973-01-01

After an introduction by S. Kepes (Fertilite Orthogenie 4(4): 174-177,1972) the participants and audience discussed general topics such as the physician-patient relationship, unconscious motives, attitudes of male partners and physicians, and treatment of minors. Resistance by male partners toward contraception was considered due to fear of inadequacy in the face of female sexuality or to adherence to a double moral standard for wives. A gynecologist claimed that high school students are more likely to request contraception and use it effectively than they were 5 years ago; a midwife said that less privileged adolescents frequently become pregnant. Opinions were expressed that it is inappropriate to consider contraception from a psychological viewpoint, since it is part of a revolution toward a better life; that some psychological difficulties come from the doctor having preferences for certain methods; that the pill does not cause frigidity but is often blamed for preexisting problems; that the press frightens women away from taking the pill; that physicians should prescribe contraception to minors without seeking parental consent (unlawful in France).

[Sexuality among university women].

PubMed

Fuentes Vasquez, L Y

1989-12-01

Changes in female sexual behavior in Bogota, Colombia are demonstrated, based on a study at Bogota's National University in 1989 analyzing 160 interview of women in such field as Anthropology, Sociology, Psychology, Social Work and Nursing and 21 in-depth interviews. The new changes include acceptance of family planning as compared to the historical subservient roles that women played in Colombia 30 years ago. Some of the conclusions of the study are: 1) 83.7% of those interviewed stated that female sexuality has been facilitated by access to contraception, while 10% disagreed; 2) 75.6% felt that a couple should decide on contraceptive methods used, while 15.6% stated that it should be the woman's decision; 3) 65% of the students stated that they were well- informed about contraceptives as against 35%; 4) 90.0% of the students were using a contraceptive at the time of the interview as against 9% (pills by 14.4%; IUD by 42.2%; condoms by 6.6%; suppositories by 14.4% and the rhythm method by 30%). (Author's modified).

Repeat use of emergency contraceptive pills in urban Kenya and Nigeria.

PubMed

Chin-Quee, Dawn; L'Engle, Kelly; Otterness, Conrad; Mercer, Sarah; Chen, Mario

2014-09-01

Little is known about the frequency and patterns of use of emergency contraceptive pills among women in urban Kenya and Nigeria. To recruit women who had used emergency contraceptive pills, individuals aged 18-49 were intercepted and interviewed at shopping venues in Nairobi, Kenya, and Lagos, Nigeria, in 2011. Information was collected on 539 Nairobi and 483 Lagos respondents' demographic and behavioral characteristics, attitudes toward the method, and frequency of use. Multinomial logistic regression analyses were used to identify associations between these characteristics and frequency of pill use. Eighteen percent of the women interviewed in Nairobi and 17% in Lagos had ever used emergency contraceptive pills. On average, these respondents had used the pills less than once per month, but greater use and acceptance were seen in Lagos. In multivariate analysis, women who had sex at least once in a typical week were generally more likely than others to have used the pills 2-5 times in the last six months, rather than once or never, or to have used them six or more times. Furthermore, Lagos respondents who said their main contraceptive method was the condom, the pill or injectable, or a natural method were generally less likely than those who did not report these methods to have used the emergency pills multiple times in the last six months. Repeated use of emergency contraceptive pills was not common in this sample.

Beyond the Effects of Comprehensive Sexuality Education: The Significant Prospective Effects of Youth Assets on Contraceptive Behaviors.

PubMed

Green, Jennifer; Oman, Roy F; Vesely, Sara K; Cheney, Marshall; Carroll, Leslie

2017-12-01

The purpose of the study was to prospectively determine if youth assets were significantly associated with contraception use after accounting for the effects of youths' exposure to comprehensive sexuality education programming. Prospective associations between youth asset scores, comprehensive sexuality education topics received, type of contraceptive used, and consistent contraceptive use were analyzed using multinomial and binomial logistic regression in a sample of 757 sexually active youth. Higher youth asset scores were associated with condom use (adjusted odds ratio [AOR] = 1.51, 95% CI = 1.01-2.28), hormonal birth control use (AOR = 2.71, 95% CI = 1.69-4.35), dual method use (AOR = 2.35, 95% CI = 1.44-3.82), and consistent contraceptive use (AOR = 1.97, 95% CI = 1.38-2.82). After controlling for youths' experience with comprehensive sexuality education, higher youth asset scores remained a significant predictor of hormonal birth control use (AOR = 2.09, 95% CI = 1.28-3.42), dual method use (AOR = 2.58, 95% CI = 1.61-4.15), and consistent contraceptive use (AOR = 1.95, 95% CI = 1.36-2.80). Youth serving organizations that are interested in preventing teen pregnancy should consider widespread implementation of evidence-based youth development programs that focus on building and strengthening specific youth assets. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

College Students' Sexual Attitudes and Behaviors, 1974-1985: A Review of the Literature.

ERIC Educational Resources Information Center

Spees, Emil R.

1987-01-01

Reviewed the literature on college students' sexual attitudes and behaviors from 1974 through 1985. Found a rise in sexual activity and in openness to discuss sexual issues, a relationship between soft drugs and sexual activity, greater concern for rape, and greater male student awareness of male responsibility for contraceptive behavior.…

An Extension of the Findings of Moore, Peterson, and Furstenberg (1986) regarding Family Sexual Communication and Adolescent Sexual Behavior.

ERIC Educational Resources Information Center

Fisher, Terri D.

1989-01-01

Used variables of gender and parental sexual attitudes to categorize college students (N=349) and their parents to examine relationship between family communication about sexuality and adolescent sexual behavior, attitudes, knowledge and contraception use. Found sexual behavior of females correlated with parent-child communication; sexual…

Differences in health behaviors and parenting knowledge between pregnant adolescents and parenting adolescents.

PubMed

Sangalang, Bernadette B; Rounds, Kathleen

2005-01-01

To better understand the differences between pregnant adolescents and parenting adolescents, we examined substance use, contraceptive behavior, and parenting knowledge among 91 first-time pregnant and parenting adolescents enrolled in an adolescent parenting case management program. After one year of program participation, pre- and post-test comparisons indicated improvements in contraception use and parenting knowledge, and increases in reported use of cigarettes, alcohol and other drugs among both groups. Adolescents who entered the program while pregnant experienced greater benefit than adolescents who entered the program already parenting. We discuss several implications for practitioners at both the programmatic and direct practice level who work with young women during pregnancy and as they transition to early parenthood.

Emotional Variation and Fertility Behavior

PubMed Central

Axinn, William G.; Ghimire, Dirgha J.; Smith-Greenaway, Emily

2017-01-01

Emotional influences on fertility behaviors are an understudied topic that may offer a clear explanation of why many couples choose to have children even when childbearing is not economically rational. With setting-specific measures of the husband-wife emotional bond appropriate for large-scale population research matched with data from a long-term panel study, we have the empirical tools to provide a test of the influence of emotional factors on contraceptive use to limit fertility. This article presents those tests. We use long-term, multilevel community and family panel data to demonstrate that the variance in levels of husband-wife emotional bond is significantly associated with their subsequent use of contraception to avert births. We discuss the wide-ranging implications of this intriguing new result. PMID:28181103

Emotional Variation and Fertility Behavior.

PubMed

Axinn, William G; Ghimire, Dirgha J; Smith-Greenaway, Emily

2017-04-01

Emotional influences on fertility behaviors are an understudied topic that may offer a clear explanation of why many couples choose to have children even when childbearing is not economically rational. With setting-specific measures of the husband-wife emotional bond appropriate for large-scale population research matched with data from a long-term panel study, we have the empirical tools to provide a test of the influence of emotional factors on contraceptive use to limit fertility. This article presents those tests. We use long-term, multilevel community and family panel data to demonstrate that the variance in levels of husband-wife emotional bond is significantly associated with their subsequent use of contraception to avert births. We discuss the wide-ranging implications of this intriguing new result.

[3rd and 4th generation estroprogestatives French controversy: What effect on women's behavior?].

PubMed

Torres, Luis; Frapard, Christian; Daumas, Aurélie; Guibert, Nicolas; Lagouanelle-Simeoni, Marie-Claude; Rakoto, Jean-Claude; Villani, Patrick; Sambuc, Roland

2016-04-01

The primary objective of this study was to determine the reasons given by women who have changed or suspended their contraceptive method in 2013. What influence had the 3rd and 4th generation estroprogestatives (EP) French controversy and advices from doctors? Did they notice any consequences of the controversy on their lifestyle? Did they feel an impact on their behavior to health professionals? A study was conducted on women of childbearing age. Data collection took place between November 4 and December 16, 2013. The included subjects were between 18 and 55 years old females. Subjects were surveyed through an anonymous self-administered questionnaire distributed through pharmacies. The protocol called for the construction of clusters of subjects by having heard about, or not, of the controversy. Patients reporting having heard about the controversy have formed the "exposed" group while the others have formed the "unexposed" group. We compared two parameters between these two groups: the rate of subjects who reported having modified or suspended their contraceptive method in 2013 on one hand, and the rate of subjects who reported having made a change in their contraceptive method without or against advices from a doctor on the other hand. The sample included 988 subjects. The average age was 34 years. The level of exposure to media debates was 86.5%. Of the respondents, 19.8% were under 3rd or 4th generation EP in 2012, thus directly involved in the discussions and affected by health recommendations. Of the patients, 38.5% reported having changed their contraception in 2013. In these women, when they confirmed having heard about the controversy, 40.1% of them claimed to have conducted this process without or against advices from a doctor. This number dropped to 18.2% for those who had not heard of it. Media coverage of the 3rd and 4th generation EP vascular risk was not mentioned more by patients who suspended all medical contraceptive method than it was by patients who simply changed their method. In all, 52.1% of women who completely stopped their contraception indicated that this choice was at least partly due to a change in their sexuality or reproductive life. This reason was evoked only in 19.0% of women who have simply made a change of contraceptive method. Among the views of women, the EP controversy was one of the reasons for a change of contraception method in 41.8% of cases, while advices from a doctor did play a role in 19.9% of cases. One has seen a decline of 11.0% of oral contraception between 2012 and 2013, almost superimposed on that of oral 3rd and 4th generation EP (10.6%). However, the use of 1st and 2nd generation EP stagnated: their increase was 0.4%. Beyond any change of contraceptive method, 66.9% of women expressed the absence of any impact of the controversy on their behavior. Of the women, 6.1% showed a loss of confidence in health professionals. We have shown how patients who stopped or modified their contraception method during 2013 placed the controversy influence in the forefront of the reasons for their decision. Although a medical reason has been widely quoted, only one in five felt that the advice of her doctor had clearly contributed to her choice. The influence of the media seemed to encroach on the doctor-patient relationship, which is fundamental to the quality of healthcare in the long term. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Trends of Modern Contraceptive Use among Young Married Women Based on the 2000, 2005, and 2011 Ethiopian Demographic and Health Surveys: A Multivariate Decomposition Analysis

PubMed Central

Worku, Abebaw Gebeyehu; Tessema, Gizachew Assefa; Zeleke, Atinkut Alamirrew

2015-01-01

Introduction Accessing family planning can reduce a significant proportion of maternal, infant, and childhood deaths. In Ethiopia, use of modern contraceptive methods is low but it is increasing. This study aimed to analyze the trends and determinants of changes in modern contraceptive use over time among young married women in Ethiopia. Methods The study used data from the three Demographic Health Surveys conducted in Ethiopia, in 2000, 2005, and 2011. Young married women age 15–24 years with sample sizes of 2,157 in 2000, 1,904 in 2005, and 2,146 in 2011 were included. Logit-based decomposition analysis technique was used for analysis of factors contributing to the recent changes. STATA 12 was employed for data management and analyses. All calculations presented in this paper were weighted for the sampling probabilities and non-response. Complex sampling procedures were also considered during testing of statistical significance. Results Among young married women, modern contraceptive prevalence increased from 6% in 2000 to 16% in 2005 and to 36% in 2011. The decomposition analysis indicated that 34% of the overall change in modern contraceptive use was due to difference in women’s characteristics. Changes in the composition of young women’s characteristics according to age, educational status, religion, couple concordance on family size, and fertility preference were the major sources of this increase. Two-thirds of the increase in modern contraceptive use was due to difference in coefficients. Most importantly, the increase was due to change in contraceptive use behavior among the rural population (33%) and among Orthodox Christians (16%) and Protestants (4%). Conclusions Modern contraceptive use among young married women has showed a remarkable increase over the last decade in Ethiopia. Programmatic interventions targeting poor, younger (adolescent), illiterate, and Muslim women would help to maintain the increasing trend in modern contraceptive use. PMID:25635389

Pharmacists' counseling on oral contraceptives: A theory informed analysis.

PubMed

Amin, Mohamed E K; Chewning, Betty

2016-01-01

Providing correct and complete counseling on the use of oral contraceptives (OCs) is central to securing the autonomy of women in child-bearing age and is a powerful, proven tool of social change. Pharmacists in many developing countries such as Egypt are involved in dispensing and at times prescribing pharmaceuticals, including oral contraceptives that are readily available without a prescription. To predict Egyptian community pharmacists' counseling on oral contraceptives while utilizing a theoretical framework guided by the Theory of Planned Behavior (TPB). A cross-sectional, self-administered survey was completed by a random sample of community pharmacists in Alexandria, Egypt to determine their attitudes and behaviors regarding counseling on OCs. Multiple regression was used to predict self-reported counseling on oral contraceptives as a function of the TPB-related constructs and six other factors - "perceived importance of profit from dispensing OCs on pharmacy revenue," "number of hours worked," "age," "gender," "pharmacy practice degree" and "marital status" of the pharmacist. Of the 181 pharmacists invited to complete the survey, 168 (93%) participated. Pharmacists indicated they talked to a slightly higher proportion of women about the importance of taking OCs at the same time daily than about topics such as which day to start taking OCs, side effects and what to do when a dose of OCs was missed. Pharmacists' reported counseling on oral contraceptives was positively associated with their perception that women welcomed pharmacist initiated OC counseling (β = 0.315, P < 0.001), perceived adequacy of time available to counsel women on OCs (β = 0.290, P = 0.003) and the perceived number of women who asked for their help in selecting an OC without providing a prescription in the past week (β = 0.160, P = 0.018). Pharmacists reported that women's welcoming pharmacists initiating OC counseling was associated with the pharmacists' reported percent who asked pharmacists for OC advice out of the last 5 women seeking OC (r = 0.45; P < 0.0001). Male pharmacists were less likely than female pharmacists to report that women welcomed pharmacist initiated OC counseling (r = -0.27; P = 0.0005). The TPB appears to help predict pharmacists' OC counseling. There is a need to prepare pharmacists who are frequently requested to assist women with the selection of an oral contraceptive. Interventions that would facilitate women's requests for information may be valuable to increase pharmacists' counseling on oral contraceptives. Future qualitative and observational studies are needed to assess complexities in counseling on oral contraceptives in developing countries. Copyright © 2015 Elsevier Inc. All rights reserved.

Using behavior change communication to lead a comprehensive family planning program: the Nigerian Urban Reproductive Health Initiative

PubMed Central

Krenn, Susan; Cobb, Lisa; Babalola, Stella; Odeku, Mojisola; Kusemiju, Bola

2014-01-01

ABSTRACT Background: The Nigerian Urban Reproductive Health Initiative (NURHI), a 6-year comprehensive family planning program (2009–2015) in 4 cities, intentionally applies communication theories to all program elements, not just the demand generation ones, relying mainly on a theory called ideation—the concept that contraceptive use is influenced by people's beliefs, ideas, and feelings and that changing these ideational factors can change people's behavior. Program Description: The project used multiple communication channels to foster dialogue about family planning, increase social approval for it, and improve accurate knowledge about contraceptives. Mobile service delivery was started in the third year to improve access to clinical methods in slums. Methods: Data from representative baseline (2010–11) and midterm (2012) surveys of women of reproductive age in the project cities were analyzed. We also used propensity score matching to create a statistically equivalent control group of women not exposed to project activities, and we examined service delivery data from NURHI-supported clinics (January 2011–May 2013) to determine the contribution of mobile services to total family planning services. Results: Three years into the initiative, analysis of longitudinal data shows that use of modern contraceptives has increased in each city, varying from 2.3 to 15.5 percentage points, and that the observed increases were predicted by exposure to NURHI activities. Of note is that modern method use increased substantially among the poorest wealth quintiles in project cities, on average, by 8.4 percentage points. The more project activities women were exposed to, the greater their contraceptive use. For example, among women not using a modern method at baseline, contraceptive prevalence among those with no exposure by midterm was 19.1% vs. 43.4% among those with high exposure. Project exposure had a positive dose-response relationship with ideation, as did ideation and contraceptive use. By the end of the observation period, mobile services were contributing nearly 50% of total family planning services provided through NURHI-supported clinics. Propensity score matching found that the increase in contraceptive use in the 4 cities attributable to project exposure was 9.9 percentage points. Intention to use family planning in the next 12 months also increased by 7.5 to 10.2 percentage points across the 4 cities. Conclusion: Demand-led family planning programs, in which demand generation is the driving force behind the design rather than the conventional, service delivery-oriented approach, may be more suitable in places where expressed demand for contraceptives is low. PMID:25611477

Does Sex Education Affect Adolescent Sexual Behaviors and Health?

ERIC Educational Resources Information Center

Sabia, Joseph J.

2006-01-01

This study examines whether offering sex education to young teenagers affects several measures of adolescent sexual behavior and health: virginity status, contraceptive use, frequency of intercourse, likelihood of pregnancy, and probability of contracting a sexually transmitted disease. Using data from the National Longitudinal Study of Adolescent…

Adapting a Comprehensive Approach to African American Women's Sexual Risk Taking.

ERIC Educational Resources Information Center

Wyatt, Gail E.; Tucker, M. Belinda; Romero, Gloria J.; Carmona, Jennifer Vargas; Newcomb, Michael D.; Wayment, Heidi A.; Loeb, Tamra Burns; Solis, Beatriz M.; Mitchell-Kernan, Claudia

1997-01-01

Examined factors predicting the context of HIV-related sexual behaviors in African American women. Surveys investigated demographics; sexual history, behavior, attitudes, risk, and communication; drug use; contraception; and risk reduction efforts since Magic Johnson's HIV disclosure. Demographics, sexual communication, and past sexual experiences…

A novel integration effort to reduce the risk for alcohol-exposed pregnancy among women attending urban STD clinics.

PubMed

Hutton, Heidi E; Chander, Geetanjali; Green, Patricia P; Hutsell, Catherine A; Weingarten, Kimberly; Peterson, Karen L

2014-01-01

Alcohol-exposed pregnancy (AEP) is a significant public health problem in the United States. Sexually transmitted disease (STD) clinics serve female clients with a high prevalence of heavy alcohol consumption coupled with ineffective contraceptive use. Project CHOICES (Changing High-Risk AlcOhol Use and Increasing Contraception Effectiveness) is an evidence-based, brief intervention to lower risk of AEP by targeting alcohol and contraceptive behaviors through motivational interviewing and individualized feedback. We describe our experience integrating and implementing CHOICES in STD clinics. This endeavor aligns with CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention's program collaboration and service integration strategic priority to strengthen collaborative work across disease areas and integrate services provided by related programs at the client level.

A Novel Integration Effort to Reduce the Risk for Alcohol-Exposed Pregnancy Among Women Attending Urban STD Clinics

PubMed Central

Hutton, Heidi E.; Chander, Geetanjali; Green, Patricia P.; Hutsell, Catherine A.; Weingarten, Kimberly

2014-01-01

Alcohol-exposed pregnancy (AEP) is a significant public health problem in the United States. Sexually transmitted disease (STD) clinics serve female clients with a high prevalence of heavy alcohol consumption coupled with ineffective contraceptive use. Project CHOICES (Changing High-Risk AlcOhol Use and Increasing Contraception Effectiveness) is an evidence-based, brief intervention to lower risk of AEP by targeting alcohol and contraceptive behaviors through motivational interviewing and individualized feedback. We describe our experience integrating and implementing CHOICES in STD clinics. This endeavor aligns with CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention's program collaboration and service integration strategic priority to strengthen collaborative work across disease areas and integrate services provided by related programs at the client level. PMID:24385650

Young women's consistency of contraceptive use – Does depression or stress matter?

PubMed Central

Moreau, Caroline; Trussell, James; Barber, Jennifer

2013-01-01

Background We prospectively examined the influence of young women's depression and stress symptoms on their weekly consistency of contraceptive method use. Study Design Women ages 18-20 years (n=689) participating in a longitudinal cohort study completed weekly journals assessing reproductive, relationship and health characteristics. We used data through 12 months follow-up (n=8,877 journals) to examine relationships between baseline depression (CES-D) and stress (PSS-10) symptoms and consistency of contraceptive methods use with sexual activity each week. We analyzed data with random effects multinomial logistic regression. Results Consistent contraceptive use (72% of weeks) was 10-15 percentage points lower among women with moderate/severe baseline depression and stress symptoms than those without symptoms (p-values<0.001). Controlling for covariates, women with depression and stress symptoms had 47% and 69% reduced odds of contraceptive consistency each week than those without symptoms, respectively (OR 0.53, CI 0.31-0.91 and OR 0.31, CI 0.18-0.52). Stress predicted inconsistent use of oral contraceptives (OR 0.27, CI 0.12-0.58), condoms (OR 0.40, CI 0.23-0.69) and withdrawal (OR 0.12, CI 0.03-0.50). Conclusion Women with depression and stress symptoms appear to be at increased risk for user-related contraceptive failures, especially for the most commonly used methods. Implications Our study has shown that young women with elevated depression and stress symptoms appear to be at risk for inconsistent contraceptive use patterns, especially for the most common methods that require greater user effort and diligence. Based upon these findings, clinicians should consider women's psychological and emotional status when helping patients with contraceptive decision-making and management. User-dependent contraceptive method efficacy is important to address in education and counseling sessions, and women with stress or depression may be ideal candidates for long-acting reversible methods, which offer highly effective options with less user-related burden. Ongoing research will provide a greater understanding of how young women's dynamic mental health symptoms impact family planning behaviors and outcomes over time. PMID:23850075

Young women's consistency of contraceptive use--does depression or stress matter?

PubMed

Stidham Hall, Kelli; Moreau, Caroline; Trussell, James; Barber, Jennifer

2013-11-01

We prospectively examined the influence of young women's depression and stress symptoms on their weekly consistency of contraceptive method use. Women ages 18-20 years (n = 689) participating in a longitudinal cohort study completed weekly journals assessing reproductive, relationship and health characteristics. We used data through 12 months of follow-up (n = 8877 journals) to examine relationships between baseline depression (CES-D) and stress (PSS-10) symptoms and consistency of contraceptive methods use with sexual activity each week. We analyzed data with random effects multivarible logistic regression. Consistent contraceptive use (72% of weeks) was 10-15 percentage points lower among women with moderate/severe baseline depression and stress symptoms than those without symptoms (p < .001). Controlling for covariates, women with depression and stress symptoms had 47% and 69% reduced odds of contraceptive consistency each week than those without symptoms, respectively (OR 0.53, CI 0.31-0.91 and OR 0.31, CI 0.18-0.52). Stress predicted inconsistent use of oral contraceptives (OR 0.27, CI 0.12-0.58), condoms (OR 0.40, CI 0.23-0.69) and withdrawal (OR 0.12, CI 0.03-0.50). Women with depression and stress symptoms appear to be at increased risk for user-related contraceptive failures, especially for the most commonly used methods. Our study has shown that young women with elevated depression and stress symptoms appear to be at risk for inconsistent contraceptive use patterns, especially for the most common methods that require greater user effort and diligence. Based upon these findings, clinicians should consider women's psychological and emotional status when helping patients with contraceptive decision-making and management. User-dependent contraceptive method efficacy is important to address in education and counseling sessions, and women with stress or depression may be ideal candidates for long-acting reversible methods, which offer highly effective options with less user-related burden. Ongoing research will provide a greater understanding of how young women's dynamic mental health symptoms impact family planning behaviors and outcomes over time. Copyright © 2013 Elsevier Inc. All rights reserved.

Association between non-barrier modern contraceptive use and condomless sex among HIV-positive female sex workers in Mombasa, Kenya: A prospective cohort analysis.

PubMed

Surie, Diya; Yuhas, Krista; Wilson, Kate; Masese, Linnet N; Shafi, Juma; Kinuthia, John; Jaoko, Walter; McClelland, R Scott

2017-01-01

As access to antiretroviral therapy in sub-Saharan Africa continues to expand, more women with HIV can expect to survive through their reproductive years. Modern contraceptives can help women choose the timing and spacing of childbearing. However, concerns remain that women with HIV who use non-barrier forms of modern contraception may engage in more condomless sex because of their decreased risk of unintended pregnancy. We examined whether non-barrier modern contraceptive use by HIV-positive female sex workers was associated with increased frequency of recent condomless sex, measured by detection of prostate-specific antigen (PSA) in vaginal secretions. Women who were HIV-positive and reported transactional sex were included in this analysis. Pregnant and post-menopausal follow-up time was excluded, as were visits at which women reported trying to get pregnant. At enrollment and quarterly follow-up visits, a pelvic speculum examination with collection of vaginal secretions was conducted for detection of PSA. In addition, women completed a structured face-to-face interview about their current contraceptive methods and sexual risk behavior at enrollment and monthly follow-up visits. Log-binomial generalized estimating equations regression was used to test for associations between non-barrier modern contraceptive use and detection of PSA in vaginal secretions and self-reported condomless sex. Data from October 2012 through September 2014 were included in this analysis. Overall, 314 women contributed 1,583 quarterly examination visits. There was minimal difference in PSA detection at contraceptive-exposed versus contraceptive-unexposed visits (adjusted relative risk [aRR] 1.28, 95% confidence interval [95% CI] 0.93-1.76). There was a higher rate of self-reported condomless sex at visits where women reported using modern contraceptives, but this difference was not statistically significant after adjustment for potential confounding factors (aRR 1.59, 95% CI 0.98-2.58). Non-barrier methods of modern contraception were not associated with increased risk of objective evidence of condomless sex.

A randomized controlled trial of the impact of a family planning mHealth service on knowledge and use of contraception.

PubMed

Johnson, Douglas; Juras, Randall; Riley, Pamela; Chatterji, Minki; Sloane, Phoebe; Choi, Soon Kyu; Johns, Ben

2017-01-01

mHealth, or the use of mobile phones for health, is a promising but largely untested method for increasing family planning knowledge in developing countries. This study estimates the effect of m4RH, an mHealth service in Kenya that provides family planning information via text message, on consumers' knowledge and use of contraception. We randomly assigned new consumers of the m4RH service to receive either full access or limited access to m4RH. We collected data on outcomes by sending questions directly to consumers via text message. Response rates to the text message surveys ranged from 51.8% to 13.5%. Despite relatively low response rates, response rates were very similar across the full-access and limited-access groups. We find that full access to m4RH increased consumers' scores on a test of contraceptive knowledge by 14% (95% confidence interval: 9.9%-18.2%) compared to a control group with limited access to m4RH. m4RH did not increase consumers' use of contraception, likelihood of discussing family planning with their partners, or likelihood of visiting a clinic to discuss family planning. Text messages may increase family planning knowledge but do not, by themselves, lead to behavior change. Text messages can be an effective method of increasing family planning knowledge but may be insufficient on their own to cause behavior change. Copyright © 2016 Elsevier Inc. All rights reserved.

Sex Knowledge, Sex Guilt and Sexual Behavior among University Students.

ERIC Educational Resources Information Center

Brown, Idalyn S.; Pollack, Robert H.

Previous research has suggested a high level of sexual activity among students, often involving unprotected intercourse. To better understand what factors contribute to consistent use of effective contraception, the relationship between sexual knowledge and sexual behavior and the relationship of sex guilt to sex knowledge were investigated in a…

Transition-Marking Behaviors of Adolescent Males at First Intercourse.

ERIC Educational Resources Information Center

McLean, Ann L.; Flanigan, Beverly J.

1993-01-01

Examined male transition-marking behaviors from adolescence into adulthood at first intercourse. Findings from 80 adolescent males revealed that alcohol use at first intercourse was unrelated to use of contraceptives at that time but was inversely related to whether first intercourse was planned. Planning was positively related to contraceptive…

Prevention of the Teenage Pregnancy Epidemic: A Social Learning Theory Approach.

ERIC Educational Resources Information Center

Hagenhoff, Carol; And Others

1987-01-01

The review provides a social learning model for explaining adolescent sexual behavior and use/nonuse of contraceptives. The model explains behavior patterns responsible for epidemic rates of teenage pregnancies, suggests research that will result in prevention of teenage pregnancies, and incorporates a range of social/cultural factors. (DB)

Indenopyride derivative RTI-4587-073(l): a candidate for male contraception in stallions.

PubMed

Pozor, Malgorzata A; Macpherson, Margo L; McDonnell, Sue M; Nollin, Maggie; Roser, Janet F; Love, Charles; Runyon, Scott; Thomas, Brian F; Troedsson, Mats H

2013-12-01

The objective of this study was to determine whether an indenopyridine derivative RTI-4587-073(l) was a good candidate for male contraception in horses. We hypothesized that a single administration of RTI-4587-073(l) causes significant suppression of testicular function in stallions without affecting sexual behavior. Three Miniature horse stallions received a single dose of 12.5 mg/kg RTI-4587-073(l) orally (group "treated"), whereas three other Miniature horse stallions received placebo only (group "control"). Semen was collected and evaluated from all stallions twice a week for three baseline weeks and 13 post-treatment weeks. Sexual behavior was video-recorded and analyzed. Testicular dimensions were measured using ultrasonography, and blood samples were drawn for endocrine evaluation once before treatment and once a week during the post-treatment period. Single administration of RTI-4587-073(l) caused severe oligoasthenozoospermia (low sperm number and low motility), shedding large numbers of immature germ cells in semen, and increased FSH concentrations in treated stallions. These effects were fully reversible within ∼71 days. However, libido and copulatory behavior remained unchanged throughout the entire experiment. We concluded that RTI-4587-073(l) was a promising candidate for male contraceptive in domestic stallions. Further research should be performed to test this compound for fertility control in wildlife and humans. Copyright © 2013 Elsevier Inc. All rights reserved.

C.A.M.P.: A Community-Based Approach to Promoting Safe Sex Behavior in Adolescence.

ERIC Educational Resources Information Center

Guzman, Bianca L.; Casad, Bettina J.; Schlehofer-Sutton, Michele M.; Villanueva, Christina M.; Feria, Aida

The primary goal of this study was to assess the Community Awareness Motivation Partnership (C.A.M.P.) theater intervention based on the behavioral ecological model. C.A.M.P addresses the role of contraceptive use in safe sex behavior through an informative and entertaining culturally relevant dramatization program. Adolescents (N=1613) between…

Developmental Exposure to Low Levels of Ethinylestradiol Affects Play Behavior in Juvenile Female Rats.

PubMed

Zaccaroni, Marco; Massolo, Alessandro; Della Seta, Daniele; Farabollini, Francesca; Giannelli, Giulietta; Fusani, Leonida; Dessì-Fulgheri, Francesco

2018-05-01

Juvenile social play contributes to the development of adult social and emotional skills in humans and non-human animals, and is therefore a useful endpoint to study the effects of endocrine disrupters on behavior in animal models. Ethinylestradiol (EE 2 ) is a widely produced, powerful synthetic estrogen that is widespread in the environment mainly because is a component of the contraceptive pill. In addition, fetuses may be exposed to EE2 when pregnancy is undetected during contraceptive treatment. To understand whether exposure to EE 2 during gestation or lactation affects social play, we exposed 72 female Sprague-Dawley rats to EE 2 or vehicle either during gestation (gestation day (GD) 5 through GD 20) or during lactation (from postnatal day (PND) 1 through PND 21). Two doses of EE 2 were used to treat the dams: a lower dose in the range of possible environmental exposure (4 ng/kg/day) and a higher dose equivalent to that received during contraceptive treatment (400 ng/kg/day). Behavioral testing was carried out between PND 40 and 45. A principal component analysis of frequencies of behavioral items observed during play sessions identified three main components: defensive-like play, aggressive-like play, and exploration. Aggressive-like play was significantly increased by both doses of EE 2 , and the gestational administration was in general more effective than the lactational one. Defensive-like play and exploration were not significantly affected by treatment. This research showed that low and very low doses of EE 2 that mimic clinical or environmental exposure during development can affect important aspects of social behavior even during restricted time windows.

IUD discontinuation rates, switching behavior, and user satisfaction: findings from a retrospective analysis of a mobile outreach service program in Pakistan

PubMed Central

Azmat, Syed Khurram; Hameed, Waqas; Mustafa, Ghulam; Hussain, Wajahat; Ahmed, Aftab; Bilgrami, Mohsina

2013-01-01

Background In Pakistan, the uptake rate for the intrauterine device (IUD) is very low at 2.5%. The most popular modern contraceptive methods in Pakistan are female sterilization and use of condoms. The Marie Stopes Society established its mobile outreach service delivery program with the aim of increasing use of modern quality contraceptive services, including the long-term reversible IUD, by women living in hard-to-reach areas. The present study attempts to assess IUD discontinuation rates and associated factors, including switching behavior and level of satisfaction with this type of service delivery. Methods Using a cross-sectional approach, we contacted 681 women who had received an IUD from the Marie Stopes Society mobile outreach program during July and August 2009. Successful interviews were conducted with 639 of these women using a structured questionnaire. The data were analyzed with Stata 11.2 using simple descriptive Chi-square and Cox proportional techniques. Results Analysis revealed that 19.4% (95% confidence interval 16.3–22.5) of the women discontinued use of their IUD at 10 months and, of these women, the majority (69.4%) cited side effects as the main reason for discontinuation. Other factors, such as geographical catchment province, age of the woman, history of contraceptive use before IUD insertion, and side effects following insertion of the device, were found to be significantly associated with IUD. Amongst the women who had their IUD removed, 56.5% did not switch to any other contraceptive method, while 36.3% switched to either short-term or traditional methods, such as withdrawal, rhythm, and folk methods. Degree of satisfaction with the device was also significantly associated with discontinuation. Conclusion Early discontinuation and not switching to another contraceptive method increases the risk of unplanned pregnancy. Health care workers should be trained in managing clients’ concerns about the IUD to prevent discontinuation and providing counseling services for clients to select an alternative contraceptive method if they decide to discontinue. PMID:23359788

Gender inequality and the 'East-West' divide in contraception: An analysis at the individual, the couple, and the country level.

PubMed

Dereuddre, Rozemarijn; Van de Velde, Sarah; Bracke, Piet

2016-07-01

Despite generally low fertility rates in Europe, contraceptive behavior varies to a substantial extent. The dichotomy between Western, and Central and Eastern European countries is particularly relevant. Whereas the former are characterized by the widespread use of modern contraception, the latter show a high prevalence of traditional methods to control fertility. The current study aims to examine whether these differences can be attributed to differences in women's individual status, and in gender inequality at the couple and the country level. We combine data from the Generations and Gender Survey (2004-2011) and the Demographic Health Survey (2005-2009), covering seventeen European countries, to perform multinomial multilevel analyses. The results confirm that higher educated and employed women, and women who have an equal occupational status relative to their partner are more likely to use modern reversible contraception instead of no, traditional, or permanent methods. Absolute and relative employment are also positively related to using female instead of male methods. Furthermore, it is shown that higher levels of country-level gender equality are associated with a higher likelihood of using modern reversible and female methods, but not sterilization. Particularly country levels of gender equality are linked to the East-West divide in type of contraceptive method used. Our findings underscore that women's higher status is closely related to their use of effective, female contraception. Copyright © 2016 Elsevier Ltd. All rights reserved.

Emergency contraception: clinical outcomes.

PubMed

Glasier, Anna

2013-03-01

Emergency contraception (EC) is widely used to prevent unwanted pregnancy. This review considers the safety and efficacy of three commonly used methods -- levonorgestrel (LNG-EC), ulipristal acetate (UPA) and the copper intrauterine device. All are extremely safe, and side effects are minimal. Concerns about increased risks of ectopic pregnancy after EC use have proved unfounded, and possible teratogenic effects seem unlikely. Although the true effectiveness of EC is impossible to estimate, recent research suggests that LNG-EC prevents around 50% of expected pregnancies in women using the method within 72 h of intercourse, whereas UPA appeared to prevent almost two thirds of pregnancies. Emergency intrauterine device insertion probably prevents over 95% of pregnancies. However, although improved accessibility of EC has clearly led to increased use, it does not appear to have had any public health benefit in reducing unintended pregnancy rates. Most of the data on sexual behavior following improved access to EC do not show any detrimental effect on subsequent use of other more effective methods of contraception or on the incidence of unintended pregnancy or sexually transmitted infection. However, unless these other methods of contraception are also made easily available from pharmacies, improved access to EC risks unlinking its use with use of subsequent ongoing contraception. Copyright © 2013 Elsevier Inc. All rights reserved.

Sexual and reproductive health in Spanish University Students. A comparison between medical and law students.

PubMed

Coronado, Pluvio J; Delgado-Miguel, Carlos; Rey-Cañas, Adriana; Herráiz, Miguel A

2017-03-01

To describe behaviors and knowledge related to sexual and reproductive health of Spanish university students and their association with the subject area studied (biomedical or not). A descriptive cross-sectional observational study conducted with 2074 students aged 18-24years from the University Complutense of Madrid in the Faculties of Medicine and Law. Simple random stratified sampling without replacement was performed. A self-administered, anonymous and voluntary questionnaire was distributed. It was based on the Youth Risk Health Behavior Survey and assessed behavior and knowledge in three areas: sex, contraceptive methods (CM) and sexually transmitted infections (STIs). In total, 83.5% of respondents had had sexual intercourse, from a mean age of 16.8years and with a mean of 3.4 sexual partners. Compared with the law students (LS), fewer medical students (MS) were sexually active, they had a later age of sexual initiation and they had had fewer sexual partners (p<0.001). High regular use of contraceptive methods was observed (92.8%), with no significant differences between groups, although LS had had more unprotected sex and had more often used emergency contraception than had MS (p<0.001). In total, 81.5% of respondents knew about the vaccine against human papillomavirus, 60.8% its relationship with cancer and 43.2% had been vaccinated, the rates being significantly higher in MS (p<0.001). The behavior and knowledge of medical students in relation to sexual and reproductive health differed from those of law students. Copyright © 2016 Elsevier B.V. All rights reserved.

A prospective study of the sexual, emotional, and behavioral correlates associated with young women's first and usual coital events.

PubMed

Tanner, Amanda E; Hensel, Devon J; Fortenberry, J Dennis

2010-07-01

First coitus is considered a major transitional event imbued with cultural relevance. Research has focused on classifying women as virgins, with primary interest in pregnancy and sexually transmitted infection prevention and less on sexuality. This study prospectively explored young women's sexual interest and love at first and subsequent coitus. Daily diary data were collected during a longitudinal study of young women's sexual health (N = 387; 14-17 years at enrollment). Variables of interest included sexual interest, love, and contraceptive and disease prevention behaviors. Analysis of variance and multinomial logistic regression were utilized. For first coital events, love and sexual interest were reported about "half of the day," with sexual interest significantly higher on the day of first coitus. Condom use was nine times more likely than no method at first compared to later coital events. For subsequent coitus, feeling of being in love was significantly higher compared to first coitus, with average sexual interest and love significantly higher with use of no contraceptive method over condoms. Condoms were associated with higher feelings of being in love, but lower sexual interest compared to hormonal contraception. The results indicated that sexual interest and love are independent components of coital behavior. Yet the results also suggest that young women's first coitus does not fully capture the expected significance of "losing one's virginity." Thus, at first coitus, women can actively engage in protective behaviors and focus on pleasure. Copyright (c) 2010 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Overlapping dose responses of spermatogenic and extragonadal testosterone actions jeopardize the principle of hormonal male contraception

PubMed Central

Oduwole, Olayiwola O.; Vydra, Natalia; Wood, Nicholas E. M.; Samanta, Luna; Owen, Laura; Keevil, Brian; Donaldson, Mandy; Naresh, Kikkeri; Huhtaniemi, Ilpo T.

2014-01-01

Testosterone (T), alone or in combination with progestin, provides a promising approach to hormonal male contraception. Its principle relies on enhanced negative feedback of exogenous T to suppress gonadotropins, thereby blocking the testicular T production needed for spermatogenesis, while simultaneously maintaining the extragonadal androgen actions, such as potency and libido, to avoid hypogonadism. A serious drawback of the treatment is that a significant proportion of men do not reach azoospermia or severe oligozoospermia, commensurate with contraceptive efficacy. We tested here, using hypogonadal luteinizing hormone/choriongonadotropin receptor (LHCGR) knockout (LHR−/−) mice, the basic principle of the T-based male contraceptive method, that a specific T dose could maintain extragonadal androgen actions without simultaneously activating spermatogenesis. LHR−/− mice were treated with increasing T doses, and the responses of their spermatogenesis and extragonadal androgen actions (including gonadotropin suppression and sexual behavior) were assessed. Conspicuously, all dose responses to T were practically superimposable, and no dose of T could be defined that would maintain sexual function and suppress gonadotropins without simultaneously activating spermatogenesis. This finding, never addressed in clinical contraceptive trials, is not unexpected in light of the same androgen receptor mediating androgen actions in all organs. When extrapolated to humans, our findings may jeopardize the current approach to hormonal male contraception and call for more effective means of inhibiting intratesticular T production or action, to achieve consistent spermatogenic suppression.—Oduwole, O. O., Vydra, N., Wood, N. E. M., Samanta, L., Owen, L., Keevil, B., Donaldson, M., Naresh, K., Huhtaniemi, I. T. Overlapping dose responses of spermatogenic and extragonadal testosterone actions jeopardize the principle of hormonal male contraception. PMID:24599970

[Acceptance and rejection of vasectomy in rural males].

PubMed

García Moreno, Juan; Solano Sainos, Luis Miguel

2005-01-01

One problem in rural population is the gap between coverage of contraception and scant masculine participation, which could be due to lack of information of to other sociocultural factors. We investigated, in two stages, the characteristics or the profile of the sexual and reproductive behavior of males in an exploratory study by means of focus groups to determine their relevant motivations and characteristics and subsequently, a structured questionnaire to ascertain the magnitude of the factors explored. The population corresponded to zones of rural hospital medical services zones of medical services in seven ethnic groups of the Mexican Republic and included men who accepted and who rejected vasectomy. The profile of males who accepted vasectomy allowed to determine that there exist a unsatisfied demand for contraceptive protection and the desire of not having additional children; in addition, we found that the decision to accept vasectomy is determined to a greater extent for reasons different from that of information on the contraceptive method. The important proportion of males who were non-users of contraceptive methods who accepted vasectomy supposed information on contraception to be the most consistent reason; nonetheless, this information was not considered sufficient and timely; thus, adverse economic situation, a certain condition related with the couple such as health or love for the female partner are the more weighty reasons for deciding to accept vasectomy, while the fear of poor sexual performance is the most powerful factor for rejection of vasectomy. Masculine participation in family planning is a factor that conditions contraceptive coverage and its respective benefits. The profile of the male who accepts vasectomy aids in identifying candidates forthe procedure and in reducing unsatisfied demand. Greater diffusion of information of the contraceptive method of vasectomy, greater links between male needs and vasectomy, and maintaining or increasing access to family planning are required.

[Survey on knowledge, attitude, practice related to contraception among college students in Beijing].

PubMed

Zhou, Yuan-Zhong; Zhang, Mei-Mei; Wei, Sheng; Guan, Huang-Tao; Yin, Ping; Ren, Ning; Pang, Xue-Bing; Xiong, Cheng-Liang

2009-07-01

To understand the current status and relative factors on knowledge, attitude, practice to contraception among college students in Beijing and to provide evidence for developing aimed contraceptive service and education in colleges. Quantitative surveys were employed, questionnaire was conducted anonymously among 12,450 unmarried college students under informed consent. Among 12,129 students, acknowledgement of contraceptive knowledge among females was superior to males in college (P=0.000). Rates on the favor for unmarried sexual practice and 'sexual liberation' were 81.9% and 60.2% for males, comparing to 74.8% and 54.3% for females respectively. The prevalence rates for masturbation were 74.3% for males and 24.9% for females respectively. 18.4% of the male and 10.5% of the female students had ever experienced unmarried sexual intercourse. Among those students who had sexual experiences, 29.4% of the males had made their sex partners pregnant and 23.1% of the female students had experienced unexpected pregnancy. Statistical significance was found between males and females (P=0.000) in terms of attitudes and behaviors. 51.3% of the male and female students took contraceptive measures during the episode of first sexual intercourse. The excuses for not taking any measures would include: sexual intercourse happened incidentally, not interested in using condom, only one sexual experience would not cause pregnancy, etc. The prevalence of unmarried sexual intercourse among college students had been rising. Among those who had experienced unmarried sexual intercourse, the rate of taking contraceptive measures was low and the incidence of unexpected pregnancy was high. It is urgent to strengthen the education and service programs on contraception among college students.

Exposure to the contraceptive progestin, gestodene, alters reproductive behavior, arrests egg deposition, and masculinizes development in the fathead minnow (Pimephales promelas)

USGS Publications Warehouse

Frankel, Tyler E.; Meyer, Michael T.; Kolpin, Dana W.; Gillis, Amanda B.; Alvarez, David A.; Orlando, Edward F.

2016-01-01

Endogenous progestogens and pharmaceutical progestins enter the environment through wastewater treatment plant effluent and agricultural field runoff. Lab studies demonstrate strong, negative exposure effects of these chemicals on aquatic vertebrate reproduction. Behavior can be a sensitive, early indicator of exposure to environmental contaminants associated with altered reproduction yet is rarely examined in ecotoxicology studies. Gestodene is a human contraceptive progestin and a potent activator of fish androgen receptors. Our objective was to test the effects of gestodene on reproductive behavior and associated egg deposition in the fathead minnow. After only 1 day, males exposed to ng/L of gestodene were more aggressive and less interested in courtship and mating, and exposed females displayed less female courtship behavior. Interestingly, 25% of the gestodene tanks contained a female that drove the male out of the breeding tile and displayed male-typical courtship behaviors toward the other female. Gestodene decreased or arrested egg deposition with no observed gonadal histopathology. Together, these results suggest that effects on egg deposition are primarily due to altered reproductive behavior. The mechanisms by which gestodene disrupts behavior are unknown. Nonetheless, the rapid and profound alterations of the reproductive biology of gestodene-exposed fish suggest that wild populations could be similarly affected.

Demand for long acting and permanent methods of contraceptives and factors for non-use among married women of Goba Town, Bale Zone, South East Ethiopia.

PubMed

Takele, Abulie; Degu, Getu; Yitayal, Mezgebu

2012-10-29

Contraceptive use including short acting, long acting and permanent methods positively influence the socio-economic development of a nation by allowing families to space and limit their family size to their economic capacity. Demand for LAPMs of contraception as detrmined by utilization and unmet need for LAPMs of contraception can provide realiable information for providers. To determine the utilization of long acting and permanent contraception and its associated factors among married women of Goba town, South East Ethiopia. A cross sectional community based study was conducted among 734 systematically selected married women of reproductive age in Goba town in September/ 2009. A structured and pretested, interview questionaire was used to collect data on socio-demographic, behavioral factors and data related to demand for LAPMs of contraception. Data were analyzed using EPI INFO and SPSS version 16. The demand for Long Acting and Permanent Methods (LAPMs) of contraception was 18.1%. Utilization of LAPMs of contraception in the town was 64 (8.7%) and the unmet need for LAPMs was 69 (9.4%). Information on LAPMs in the town was 636 (86.6%). Media (radio and television) was the major sources of information 641 (87.3%). The use of LAPMs was significatly associated with ever use AOR[17.43, 95% CI:9.19, 33.03], number of times discussions made on methods AOR[4.6, 95% CI: 1.72,12.17] and main decider of using methods AOR[ 2.2, 95% CI:1.03, 4.65]. It was not associated with socio-demographic variables. The utilization of LAPMs in the town was less although higher than the Ethiopian demographic and health survey 2005 result. Moreover, there was a considerable unmet need. Increase the method mix of LAPMs by incorporating varaies of implnats in order to increase utilization. Proper counseling of client and partners discussion were some of the recommendation forwarded.

Fertility Behavior in a Tri-Racial, Low Income Rural County. Project Report.

ERIC Educational Resources Information Center

Davis, Adam Clarke; And Others

Child bearing is probably one of the most important functions of the family in American society today. This study identified and investigated the (1) reasons for the existing differentials in fertility behavior (preferences, contraceptive use and effectiveness, and actual fertility) of white, black, and American Indian groups in a low income…

Gender, Ethnic, and Acculturation Differences in Sexual Behaviors: Hispanic and Non-Hispanic White Adults.

ERIC Educational Resources Information Center

Sabogal, Fabio; And Others

1995-01-01

Two northern California surveys examined prevalence of sexual relations, number of sexual partners, contraception, age at first intercourse, and sexually transmitted diseases among 2,596 Hispanic and non-Hispanic white adults aged 35-74. Differences in sexual behaviors were somewhat related to ethnicity and acculturation but were more strongly…

Attitudes, Knowledge, and Behavior Regarding Condom Use in Urban Black Adolescent Males.

ERIC Educational Resources Information Center

Wilson, Michele D.; And Others

1994-01-01

Examined male adolescent behavior, attitudes, and knowledge concerning condom use. Findings from 241 sexually active black adolescent males revealed that factors associated with condom use included higher grade level, having 2 or more sexual partners in past 6 months, communication about contraception with sexual partner, desire for sexually…

Clitoral vascularization and sexual behavior in young patients treated with drospirenone-ethinyl estradiol or contraceptive vaginal ring: a prospective, randomized, pilot study.

PubMed

Battaglia, Cesare; Morotti, Elena; Persico, Nicola; Battaglia, Bruno; Busacchi, Paolo; Casadio, Paolo; Paradisi, Roberto; Venturoli, Stefano

2014-02-01

Oral contraceptives (OC) are effective for birth control and have good cycle control and tolerability. However, the hormonal components could modify mood and libido. The aim of this study is to evaluate the genital vascular effects and sexual behavior of an OC containing 30 μg ethinyl estradiol and 3 mg drospirenone in comparison with a flexible combined contraceptive vaginal ring. Forty women underwent a sonographic assessment of the clitoral anatomy and vascularization and were administered the McCoy Female Sexuality Questionnaire (MFSQ) and the Beck's Depression Inventory questionnaire (BDI). Estradiol, androstenedione, testosterone, and SHBG were assayed. Free Androgen Index (FAI) and Free Estrogen Index (FEI) were calculated. The patients were randomly submitted to OC (group I; n = 21) or vaginal ring (group II; n = 19). Ultrasonographic clitoral volume, pulsatility index (PI) of dorsal clitoral arteries, MFSQ, BDI, and hormonal and biochemical assays were analyzed. After therapy, the testosterone levels were reduced in both groups, whereas estradiol decreased only in group I women. The SHBG increased in all the subjects, and both FAI and FEI decreased. The clitoral volume decreased in all the women. The PI of the dorsal clitoral artery increased only in patients on OC. The hormonal contraception was associated, in both studied groups, with a significant decrease of the two-factor Italian MFSQ score, which was more marked in OC users. In group I subjects, there was a reduction of the number of intercourse/week and a reduction of orgasm frequency during intercourse. The pain during intercourse worsened after OC use. The vaginal ring users reported a vaginal wetness. Six-month treatment with hormonal contraception is associated with a diminished MFSQ score. However, the frequency of sexual intercourse and orgasm was reduced only by the use of OC. The OC use was associated with increased pain during intercourse. © 2013 International Society for Sexual Medicine.

Immunocontraception in Wild Horses (Equus caballus) Extends Reproductive Cycling Beyond the Normal Breeding Season

PubMed Central

Nuñez, Cassandra M. V.; Adelman, James S.; Rubenstein, Daniel I.

2010-01-01

Background Although the physiological effects of immunocontraceptive treatment with porcine zona pellucida (PZP) have been well studied, little is known about PZP's effects on the scheduling of reproductive cycling. Recent behavioral research has suggested that recipients of PZP extend the receptive breeding period into what is normally the non-breeding season. Methodology/Principal Findings To determine if this is the case, we compiled foaling data from wild horses (Equus caballus) living on Shackleford Banks, North Carolina for 4 years pre- and 8 years post-contraception management with PZP (pre-contraception, n = 65 births from 45 mares; post-contraception, n = 97 births from 46 mares). Gestation lasts approximately 11–12 months in wild horses, placing conception at approximately 11.5 months prior to birth. Since the contraception program began in January 2000, foaling has occurred over a significantly broader range than it had before the contraception program. Foaling in PZP recipients (n = 45 births from 27 mares) has consistently occurred over a broader range than has foaling in non-recipients (n = 52 births from 19 mares). In addition, current recipients of PZP foaled later in the year than did prior recipient and non-recipient mares. Females receiving more consecutive PZP applications gave birth later in the season than did females receiving fewer applications. Finally, the efficacy of PZP declined with increasing consecutive applications before reaching 100% after five consecutive applications. Conclusions/Significance For a gregarious species such as the horse, the extension of reproductive cycling into the fall months has important social consequences, including decreased group stability and the extension of male reproductive behavior. In addition, reproductive cycling into the fall months could have long-term effects on foal survivorship. Managers should consider these factors before enacting immunocontraceptive programs in new populations. We suggest minor alterations to management strategies to help alleviate such unintended effects in new populations. PMID:21049017

Applying clinically proven human techniques for contraception and fertility to endangered species and zoo animals: a review.

PubMed

Silber, Sherman J; Barbey, Natalie; Lenahan, Kathy; Silber, David Z

2013-12-01

Reversible contraception that does not alter natural behavior is a critical need for managing zoo populations. In addition to reversible contraception, other fertility techniques perfected in humans may be useful, such as in vitro fertilization (IVF) or oocyte and embryo banking for endangered species like amphibians and Mexican wolves (Canis lupus baileyi). Furthermore, the genetics of human fertility can give a better understanding of fertility in more exotic species. Collaborations were established to apply human fertility techniques to the captive population. Reversible vasectomy might be one solution for reversible contraception that does not alter behavior. Reversible approaches to vasectomy, avoiding secondary epididymal disruption, were attempted in South American bush dogs (Speothos venaticus), chimpanzees (Pan troglodytes), gorillas (Gorilla gorilla), Przewalski's horse (Equus przewalski poliakov), and Sika deer (Cervus nippon) in a variety of zoos around the world. These techniques were first perfected in > 4,000 humans before attempting them in zoo animals. In vitro fertilization with gestational surrogacy was used to attempt to break the vicious cycle of hand rearing of purebred orangutans, and egg and ovary vitrification in humans have led to successful gamete banking for Mexican wolves and disappearing amphibians. The study of the human Y chromosome has even explained a mechanism of extinction related to global climate change. The best results with vasectomy reversal (normal sperm counts, pregnancy, and live offspring) were obtained when the original vasectomy was performed "open-ended," so as to avoid pressure-induced epididymal disruption. The attempt at gestational surrogacy for orangutans failed because of severe male infertility and the lack of success with human ovarian hyperstimulation protocols. Vitrification of oocytes is already being employed for the Amphibian Ark Project and for Mexican wolves. Vasectomy can be a reversible contraception option in zoo animals, even in endangered species. Ongoing use of gamete and embryo freezing may salvage vanishing species.

Marital Processes, Arranged Marriage, and Contraception to Limit Fertility

PubMed Central

Ghimire, Dirgha J.; Axinn, William G.

2013-01-01

An international transition away from familially-arranged marriages toward participation in spouse choice has endured for decades and continues to spread through rural Asia today. Though we know this transformation has important consequences for childbearing early in marriage, we know much less about longer-term consequences of this marital revolution. This study draws upon theories of family and fertility change and a rural Asian panel study designed to investigate changes in both marital and childbearing behaviors to investigate these long-term consequences. Controlling for social changes that shape both marital practices and childbearing behaviors, and explicitly considering multiple dimensions of marital processes, we find evidence consistent with an independent, long-standing association of participation in spouse choice with higher rates of contraception to terminate childbearing. These results add a new dimension to the evidence linking revolutions in marital behavior to long-term declines in fertility, but also motivate new research to consider a broader range of long-term consequences of changing marital processes. PMID:23709184

Environmental Quality and Fertility: The Effects of Plant Density, Species Richness, and Plant Diversity on Fertility Limitation *

PubMed Central

Brauner-Otto, Sarah R.

2013-01-01

The relationship between the environment and population has been of concern for centuries and climate change is making this an even more pressing area of study. In poor rural areas declining environmental conditions may elicit changes in family related behaviors. This paper explores this relationship in rural Nepal looking specifically at how plant density, species richness, and plant diversity are related to women’s fertility limitation behavior. Taking advantage of a unique data set with detailed micro-level environmental measures and individual fertility behavior I link geographically weighted measures of flora at one point in time to women’s later contraceptive use as a way to examine this complex relationship. I find a significant, positive relationship between plant density, species richness, and plant diversity and the timing of contraceptive use. Women in poor environmental conditions are less likely to terminate childbearing, or do so later, and therefore more likely to have larger families. PMID:25593378

Theory-based interventions for contraception.

PubMed

Lopez, Laureen M; Tolley, Elizabeth E; Grimes, David A; Chen, Mario; Stockton, Laurie L

2013-08-07

The explicit use of theory in research helps expand the knowledge base. Theories and models have been used extensively in HIV-prevention research and in interventions for preventing sexually transmitted infections (STIs). The health behavior field uses many theories or models of change. However, educational interventions addressing contraception often have no stated theoretical base. Review randomized controlled trials (RCTs) that tested a theoretical approach to inform contraceptive choice; encourage contraceptive use; or promote adherence to, or continuation of, a contraceptive regimen. Through June 2013, we searched computerized databases for trials that tested a theory-based intervention for improving contraceptive use (MEDLINE, POPLINE, CENTRAL, PsycINFO, ClinicalTrials.gov, and ICTRP). Previous searches also included EMBASE. For the initial review, we wrote to investigators to find other trials. Trials tested a theory-based intervention for improving contraceptive use. We excluded trials focused on high-risk groups and preventing sexually transmitted infections or HIV. Interventions addressed the use of one or more contraceptive methods for contraception. The reports provided evidence that the intervention was based on a specific theory or model. The primary outcomes were pregnancy, contraceptive choice or use, and contraceptive adherence or continuation. The primary author evaluated abstracts for eligibility. Two authors extracted data from included studies. For the dichotomous outcomes, the Mantel-Haenszel odds ratio (OR) with 95% CI was calculated using a fixed-effect model. Cluster randomized trials used various methods of accounting for the clustering, such as multilevel modeling. Most reports did not provide information to calculate the effective sample size. Therefore, we presented the results as reported by the investigators. No meta-analysis was conducted due to differences in interventions and outcome measures. We included three new trials for a total of 17. Ten randomly assigned individuals and seven were cluster-randomized. Eight trials showed some intervention effect.Two of 12 trials with pregnancy or birth data showed some effect. A theory-based group was less likely than the comparison group to have a second birth (OR 0.41; 95% CI 0.17 to 1.00) or to report a pregnancy (OR 0.24 (95% CI 0.10 to 0.56); OR 0.27 (95% CI 0.11 to 0.66)). The theoretical bases were social cognitive theory (SCT) and another social cognition model.Of 12 trials with data on contraceptive use (non-condom), six showed some effect. A theory-based group was more likely to consistently use oral contraceptives (OR 1.41; 95% CI 1.06 to 1.87), hormonal contraceptives (reported relative risk (RR) 1.30; 95% CI 1.06 to 1.58) or dual methods (reported RR 1.36; 95% CI 1.01 to 1.85); to use an effective contraceptive method (reported effect size 1.76; OR 2.04 (95% CI 1.47 to 2.83)) or use more habitual contraception (reported P < 0.05); and were less likely to use ineffective contraception (OR 0.56; 95% CI 0.31 to 0.98). Theories and models included the Health Belief Model (HBM), SCT, SCT plus another theory, other social cognition, and motivational interviewing (MI).For condom use, a theory-based group had favorable results in 5 of 11 trials. The main differences were reporting more consistent condom use (reported RR 1.57; 95% CI 1.28 to 1.94) and more condom use during last sex (reported results: risk ratio 1.47 (95% CI 1.12 to 1.93); effect size 1.68; OR 2.12 (95% CI 1.24 to 3.56); OR 1.45 (95% CI 1.03 to 2.03)). The theories were SCT, SCT plus another theory, and HBM.Nearly all trials provided multiple sessions or contacts. SCT provided the basis for seven trials focused on adolescents, of which five reported some effectiveness. Two others based on other social cognition models had favorable results with adolescents. Of six trials including adult women, five provided individual sessions. Some effect was seen in two using MI and one using the HBM. Two based on the Transtheoretical Model did not show any effect. Eight trials provided evidence of high or moderate quality. Family planning researchers and practitioners could adapt the effective interventions, although most provided group sessions for adolescents. Three were conducted outside the USA. Clinics and low-resource settings need high-quality evidence on changing behavior. Thorough use of single theories would help in identifying what works, as would better reporting on research design and intervention implementation.

A repeated survey of sexual behavior among female university students in Sweden.

PubMed

Tydén, Tanja; Palmqvist, Maria; Larsson, Margareta

2012-02-01

To investigate sexual behavior and use of contraceptives among female university students in 2009, and compare the results with surveys from 1999 and 2004. Comparative, repeated cross-sectional surveys. A Student Health Center in Sweden. Female university students (n=350). Multiple-choice waiting-room questionnaire. Number of sexual partners, sexually transmitted diseases, contraceptive methods. Mean age was 23.5 years and 57% (n=198) had a stable relationship. Almost all of the women, 99% (n=345), had had intercourse; 97% (n=328) had received and 94% (n=328) had given oral sex. The mean number of sexual partners had increased to 11.0, compared with 7.4 in 2004 and 5.4 in 1999. Sixty-five percent had had 'first-date' intercourse without using a condom, compared to 45% in 2004 and 37% in 1999. More than one-third (39%) had experience of anal intercourse compared with 32% in 2004 and 27% in 1999. Experience of sexually transmitted infections had increased (29% in 2009, 21% in 2004, and 14% in 1999). Condoms were often used at very first intercourse (76%) and oral contraceptives were used at latest intercourse (54%). The use of emergency contraceptive pills had increased to 67%, compared with 52% in 2004 and 22% in 1999. The sexual lifestyle of female university students has become riskier and this might have serious consequences for their sexual and reproductive health in the future. © 2011 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2011 Nordic Federation of Societies of Obstetrics and Gynecology.

Magazine reading and involvement and young adults' sexual health knowledge, efficacy, and behaviors.

PubMed

Walsh, Jennifer L; Ward, L Monique

2010-07-01

These studies investigate connections between magazine reading and involvement and young people's sexual health knowledge, self-efficacy, intentions, and contraception use. Study 1 assessed sexual health behaviors and magazine reading among 579 undergraduate students (69% were female; 68% were White; M(age) = 19.73). As expected, more frequent reading of mainstream magazines was associated with greater sexual health knowledge, safe-sex self-efficacy, and consistency of using contraception, although results varied across sex and magazine genre. Study 2 replicated and expanded on these findings with a survey of 422 undergraduate students (51% were female; 71% were White; 49% were age 18 or younger), incorporating a more extensive knowledge scale, questions about safe-sex intentions, and measures of magazine involvement. Results suggest that magazine use is associated with positive sexual health outcomes among young people.

Market research completed in El Salvador.

PubMed

1983-01-01

Intensive market research, completed in El Salvador for the contraceptive social marketing project of the Asociacion Demografica Salvadorena (ADS), was designed to obtain a better understanding of Salvadoran usage of and attitudes toward contraceptives in general and ADS products in particular. The research results are being used to develop a new marketing plan for the Contraceptive Social Marketing (CSM) program as it works to increase the program's effectiveness in reaching consumers. Points-of-purchase (retail outlets) were surveyed in November 1982 to study brand presence and vendor perceptions of consumer behavior in order to define the market in terms of products, prices, and distribution. Focus groups were conducted during November and December 1982 to probe consumer awareness and attitudes regarding methods, brands, and purchasing behavior. The results of the focus groups helped guide the development of a door-to-door consumer survey conducted from December 1982 through February 1983 to further define the market in terms of consumer size and characteristics. Personal interviews were conducted with the owner or manager of each of 247 pharmacies selected at random but in proportion to their distributional weight as to location. Aragon and Associates found that standard-dose orals and condoms were sold in 86% of the outlets surveyed and foaming tablets and low-dose pills in 37%. In terms of brand presence in outlets, the CSM products Perla (orals) and Condor (condom) both led their respective categories. In the foaming tablet category Suave had the lowest presence and Neo Sampoon the highest. The difference between reported and actual presence of contraceptives in the outlets was significant: 32% of the sellers of Perla, 18% of the sellers of Condor, and 26% of the sellers of Suave were out of stock at the time of the survey. The difference in average CSM product prices and the next lowest priced brands is very large. Dealers reported that their contraceptive consumers are fairly evenly divided between men and women. Results of the 8 focus groups suggested that there is a high awareness of and positive attitude toward family planning, although there was some confusion between family planning and birth control. Most respondents regarded control. Most respondents regarded 2-4 children as ideal. Men were much less concerned about using contraceptives than were women. Focus group participants had a high level of knowledge about contraceptives and were interested in learning more. Most thought mass media was an appropriate source for this type of information.

Contraceptive method switching in the United States.

PubMed

Grady, William R; Billy, John O G; Klepinger, Daniel H

2002-01-01

Switching among contraceptive method types is the primary determinant of the prevalence of use of specific contraceptive methods, and it has direct implications for women's ability to avoid unintended pregnancies. Yet, method switching among U.S. women has received little attention from researchers. Data from the 1995 National Survey of Family Growth were used to construct multiple-decrement life tables to explore the gross switching rates of married and unmarried women. Within each group, discrete-time hazard models were estimated to determine how women's characteristics affect their switching behavior. Overall rates of method switching are high among both married and unmarried women (40% and 61%, respectively). Married women's two-year switching rates vary from 30% among women who use the implant, injectable, IUD or other reversible methods to 43% among nonusers, while unmarried women's rates vary from 33% among women who use the implant, injectable or IUD to 70% among nonusers. Multivariate analyses of method switching according to women's characteristics indicate that among married women, women without children are less likely than other women to adopt sterilization or a long-term reversible contraceptive (the implant, injectable or IUD). Older married women have a higher rate than their younger counterparts of switching to sterilization, but are also more likely to continue using no method. Among unmarried women, younger and more highly educated women have high rates of switching to the condom and to dual methods. Women's method switching decisions may be driven primarily by concerns related to level and duration of contraceptive effectiveness, health risks associated with contraceptive use and, among single women, sexually transmitted disease prevention.

Couple's concordance and discordance in household decision-making and married women's use of modern contraceptives in Bangladesh.

PubMed

Uddin, Jalal; Hossin, Muhammad Zakir; Pulok, Mohammad Habibullah

2017-11-09

Although a large body of studies documents that women's autonomy in the household is associated with better reproductive health outcomes, these studies typically examined autonomy only from women's point of view. The current study employs husband's and wife's perspectives together to examine the relationship between the decision-making arrangements in the household and the women's use of modern contraceptives in Bangladesh. The study used the couple dataset of 2007 Bangladesh Demographic and Health Survey. The sample was comprised of 3336 married couples. Binary logistic regression models were used to examine the associations between the selected items on household decision-making and the use of modern contraceptives. Our results indicate that the couples disagree considerably as to who in the household exercises the decision-making power. The pattern of decision-making regarding visiting family and relatives emerged as an important predictor of use of modern contraceptives in the multivariate regression analysis. The results suggest that compared to the couple's concordant joint decision-making, the husband-only decision-making is associated with lower odds of contraceptives use (OR 0.49; 95% CI 0.28-0.85). Only a small part of this association is explained by spousal communication about family planning issues while the socio-demographic correlates hardly affected the association. On the contrary, the wife-only decision-making did not result in increased contraceptives use (OR 0.71; 95% CI 0.45-1.13). The study findings imply that women's greater autonomy may not necessarily result in improved reproductive health behavior, and therefore, a balance of power in the spousal relationship is warranted.

Adolescent males' orientation toward paternity and contraception.

PubMed

Marsiglio, W

1993-01-01

Data from a nationally representative sample of 1,880 young men aged 15-19 reveal that neighborhood quality, parental education, race or ethnicity, and attitudes about male gender roles are related to young men's attitudes toward an unplanned pregnancy and to their contraceptive experiences. Young men who live in poor neighborhoods are more likely to be pleased about an unplanned pregnancy than those who have better living conditions (12% vs. 2%) and are also more likely to view impregnating a woman as enhancing their masculinity (8% vs. 3%). Among men with average living conditions, 12% of black adolescents view fathering a child as enhancing their masculinity, compared with 6% of white adolescents; among those with very good living conditions, these proportions were 10% and 2%, respectively. Young men whose parents had less education and those who held traditional male gender role attitudes were also more likely than their counterparts to view fathering a child as enhancing their masculinity. Regarding contraceptive behavior, sexually active black men and Hispanic men were more likely than white men to have discussed contraception with their last partner; black men were more likely to have used an effective contraceptive method the last time they had intercourse; and black men were more likely to have used a condom at last intercourse. However, young men who were aware that they had been responsible for a previous pregnancy were less likely than those who reported no pregnancies to have used an effective contraceptive the last time they had intercourse. These same young men were also more likely to report that fathering a child would please them and enhance their masculinity.

Drospirenone/ethinyl estradiol.

PubMed

Rapkin, Andrea J; Sorger, Shelley N; Winer, Sharon A

2008-02-01

Drospirenone 3 mg/ethinyl estradiol 20 microg (24/4) is a new unique oral contraceptive formulation that combines in a novel dosing regimen the lowest dosage of ethinyl estradiol commonly used today with drospirenone, an innovative progestin. Drospirenone is a compound closely resembling progesterone, but with the antimineralocorticoid and antiandrogenic properties of a related therapeutic agent, the diuretic, antihypertensive and androgen receptor antagonist, 17alpha-spironolactone. The prolongation of hormonally active pills in the monthly drospirenone/ethinyl estradiol cycle from 21 days to 24 days, followed by 4 days of inactive pills, is an interesting variant of the recently developed extended pill regimens (1). Recent contraceptive research has focused on improving side effect profiles and providing noncontraceptive health and lifestyle advantages. Many of these benefits are now supported with evidence-based medicine (2). Most available oral contraceptives improve cycle regularity, menstrual pain, excessive menstrual flow and acne. However, weight gain, bloating, food cravings, breast tenderness and mood alterations (especially irritability and depression and the complex of affective, behavioral and somatic symptoms of premenstrual syndrome [PMS] and the severe form of PMS, premenstrual dysphoric disorder [PMDD]) are not generally improved with the traditional oral contraceptive formulations (3). Drospirenone/ethinyl estradiol 24/4 is currently the only hormonally based contraceptive regimen with large, randomized, controlled trials demonstrating efficacy for PMDD. It has received U.S. Food and Drug Administration (FDA) indications not only for the prevention of pregnancy but also for PMDD and for moderate acne vulgaris in women who choose oral contraception for birth control (4, 5). Copyright 2008 Prous Science, S.A.U. or its licensors. All rights reserved.

A retrospective cohort analysis comparing pregnancy rates among HIV-positive women using contraceptives and efavirenz- or nevirapine-based antiretroviral therapy in Kenya

PubMed Central

PATEL, Rena C.; ONONO, Maricianah; GANDHI, Monica; BLAT, Cinthia; HAGEY, Jill; SHADE, Starley B.; VITTINGHOFF, Eric; BUKUSI, Elizabeth A.; NEWMANN, Sara J.; COHEN, Craig R.

2015-01-01

SUMMARY Background Given recent concerns of efavirenz reducing the efficacy of contraceptive implants, we sought to determine if pregnancy rates differ among HIV-positive women using various contraceptive methods and efavirenz- or nevirapine-based antiretroviral therapy (ART) regimens. Methods We conducted a retrospective cohort analysis of HIV-positive women aged 15–45 years enrolled in HIV care facilities in western Kenya from January 2011 to December 2013. Pregnancy was diagnosed clinically and the primary exposure was a combination of contraceptive method and ART regimen. We used Poisson models, adjusting for repeated measures, as well as demographic, behavioral and clinical factors, to compare pregnancy rates among women on different contraceptive/ART combinations. Findings 24,560 women contributed 37,635 years of follow-up with 3,337 incident pregnancies. Among women using implants, adjusted pregnancy incidence for nevirapine- and efavirenz-based ART users were 1·1 (95% CI 0·72–1·5) and 3·3 (95% CI 1·8–4·8) per 100 women-years (w-y), respectively (adjusted incidence rate ratio (aIRR) 3·0, 95% CI 1·3–4·6). Among women using depomedroxyprogesterone acetate (DMPA), adjusted pregnancy incidence for nevirapine- and efavirenz-based ART users were 4·5 (95% CI 3·7–5·2) and 5·4 (95% CI 4·0–6·8) per 100 w-y, respectively (aIRR 1·2, 95% CI 0·91–1·5). Women using other contraceptive methods, except for intrauterine devices and permanent methods, experienced 3·1–4·1 higher rates of pregnancy than women using implants, with 1·6–2·8 higher rates specifically among women using efavirenz-based ART. Interpretation While HIV-positive women using implants on efavirenz-based ART faced three times higher risk of contraceptive failure than those on nevirapine-based ART, these women still experienced lower contraceptive failure rates than women on all other contraceptive methods, except for intrauterine devices and permanent methods. Guidelines for contraceptive and ART combinations should balance the failure rates for each contraceptive method and ART regimen combination against the high effectiveness of implants. Funding Supported by the President’s Emergency Plan for AIDS Relief and the Centers for Disease Control and Prevention. PMID:26520927

Cognitive, Psychosocial, and Reported Sexual Behavior Differences between Pregnant and Nonpregnant Adolescents.

ERIC Educational Resources Information Center

Holden, George W.; And Others

1993-01-01

Assessed differences in pregnant (n=69) and nonpregnant (n=58) adolescents on cognitive, psychosocial, and sexual behavior variables. Pregnant teenagers were more likely than nonpregnant teenagers to be doing poorly in school; less likely to use contraceptives; more likely to have relative or friend who was adolescent mother; and more likely to…

Sexual initiation among adolescents (10 to 14 years old) and health behaviors.

PubMed

Gonçalves, Helen; Machado, Eduardo Coelho; Soares, Ana Luiza Gonçalves; Camargo-Figuera, Fabio Alberto; Seering, Lenise Menezes; Mesenburg, Marília Arndt; Guttier, Marília Cruz; Barcelos, Raquel Siqueira; Buffarini, Romina; Assunção, Maria Cecília Formoso; Hallal, Pedro Curi; Menezes, Ana Maria Baptista

2015-01-01

To assess the prevalence of sexual initiation until the age of 14 years old, as well as sociodemographic and behavioral factors. In 2008, 4,325 from the 5,249 adolescents of the 1993 birth cohort in Pelotas, Rio Grande do Sul, were interviewed. Sexual initiation was defined as the first intercourse up to the age of 14 years old. The information was obtained by interviewing adolescents in their houses, during the 2008 follow-up. The analyzed variables were: skin color, asset index, maternal and adolescents' schooling, experimental use of tobacco and alcohol, drunkenness episode, use of any illicit drug, illegal drug use by friends and involvement in fights during the past year. Use of condoms and contraceptive methods, number of partners and the age of sexual initiation were also analyzed. The prevalence of sexual initiation by the age of 14 was of 18.6%. Lower schooling, asset index and maternal education were related to higher prevalence of sexual initiation until the age of 14, as well as being male or being born to adolescent mothers. Sexual intercourse was also related to the behavioral variables analyzed. Among adolescent girls who had intercourse up to the age of 14, 30% did not use contraception and 18% did not use condoms in the last sexual intercourse. Boys reported a higher number of sexual partners than girls. The results suggest a relationship between sexual intercourse (≤ 14 years) and some health-risk behaviors. The non-use of condoms and contraceptives may make them vulnerable to experiencing unwanted situations. Education and sociocultural strategies for health should be implemented from the beginning of adolescence.

Reproductive health experiences of women with cardiovascular disease.

PubMed

Chor, Julie; Oswald, Lora; Briller, Joan; Cowett, Allison; Peacock, Nadine; Harwood, Bryna

2012-11-01

Limited research exists exploring contraceptive and pregnancy experiences of women with cardiovascular diseases. We conducted semistructured interviews with reproductive-age women with chronic hypertension or peripartum cardiomyopathy exploring thoughts and behaviors regarding future fertility. Transcribed interviews were coded and analyzed identifying salient themes. We interviewed 20 women with chronic hypertension and 10 women with peripartum cardiomyopathy. Women described a spectrum of perspectives regarding the relationship between disease and fertility: from complete disconnect to full integration of diagnosis and future fertility plans. Integration of reproductive and cardiovascular health was influenced by and reflected in circumstances of diagnosis, pregnancy-related experiences, contraception-related experiences and conceptualization of disease risk related to reproductive health. Providers must better understand how women perceive and consider their reproductive and cardiovascular health in order to optimize contraceptive care of women with cardiovascular disease and help them make safe, informed decisions about future fertility. Copyright © 2012 Elsevier Inc. All rights reserved.

Assessing a thematic condom advertising campaign on condom use in urban Pakistan.

PubMed

Agha, Sohail; Beaudoin, Christopher E

2012-01-01

This study aims to assess communication processes involving a thematic condom advertising campaign in Pakistan in 2009. To evaluate the social marketing campaign for Touch condoms, the authors conducted a nationally representative survey of 1,606 men married to women aged 15-49 years. About 15% of urban married men were aware of Touch advertising. After controlling for a range of other variables including daily television viewership, confirmed awareness of Touch advertising was associated with a higher level of belief in the effectiveness of condoms, reduced embarrassment in negotiating condom use, reduced embarrassment in purchasing condoms, increased discussion of family planning, and increased use of condoms and other contraceptive methods. The findings have implications for the further development and dissemination of contraceptive advertising in Pakistan, as well as the broader construction of scientific knowledge on how advertising can influence contraceptive and other critical health behaviors in other contexts.

Factors associated with contraceptive ideation among urban men in Nigeria.

PubMed

Babalola, Stella; Kusemiju, Bola; Calhoun, Lisa; Corroon, Meghan; Ajao, Bolanle

2015-08-01

To determine factors influencing the readiness of urban Nigerian men to adopt contraceptive methods. The data were derived from a cross-sectional household survey conducted in Ibadan and Kaduna between September and November 2012. The sample included 2358 men from both cities. An ideation framework was constructed and a multilevel analysis performed to identify factors associated with positive thinking about contraception. Correlates of ideation operated at the individual, household, and community levels. There is considerable cluster-level variability in ideation score. The key correlates included exposure to family planning promotion campaigns, education, age, religion, marital status, and community norms. Compared with no education, high education is associated with an approximately 6.7-point increase in ideation score (P<0.001). Men with a high level of NURHI program exposure had an average ideation score that was about 3.4 points higher than for their peers with no exposure (P<0.001). The ideation score for Muslims was lower by approximately 1.7 points, on average, than for Christians (P<0.001). A comprehensive strategy of communication and behavior change activities surrounding contraceptive use should be tailored to meet the needs of specific groups of men. Community-level interventions designed to mobilize community members and change social norms that hinder the spread of ideational characteristics that favor contraceptive use should be part of this comprehensive strategy. Copyright © 2015. Published by Elsevier Ireland Ltd.

[Social-hygienic characteristics of adolescent girls and assessment of their reproductive behavior].

PubMed

Grebesheva, I I; El'tsova-Strelkova, V M; Gulevskaia, R M

1990-01-01

As a result of sociological study conducted among teen-age girls--pupils of schools, technical schools and vocational schools the level of knowledge of the general facts about the relationship between sexes and methods of contraception was found. A large proportion of girls who have had sexual intercourse at this age was identified, their contraceptive culture was low. The main reasons for their reluctance to seek care at women's consultation centres were determined. The establishment of anonymous service for the teen-agers was suggested to improve the present form of gynaecological care for the teen-agers.

Type of contraception method used at last intercourse and associations with health risk behaviors among US adolescents

PubMed Central

Cavazos-Rehg, Patricia A.; Krauss, Melissa J.; Spitznagel, Edward L.; Schootman, Mario; Peipert, Jeffrey F.; Cottler, Linda B.; Bierut, Laura Jean

2010-01-01

Background This study was conducted to examine associations with contraception methods used at last sexual intercourse among US adolescents. Study design Data consisted of sexually active adolescents (9th–12th grade, weighted n = 24,638) from 1999–2007 Youth Risk Behavior Surveillance System (YRBSS). We performed multinomial multivariable logistic regression analyses with condom users at last sexual intercourse as the reference group. Results Males who used alcohol, cigarettes, marijuana, and cocaine were more likely to use no method/unsure of method (OR = 2.4 CI: 1.7–3.4) or rely on withdrawal (OR = 2.6 CI: 1.5–4.3). Females with six or more sexual partners were more likely to rely on withdrawal (OR: 2.9 CI: 2.1–3.9) or contraception methods that offer no STI protection (i.e., birth control pills, OR: 1.9 CI: 1.4–2.5, and depot medroxyprogesterone acetate [DMPA, marketed as Depo Provera], OR: 2.6 CI: 1.6–4.2). Earlier age of sexual debut was also associated with nonuse. Conclusion Prevention efforts should focus on at-risk adolescents including substance-using males, females with six or more sexual partners, and those who initiate sexual intercourse at an early age. PMID:21074019

Type of contraception method used at last intercourse and associations with health risk behaviors among US adolescents.

PubMed

Cavazos-Rehg, Patricia A; Krauss, Melissa J; Spitznagel, Edward L; Schootman, Mario; Peipert, Jeffrey F; Cottler, Linda B; Bierut, Laura Jean

2010-12-01

This study was conducted to examine associations with contraception methods used at last sexual intercourse among US adolescents. Data consisted of sexually active adolescents (9th-12th grade, weighted n=24,638) from the 1999-2007 Youth Risk Behavior Surveillance System (YRBSS). We performed multinomial multivariable logistic regression analyses with condom users at last sexual intercourse as the reference group. Males who used alcohol, cigarettes, marijuana and cocaine were more likely to use no method/unsure of method (OR=2.4, CI=1.7-3.4) or rely on withdrawal (OR=2.6, CI=1.5-4.3). Females with six or more sexual partners were more likely to rely on withdrawal (OR=2.9, CI=2.1-3.9) or contraception methods that offer no STI protection [i.e., birth control pills: OR=1.9, CI=1.4-2.5; and depot medroxyprogesterone acetate (DMPA, marketed as Depo-Provera): OR=2.6, CI=1.6-4.2]. Earlier age of sexual debut was also associated with nonuse. Prevention efforts should focus on at-risk adolescents including substance-using males, females with six or more sexual partners, and those who initiate sexual intercourse at an early age. Copyright © 2010 Elsevier Inc. All rights reserved.

Interpersonal communication as an agent of normative influence: a mixed method study among the urban poor in India.

PubMed

Rimal, Rajiv N; Sripad, Pooja; Speizer, Ilene S; Calhoun, Lisa M

2015-08-12

Although social norms are thought to play an important role in couples' reproductive decisions, only limited theoretical or empirical guidance exists on how the underlying process works. Using the theory of normative social behavior (TNSB), through a mixed-method design, we investigated the role played by injunctive norms and interpersonal discussion in the relationship between descriptive norms and use of modern contraceptive methods among the urban poor in India. Data from a household survey (N = 11,811) were used to test the underlying theoretical propositions, and focus group interviews among men and women were then conducted to obtain more in-depth knowledge about decision-making processes related to modern contraceptive use. Spousal influence and interpersonal communication emerged as key factors in decision-making, waning in the later years of marriage, and they also moderated the influence of descriptive norms on behaviors. Norms around contraceptive use, which varied by parity, are rapidly changing with the country's urbanization and increased access to health information. Open interpersonal discussion, community norms, and perspectives are integral in enabling women and couples to use modern family planning to meet their current fertility desires and warrant sensitivity in the design of family planning policy and programs.

Controlling Adolescent Fertility.

ERIC Educational Resources Information Center

Rodman, Hyman

1985-01-01

Public concern over adolescent sexual and contraceptive behavior is increasing. One recommended policy response is for states to pass legislation giving minors the right to consent to reproductive health services. Such services are likely to benefit individuals, families, and society. (KH)

Laying the Groundwork for an Interdisciplinary Effort Aimed at Prevention of Pregnancy among Middle School Students. Final Report, from July 1978 to June 1979.

ERIC Educational Resources Information Center

Morse, Betty R.; And Others

This report presents results of a project to provide useful information for planning pregnancy prevention programs. It focuses on five project objectives: (1) identification of factors associated with adolescent sexual behavior, contraceptive behavior, and pregnancy; (2) development of instructional objectives or skills associated with pregnancy…

Effects of porcine zona pellucida immunocontraceptives in zoo felids.

PubMed

Harrenstien, Lisa A; Munson, Linda; Chassy, Lisa M; Liu, Irwin K M; Kirkpatrick, Jay F

2004-09-01

Methods of contraception are necessary for management of zoo felids; however, the most commonly used contraceptive (melengestrol acetate implant) is associated with serious adverse reactions with long-term use. Porcine zona pellucida (pZP) vaccines are promising as contraceptives, but their safety in zoo felids has not been tested. pZP vaccine was administered to 27 female felids representing 10 species, including African lion (Panthera leo), Asian leopard (P. pardus), jaguar (P. onca), tiger (P. tigris), snow leopard (P. uncia), cougar (Felis concolor), Siberian lynx (F. lynx), Canada lynx (F. canadensis), serval (F. serval), and bobcat (F. rufus), in 15 facilities. Over 6 wk, each animal received three i.m. injections of 65 microg pZP with Freund's complete adjuvant (FCA), Freund's incomplete adjuvant, or carbopol as the adjuvant. Behavioral signs of estrus were seen in 14 of the vaccinated felids. An unacceptably high incidence of adverse reactions was seen including injection site swelling, lameness, limb swelling, or abscessation (or all) in five felids after injection with FCA as the initial adjuvant. Adverse behavioral signs, including increased irritability and aggression, were seen in four felids. Six of the felids were assayed for antibodies against pZP during the 12 mo after vaccination; all showed antibody production. Antibody levels appeared to peak 1-4 mo after vaccination began, although elevated antibody levels persisted in two animals for > 12 mo after the first injection. All vaccinated felids were ovariohysterectomized 3-13 mo after vaccination. Folliculogenesis was present in all treated animals, and there was no histopathologic evidence of inflammatory damage to ovaries. Contraceptive efficacy was not specifically evaluated in this study; however, two of the three felids housed with an intact male became pregnant during the study, one of which gave birth to healthy cubs.

Reproductive and relational trajectories leading to pregnancy: Differences between adolescents and adult women who had an abortion.

PubMed

Pereira, Joana I F; Pires, Raquel S A; Araújo-Pedrosa, Anabela F; Canavarro, Maria Cristina C S P

2018-05-01

The literature has been conceptualizing pregnancy occurrence as a multiphase event. However, the different combinations of decisions and behaviors leading to pregnancy that end in abortion remain unexplored in the literature. The aims of the study were to describe the reproductive and relational trajectories leading to pregnancy in women who decide to abort and to explore the differences in this process according to women's age [adolescents (<20 years old) vs. adults]. In this cross-sectional study, 426 women [246 adolescents (58.4%), 177 adults (41.6%)] who chose abortion were recruited. Data on reproductive and relational characteristics were collected through a self-report questionnaire at 16 healthcare services that provide abortion. The variables were introduced in trajectories according to the criterion of temporal sequence between them: age at first sexual intercourse, relationship type, pregnancy planning, use of contraception, identification of contraceptive failure, and occurrence of pregnancy. Seven trajectories leading to pregnancy were identified. The most frequent trajectory (30.8%) included women who 1) were involved in a long-term romantic relationship, 2) did not plan the pregnancy, 3) were using contraception, and 4) did not identify the contraceptive failure that led to pregnancy. Although this was the most frequent trajectory for both age groups, the remaining trajectories showed a different distribution. Compared to adolescents, adult women's trajectories more frequently included casual relationships with non-use of contraception, or contraceptive use with no contraceptive failure identification. Our study highlights the need to recognize the multiplicity of reproductive and relational trajectories leading to pregnancies that end in abortion and their specificities according to women's age. These findings have important implications for abortion counselling and for the development of age-appropriate guidelines for preventive interventions, by drawing attention to prioritization of different contexts of intervention according women's age. Copyright © 2018 Elsevier B.V. All rights reserved.

Adolescents and oral contraceptives.

PubMed

Sanfilippo, J S

1991-01-01

Oral contraceptive (OC) options for adolescents are provides. Clarification for those desiring a birth control method is necessary and the benefits of decreased acne and dysmenorrhea with low dose OCs should be stressed along with the importance of compliance. A community effort is suggested to communicate the sexual and contraceptive alternatives, including abstinence and outercourse (sexual stimulation to orgasm without intercourse). Attention is given to concerns associated with teenage sexual activity, prevention of adolescent pregnancy, contraceptive options for the adolescent patient, adolescent attitudes toward birth control OCs, management of the adolescent OC user, manipulation of steroid components of OCs to respond to adolescent concerns, and other hormonal contraceptive options such as minipills or abstinence. The text is supplemented with tables: the % of US women by single years of age for 1971, 1976, 1979, and 1982; comparative pregnancy and abortion rates for the US and 5 other countries; federal cost for teen childbearing; adolescent nonhormonal contraceptive methods (advantages, disadvantages, and retail cost); checklist to identify those at risk for noncompliance with OCs; hormonal side effects of OCs; risks from OCs to adolescents; and benefits of OCs. Concern about adolescent pregnancy dates back to Aristotle. A modern profile shows girls form single-parent families are sexually active at an earlier age, adolescent mothers produce offspring who repeat the cycle, victims of sexual abuse are more likely to be sexually active, and teenagers in foster care are 4 times more likely to be sexually active and 8 times more likely to become pregnant. Prevention involves a multifaceted approach. OCs are the most appropriate contraceptive choice for adolescents. Frequency of intercourse is closely associated with OC use after approximately 15 months of unprotected sexual activity. At risk for noncompliance variables are scales of personality development (autonomy, self-esteem, locus of control), life expectations (marriage, college, career), dating behavior, age at 1st intercourse, perceived risk for becoming pregnant, personal attributes (sex, birth control, acquisition of birth control, pregnancy, parents' and peers' feelings toward sex and birth control), and previous experiences with birth control.

The urgent need for quality improvement in Russia.

PubMed

Ruevekamp, D

1994-01-01

Induced abortion became accepted as a legal method of family planning after the October Revolution of 1917 from which terminations were performed in state hospitals free of charge upon a woman's request. The procedure was made legal in response to then newly voiced egalitarian ideals and the increasing involvement of women in the labor market, as well as because of the rapidly deteriorating situation and post-Revolution period of famine. Administrators fully expected to reduce the incidence of abortion once living conditions improved. Little was done at the time to develop contraceptives. Stalin, however, in the 1920s and 1930s, lamented a falling birth rate in the face of manpower needed for labor and the military; abortion and contraceptives were banned, leading to post-abortion complications without really stimulating the birth rate. Abortion was relegalized in 1956, but the right to contraception was never fully restored. Seven million induced abortions were officially registered to have taken place in each of the last ten years in the former Soviet Union. A woman typically undergoes one abortion per year, or approximately twenty abortions during the childbearing period of her life. Lacking knowledge about contraception, contraceptives, and what many Western countries regard to be women's reproductive health rights, most Russian women, however, freely tolerate frequent repeated abortion as a normal method of fertility regulation. Lack of access to contraceptives along with the lack of domestic contraceptive method production facilities and lack of hard currency to secure quality supplies from abroad are contributing factors to this ongoing trend. Gynecologists also receive lucrative fees for illegal abortions and are unlikely to promote change. Plans to open twelve family planning centers in Moscow have been hampered by the inertia of bureaucracy, the lack of financial means, the lack of trained personnel, and people's suspicion of government bodies. Much needs to be done in Russia about family planning, including involving men in matters of sexual behavior and birth control.

Knowledge and utilization of contraceptive devices among unmarried undergraduate students of a tertiary institution in Kano State, Nigeria 2016.

PubMed

Ahmed, Zainab Datti; Sule, Ibrahim Baffa; Abolaji, Mohammed Lukman; Mohammed, Yahaya; Nguku, Patrick

2017-01-01

Students in the universities mostly live independently from their parents or guardians, some of them for the first time. This gives them freedom and opportunity for high risk behavior such as unplanned and unprotected sex. The results of such sexual experimentation may include unplanned and or unwanted pregnancies that may lead to unsafe abortions and sexually transmitted infections (STIs) including HIV/AIDS. Contraception has the potential to prevent unwanted pregnancies, abortion, and STIs. This study aimed at assessing the general knowledge on contraceptives, sexual practices, and level of utilization of contraceptives devices among unmarried students of the Bayero University Kano. We did an institutional based cross-sectional descriptive study. We administered a pretested, self-administered, structured questionnaire to randomly selected unmarried undergraduate students of the institution. We analyzed data using Microsoft Excel 2016 and Epi-info7. A total of 300 students were interviewed. The median age for respondents was 23 years with an age range of 16-25 years. Male respondents made up 61.3% (184) while the females made up the remaining 38.7% (116). Also, 158(47.33%) of respondents lived outside the school campus, while 158(52.67%) lived in the school hostels. Knowledge on contraception was 87.7% among respondents with internet (91%) and media (89.3%) as the commonest sources of knowledge. Proportion of sexually active students was 10.67%, while prevalence of contraceptive utilization among sexually active students was 15.63%. About 8(25%) had their sexual debut at < 16years of age, 22(68.75%) at ages between 16-20years, and 4(12.5%) above 20years of age. All sexually active respondents practice vaginal sex. Most sexual debuts were planned (44.75 %) and with friends (86.4%), and they occurred between the ages of 16-20years age group in 70.3% of respondents. Even though knowledge on contraceptive used was high among the respondents, utilization of contraceptives among sexually active students was low, thus creating a window for possible unintended and unwanted pregnancies among these group of students.

Expanding contraceptive options for PMTCT clients: a mixed methods implementation study in Cape Town, South Africa

PubMed Central

2014-01-01

Background Clients of prevention of mother-to-child transmission (PMTCT) services in South Africa who use contraception following childbirth rely primarily on short-acting methods like condoms, pills, and injectables, even when they desire no future pregnancies. Evidence is needed on strategies for expanding contraceptive options for postpartum PMTCT clients to include long-acting and permanent methods. Methods We examined the process of expanding contraceptive options in five health centers in Cape Town providing services to HIV-positive women. Maternal/child health service providers received training and coaching to strengthen contraceptive counseling for postpartum women, including PMTCT clients. Training and supplies were introduced to strengthen intrauterine device (IUD) services, and referral mechanisms for female sterilization were reinforced. We conducted interviews with separate samples of postpartum PMTCT clients (265 pre-intervention and 266 post-intervention) to assess knowledge and behaviors regarding postpartum contraception. The process of implementing the intervention was evaluated through systematic documentation and interpretation using an intervention tracking tool. In-depth interviews with providers who participated in study-sponsored training were conducted to assess their attitudes toward and experiences with promoting voluntary contraceptive services to HIV-positive clients. Results Following the intervention, 6% of interviewed PMTCT clients had the desired knowledge about the IUD and 23% had the desired knowledge about female sterilization. At both pre- and post-intervention, 7% of clients were sterilized and IUD use was negligible; by comparison, 75% of clients used injectables. Intervention tracking and in-depth interviews with providers revealed intervention shortcomings and health system constraints explaining the failure to produce intended effects. Conclusions The intervention failed to improve PMTCT clients’ knowledge about the IUD and sterilization or to increase use of those methods. To address the family planning needs of postpartum PMTCT clients in a way that is consistent with their fertility desires, services must expand the range of contraceptive options to include long-acting and permanent methods. In turn, to ensure consistent access to high quality family planning services that are effectively linked to HIV services, attention must also be focused on resolving underlying health system constraints weakening health service delivery more generally. PMID:24410922

A Micro-Level Event-Centered Approach to Investigating Armed Conflict and Population Responses

PubMed Central

Williams, Nathalie E.; Ghimire, Dirgha J.; Axinn, William G.; Jennings, Elyse A.; Pradhan, Meeta S.

2012-01-01

In this article, we construct and test a micro-level event-centered approach to the study of armed conflict and behavioral responses in the general population. Event-centered approaches have been successfully used in the macro-political study of armed conflict but have not yet been adopted in micro-behavioral studies. The micro-level event-centered approach that we advocate here includes decomposition of a conflict into discrete political and violent events, examination of the mechanisms through which they affect behavior, and consideration of differential risks within the population. We focus on two mechanisms: instability and threat of harm. We test this approach empirically in the context of the recent decade-long armed conflict in Nepal, using detailed measurements of conflict-related events and a longitudinal study of first migration, first marriage, and first contraceptive use. Results demonstrate that different conflict-related events independently shaped migration, marriage, and childbearing and that they can simultaneously influence behaviors in opposing directions. We find that violent events increased migration, but political events slowed migration. Both violent and political events increased marriage and contraceptive use net of migration. Overall, this micro-level event-centered approach yields a significant advance for the study of how armed conflict affects civilian behavioral responses. PMID:22911154

Using behavior change communication to lead a comprehensive family planning program: the Nigerian Urban Reproductive Health Initiative.

PubMed

Krenn, Susan; Cobb, Lisa; Babalola, Stella; Odeku, Mojisola; Kusemiju, Bola

2014-12-10

The Nigerian Urban Reproductive Health Initiative (NURHI), a 6-year comprehensive family planning program (2009-2015) in 4 cities, intentionally applies communication theories to all program elements, not just the demand generation ones, relying mainly on a theory called ideation-the concept that contraceptive use is influenced by people's beliefs, ideas, and feelings and that changing these ideational factors can change people's behavior. The project used multiple communication channels to foster dialogue about family planning, increase social approval for it, and improve accurate knowledge about contraceptives. Mobile service delivery was started in the third year to improve access to clinical methods in slums. Data from representative baseline (2010-11) and midterm (2012) surveys of women of reproductive age in the project cities were analyzed. We also used propensity score matching to create a statistically equivalent control group of women not exposed to project activities, and we examined service delivery data from NURHI-supported clinics (January 2011-May 2013) to determine the contribution of mobile services to total family planning services. Three years into the initiative, analysis of longitudinal data shows that use of modern contraceptives has increased in each city, varying from 2.3 to 15.5 percentage points, and that the observed increases were predicted by exposure to NURHI activities. Of note is that modern method use increased substantially among the poorest wealth quintiles in project cities, on average, by 8.4 percentage points. The more project activities women were exposed to, the greater their contraceptive use. For example, among women not using a modern method at baseline, contraceptive prevalence among those with no exposure by midterm was 19.1% vs. 43.4% among those with high exposure. Project exposure had a positive dose-response relationship with ideation, as did ideation and contraceptive use. By the end of the observation period, mobile services were contributing nearly 50% of total family planning services provided through NURHI-supported clinics. Propensity score matching found that the increase in contraceptive use in the 4 cities attributable to project exposure was 9.9 percentage points. Intention to use family planning in the next 12 months also increased by 7.5 to 10.2 percentage points across the 4 cities. Demand-led family planning programs, in which demand generation is the driving force behind the design rather than the conventional, service delivery-oriented approach, may be more suitable in places where expressed demand for contraceptives is low. © Krenn et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly cited. To view a copy of the license, visit http://creativecommons.org/licenses/by/3.0/. When linking to this article, please use the following permanent link: http://dx.doi.org/10.9745/GHSP-D-14-00009.

Family Planning Policy in the United States: The Converging Politics of Abortion and Contraception

PubMed Central

Aiken, Abigail R.A.; Scott, James

2016-01-01

Objectives Following decades of mainstream bipartisan support, contraception has re-emerged as a controversial political issue in the United States. At the same time, opposition to abortion has intensified. State legislatures across the country have enacted highly visible policies limiting access to family planning. Perhaps the most striking example occurred in 2011 in Texas, when legislators instituted unprecedented requirements on abortion providers and cut public funding for contraception by two-thirds. Yet despite popular interpretations of this phenomenon as a simple byproduct of increasing partisan divisions, little is understood about the factors underlying such policy shifts. Study Design We fit Bayesian ideal-point models to analyze correlation patterns in record-vote data in the Texas House of Representatives in the 2003 and 2011 Legislatures. Both sessions had large Republican majorities and saw the passage of restrictive abortion bills, but they differed markedly with respect to public funding for contraception. Results We demonstrate that variation in voting on family-planning issues cannot be fully attributed to partisanship in either session. However, the politics of abortion and contraception have converged over time, and—at least for Democrats—the correlation between constituency characteristics and voting behavior on family-planning legislation is markedly higher in 2011 than in 2003. These shifts have been partly driven by legislators from high-poverty, majority Latino districts near the U.S.-Mexico border. Conclusions Recent dramatic shifts in family-planning policy go beyond simple partisan divisions. As the politics of abortion and contraception have converged, policies that are increasingly hostile to reproductive health and that disproportionately affect low-income minority women have emerged. PMID:26794846

Divorced women's sexual and contraceptive issues.

PubMed

Leslie, N J

1988-01-01

This work attempts to answer the question: could divorce create a feeling of alienation in women which causes one to feel vulnerable and detached and thus making sexual decision-making and planning difficult? When a women is married her sexuality is taken for granted because she is expected to have children; however, after a divorce, she must face many of the conflicts she felt as a young single woman. Guilt, planning contraceptive use, and coming to terms with her sexual behavior all present themselves again. 1 factor that must be considered is that contraceptive use is always assumed to be the function of the married women. Very little research has gone into the contraceptive use habits of unmarried women. This is primarily due to the societal assumption that unmarried woman don't have sex. This work contains the clinical observation of the author in which 28% of 459 prenatal patients were interviewed specifically because they were divorced. The conclusion is that divorced women are being neglected by the health care profession and are in great need of contraceptive counseling. This work primarily discusses a study done to expand and examine the conclusions of the clinical research. The study consisted of 101 sexually active, legally divorced, single women between the ages of 18-44 and physiologically capable of becoming pregnant. 53 of these women had experienced post-divorce pregnancies. Each woman was interviewed and given 3 standard tests: the Rosenberg Self-Acceptance Scale, the Snyder's Self-Monitoring Scale and Beckham's Coping Strategies Scale. The conclusion of the author is that divorce and its associated psychological problems may temporarily or permanently affect one's thoughts, feelings, and life course. Sexual and contraceptive use decision-making are both directly both directly affected by these changes. Some divorced women may be experiencing inadequate self-esteem, identity, and self-awareness.

Divergent Trends in Abortion and Birth Control Practices in Belarus, Russia and Ukraine

PubMed Central

Denisov, Boris P.; Sakevich, Victoria I.; Jasilioniene, Aiva

2012-01-01

Context The last decade witnessed growing differences in abortion dynamics in Belarus, Russia, and Ukraine despite demographic, social, and historical similarities of these nations. This paper investigates changes in birth control practices in the three countries and searches for an explanation of the diverging trends in abortion. Methods Official abortion and contraceptive use statistics, provided by national statistical agencies, were analysed. Respective laws and other legal documents were examined and compared between the three countries. To disclose inter-country differences in prevalence of the modern methods of contraception and its association with major demographic and social factors, an analysis of data from national sample surveys was performed, including binary logistic regression. Results The growing gap in abortion rate in Belarus, Russia, and Ukraine is a genuine phenomenon, not a statistical artefact. The examination of abortion and prevalence of contraception based on official statistics and three national sample surveys did not reveal any unambiguous factors that could explain differences in abortion dynamics in Belarus, Russia, and Ukraine. However, it is very likely that the cause of the inter-country discrepancies lies in contraceptive behavior itself, in adequacies of contraceptive knowledge and practices. Additionally, large differences in government policies, which are very important in shaping contraceptive practices of the population, were detected. Conclusion Since the end of the 1990s, the Russian government switched to archaic ideology in the area of reproductive health and family planning and neglects evidence-based arguments. Such an extreme turn in the governmental position is not observed in Belarus or Ukraine. This is an important factor contributing to the slowdown in the decrease of abortion rates in Russia. PMID:23349656

Use of dual protection among female sex workers in Swaziland.

PubMed

Yam, Eileen A; Mnisi, Zandile; Mabuza, Xolile; Kennedy, Caitlin; Kerrigan, Deanna; Tsui, Amy; Baral, Stefan

2013-06-01

Female sex workers are at heightened risk of both HIV infection and unwanted pregnancy. Nonbarrier modern contraceptives are highly effective at preventing pregnancy, but offer no HIV protection. A better understanding of sex workers' use of condoms and nonbarrier methods is needed to help them meet their contraceptive and STI protection needs. A 2011 respondent-driven sampling survey collected reproductive health and contraceptive use data from 325 female sex workers in Swaziland. Multinomial logistic regression analysis was used to identify associations between selected characteristics and four outcomes of contraceptive use over the past month: consistent condom use alone; nonbarrier modern contraceptive use (either alone or with inconsistent condom use); dual method use; and inconsistent condom use, other method use or nonuse. Adjusted predicted probabilities were also calculated to determine patterns of association. After adjustments were made for background and behavioral factors, 16% of female sex workers were found to be consistent users of condoms alone; 39% used nonbarrier modern methods (without consistent condom use); 8% were dual method users; and 38% were inconsistent condom users or used other methods or none. Women who reported recent condom failure were less likely than others to be consistent condom users (6% vs. 22%). Consistent use of condoms alone was more common among women who had had no noncommercial partners in the past month than among those who reported two or more such partners (39% vs. 3%). In addition, respondents who had children were more likely than their nulliparous counterparts to report use of nonbarrier methods alone (65% vs. 14%). Inconsistent or no condom use among nonbarrier contraceptive users underscores the need to incorporate HIV prevention into family planning interventions, particularly among female sex workers who have children and noncommercial partners.

Teen Parents

MedlinePlus

... of tobacco use, drinking, taking drugs and reckless sexual behavior. If you have reason to believe the mother isn’t acting in her baby’s best interest, alert the obstetrician. At each appointment, girls receive counseling on other aspects of pregnancy, such as contraception, ...

Impact of Contraceptive Counseling in Clinical Settings

PubMed Central

Zapata, Lauren B.; Tregear, Stephen J.; Curtis, Kathryn M.; Tiller, Marie; Pazol, Karen; Mautone-Smith, Nancy; Gavin, Loretta E.

2015-01-01

Context This systematic review evaluated the evidence on the impact of contraceptive counseling provided in clinical settings on reproductive health outcomes to provide information to guide national recommendations on quality family planning services. Evidence acquisition Multiple databases were searched during 2010–2011 for peer-reviewed articles published in English from January 1985 through February 2011 describing studies that evaluated contraceptive counseling interventions in clinical settings. Studies were excluded if they focused primarily on prevention of HIV or sexually transmitted infections, focused solely on men, or were conducted outside the U.S., Canada, Europe, Australia, or New Zealand. Evidence synthesis The initial search identified 12,327 articles, of which 22 studies (from 23 articles) met the inclusion criteria. Six studies examined the impact of contraceptive counseling among adolescents, with four finding a significant positive impact on at least one outcome of interest. Sixteen studies examined the impact of counseling among adults or mixed populations (adults and adolescents), with 11 finding a significant positive impact on at least one outcome of interest. Conclusions Promising components of contraceptive counseling were identified despite the diversity of interventions and inability to compare the relative effectiveness of one approach versus another. The evidence base would be strengthened by improved documentation of counseling procedures; assessment of intervention implementation and fidelity to put study findings into context; and development and inclusion of more RCTs, studies conducted among general samples of women, and studies with sample sizes sufficient to detect important behavioral outcomes at least 12 months post-intervention. PMID:26190845

Impact of Contraceptive Counseling in Clinical Settings: A Systematic Review.

PubMed

Zapata, Lauren B; Tregear, Stephen J; Curtis, Kathryn M; Tiller, Marie; Pazol, Karen; Mautone-Smith, Nancy; Gavin, Loretta E

2015-08-01

This systematic review evaluated the evidence on the impact of contraceptive counseling provided in clinical settings on reproductive health outcomes to provide information to guide national recommendations on quality family planning services. Multiple databases were searched during 2010-2011 for peer-reviewed articles published in English from January 1985 through February 2011 describing studies that evaluated contraceptive counseling interventions in clinical settings. Studies were excluded if they focused primarily on prevention of HIV or sexually transmitted infections, focused solely on men, or were conducted outside the U.S., Canada, Europe, Australia, or New Zealand. The initial search identified 12,327 articles, of which 22 studies (from 23 articles) met the inclusion criteria. Six studies examined the impact of contraceptive counseling among adolescents, with four finding a significant positive impact on at least one outcome of interest. Sixteen studies examined the impact of counseling among adults or mixed populations (adults and adolescents), with 11 finding a significant positive impact on at least one outcome of interest. Promising components of contraceptive counseling were identified despite the diversity of interventions and inability to compare the relative effectiveness of one approach versus another. The evidence base would be strengthened by improved documentation of counseling procedures; assessment of intervention implementation and fidelity to put study findings into context; and development and inclusion of more RCTs, studies conducted among general samples of women, and studies with sample sizes sufficient to detect important behavioral outcomes at least 12 months post-intervention. Published by Elsevier Inc.

Effects of state contraceptive insurance mandates.

PubMed

Dills, Angela K; Grecu, Anca M

2017-02-01

Using U.S. Natality data for 1996 through 2009 and an event analysis specification, we investigate the dynamics of the effects of state insurance contraceptive mandates on births and measures of parental investment: prenatal visits, non-marital childbearing, and risky behaviors during pregnancy. We analyze outcomes separately by age, race, and ethnicity. Among young Hispanic women, we find a 4% decline in the birth rate. There is evidence of a decrease in births to single mothers, consistent with increased wantedness. We also find evidence of selection into motherhood, which could explain the lack of a significant effect on birth outcomes. Copyright © 2016 Elsevier B.V. All rights reserved.

What is the Best Way to Reduce Unintended Pregnancies? A Micro Simulation of Contraceptive Switching, Discontinuation and Failure Patterns in France

PubMed Central

Diamond-Smith, Nadia; Moreau, Caroline; Bishai, David

2015-01-01

Despite high rates of contraceptive use in France, over a third of pregnancies are unintended. We built a dynamic micro simulation model which applies data from the French COCON study on method switching, discontinuation, and failure rates to a hypothetical population of 20,000 women, followed for 5 years. We use the model to estimate the adjustment factor needed to make the survey data fit the demographic profile of France, by adjusting for underreporting of contraceptive non-use and abortions. We then test three behavior change scenarios which would aim to reduce unintended pregnancies: decreasing method failure, increasing time spent on effective methods, and increasing switching from less to more effective methods. Our model suggests that decreasing method failure is the most effective strategy for reducing unintended pregnancies, but all scenarios reduced unintended pregnancies by at least 25%. Dynamic micro simulations such as this may be useful for policy makers. PMID:25469928

Reducing unintended pregnancies: a microsimulation of contraceptive switching, discontinuation, and failure patterns in france.

PubMed

Diamond-Smith, Nadia G; Moreau, Caroline; Bishai, David M

2014-12-01

Although the rate of contraceptive use in France is high, more than one-third of pregnancies are unintended. We built a dynamic microsimulation model that applies data from the French COCON study on method switching, discontinuation, and failure rates to a hypothetical population of 20,000 women, followed for five years. We use the model to estimate the adjustment factor needed to make the survey data fit the demographic profile of France by adjusting for underreporting of contraceptive nonuse and abortion. We then test three behavior-change scenarios that could reduce unintended pregnancies: decreasing method failure, increasing time using effective methods, and increasing switching from less effective to more effective methods. Our model suggests that decreasing method failure is the most effective means of reducing unintended pregnancies, but we found that all of the scenarios reduced unintended pregnancies by at least 25 percent. Dynamic microsimulations may have great potential in reproductive health research and prove useful for policymakers. © 2014 The Population Council, Inc.

Body Mapping to Explore Reproductive Ethno-Physiological Beliefs and Knowledge of Contraception in Timor-Leste.

PubMed

Wallace, Heather Julie; McDonald, Susan; Belton, Suzanne; Miranda, Agueda Isolina; da Costa, Eurico; da Conceicao Matos, Livio; Henderson, Helen; Taft, Angela

2018-06-01

Maternal mortality remains a significant public health challenge for Timor-Leste. Although access to quality family planning measures may greatly reduce such deaths, consideration of indigenous perceptions, and how they influence reproductive health decision-making and behavior, is crucial if health services are to provide initiatives that are accepted and helpful in improving reproductive health outcomes. We aimed to demonstrate that body mapping is an effective method to traverse language and culture to gain emic insights and indigenous worldviews. The authors' two qualitative research projects (2013 and 2015) used a decolonizing methodology in four districts of Timor-Leste, body mapping with 67 men and 40 women to illuminate ethno-physiology and indigenous beliefs about conception, reproduction, and contraception. Body mapping provided a beneficial conduit for identifying established indigenous reproductive perceptions, understandings, and vocabulary, plus fears surrounding contraception. This may inform health service provision and engagement, ultimately improving the reproductive health of community members.

[Dynamic model of seasonal breeding rodent pest population controlled with short-acting sterilant].

PubMed

Liu, Han-wu; Jin, Zhen; Zhang, Feng-qin; Li, Qiu-ying

2013-04-01

Rodent pests bring great damage to human beings, while rodenticide and sterilant can be used to control the pests. After ingesting sterilant, rodent pests lose their fertility, but in some cases, the sterile individuals may gain their fertility again, produce offspring, and enlarge population size. In this paper, the dynamic models of rodent pest population under lethal control and shortacting contraception control were formulated, and, with the prerequisite of the seasonal breeding of rodent pest population, the models were used to regularly analyze their behaviors and the effects of the contraception rate, lethal rate, control interval, and sterilant valid period on the dynamics of the pest population. The results showed that larger contraception rate and lethal rate and shorter control interval could have better control effect, making the controlled population become smaller and even died out. Short-acting sterilant limited the control effect. At the later period of breeding season, the rodent pest population controlled with short-acting sterilant would have a weak recovery.

Adolescent women's contraceptive decision making.

PubMed

Weisman, C S; Plichta, S; Nathanson, C A; Chase, G A; Ensminger, M E; Robinson, J C

1991-06-01

A modified rational decision model incorporating salient events and social influences (particularly from sexual partners) is used to analyze adolescent women's consistent use of oral contraceptives (OCs) over a six-month period. Data are taken from a panel study of 308 clients of an inner-city family planning clinic. Expected OC use was computed for each subject on the basis of subjective expected utility (SEU) theory, and is found in multivariate analyses to be a significant predictor of actual OC use. In addition, variables representing baseline and follow-up partner influences, the salience of pregnancy for the subject, and positive side effects of OCs during the first months of use are found to predict OC use. Partner's support of OC use during follow-up and positive side effects of OCs are found to predict OC use among subjects for whom OC use was not the expected decision according to baseline SEU. Implications of the findings for models of adolescents' contraceptive behavior and for clinicians are discussed.

Emergency contraception: why can't you give it away? Qualitative findings from an evaluation of advance provision of emergency contraception.

PubMed

Fairhurst, Karen; Ziebland, Sue; Wyke, Sally; Seaman, Peter; Glasier, Anna

2004-07-01

The Lothian Emergency Contraception Project (LECP)--a primary care-based intervention to offer advance supplies of emergency contraception (EC) to women aged 16-29 was not associated with a reduction in abortion rates. We undertook case studies, utilizing qualitative and quantitative methods, to evaluate the intervention. In this article we present findings from qualitative interviews with 44 primary care professionals working at case study sites and 22 women who had received advance supplies to explain this failure. Professionals reported that women rarely asked for advance supplies of EC and they were reluctant to offer supplies to women because of concerns about contradictory sexual health messages implied by the offer, a perceived association of EC use with chaotic behavior by women, views about the sort of women suitable for advance supplies and practical difficulties making the offer. Women were reluctant to ask for advance supplies because of misgivings about the appropriateness of offering advance supplies to everybody and concerns about being judged by health professionals as morally inadequate. If advance provision of EC is to be successful in reducing abortion rates, professionals must address their concerns about EC and develop imaginative ways of encouraging women most at risk of unwanted pregnancy to take supplies home.

Early Marriage and Barriers to Contraception among Syrian Refugee Women in Lebanon: A Qualitative Study.

PubMed

Cherri, Zeinab; Gil Cuesta, Julita; Rodriguez-Llanes, Jose M; Guha-Sapir, Debarati

2017-07-25

The Syrian conflict has displaced five million individuals outside their country with Lebanon hosting the largest numbers per capita. Around 24% of Syrian refugees fleeing to Lebanon are women of reproductive age (15-49). Yet, a better understanding of the sexual and reproductive health needs of Syrian refugee women in Lebanon is required to improve provided services. Eleven focus group discussions were conducted in four regions of Lebanon with 108 Syrian refugee women of reproductive age. Thematic analysis was used to examine the data. Interviewed women were mainly adults. They believed that, in Lebanon, they were subjected to early marriage compared to the norm in Syria due to their financial situation and uncertainty. Cost was reported as the main barrier to use contraception in Lebanon but some Syrian refugee women were not aware of free services covering sexual and reproductive health. In general, marriage, pregnancy, and family planning behavior of Syrian refugee women in Lebanon slightly differed from those in Syria pre-conflict in terms of age of marriage, conception subsequent to marriage, and contraception method. Hence, interventions to increase awareness of subsidized sexual and reproductive health services, including free contraceptives at primary health care centers, and those targeting protection from early marriage of Syrian refugee women in Lebanon are strongly recommended.

Contraceptive vaccines for wildlife: a review.

PubMed

Kirkpatrick, Jay F; Lyda, Robin O; Frank, Kimberly M

2011-07-01

Wildlife, free-ranging and captive, poses and causes serious population problems not unlike those encountered with human overpopulation. Traditional lethal control programs, however, are not always legal, wise, safe, or publicly acceptable; thus, alternative approaches are necessary. Immunocontraception of free-ranging wildlife has reached the management level, with success across a large variety of species. Thus far, the immunocontraceptive research and management applications emphasis have been centered on porcine zona pellucida and gonadotropin-releasing hormone vaccines. Contraceptive success has been achieved in more than 85 different wildlife species, at the level of both the individual animal and the population. At the population management level with free-ranging species, the primary focus has been on wild horses, urban deer, bison, and African elephants. The challenges in the development and application of vaccine-based wildlife contraceptives are diverse and include differences in efficacy across species, safety of vaccines during pregnancy, the development of novel delivery systems for wild and wary free-ranging animals, and the constraints of certain non-contraceptive effects, such as effects on behavior. Beyond the constraints imposed by the public and a host of regulatory concerns, there exists a real limitation for funding of well-designed programs that apply this type of fertility control. © 2011 John Wiley & Sons A/S.

Early Marriage and Barriers to Contraception among Syrian Refugee Women in Lebanon: A Qualitative Study

PubMed Central

Guha-Sapir, Debarati

2017-01-01

The Syrian conflict has displaced five million individuals outside their country with Lebanon hosting the largest numbers per capita. Around 24% of Syrian refugees fleeing to Lebanon are women of reproductive age (15–49). Yet, a better understanding of the sexual and reproductive health needs of Syrian refugee women in Lebanon is required to improve provided services. Eleven focus group discussions were conducted in four regions of Lebanon with 108 Syrian refugee women of reproductive age. Thematic analysis was used to examine the data. Interviewed women were mainly adults. They believed that, in Lebanon, they were subjected to early marriage compared to the norm in Syria due to their financial situation and uncertainty. Cost was reported as the main barrier to use contraception in Lebanon but some Syrian refugee women were not aware of free services covering sexual and reproductive health. In general, marriage, pregnancy, and family planning behavior of Syrian refugee women in Lebanon slightly differed from those in Syria pre-conflict in terms of age of marriage, conception subsequent to marriage, and contraception method. Hence, interventions to increase awareness of subsidized sexual and reproductive health services, including free contraceptives at primary health care centers, and those targeting protection from early marriage of Syrian refugee women in Lebanon are strongly recommended. PMID:28757595

Sexual behavior, contraceptive practice, and reproductive health among Liberian adolescents.

PubMed

Nichols, D; Woods, E T; Gates, D S; Sherman, J

1987-01-01

This paper reports on a survey that was aimed at obtaining information for use in designing programs to reduce the incidence of adolescent pregnancy in Liberia. The sample of 1,488 never-married adolescents aged 14-21 was divided into subgroups based on age, sex, student status, and (for non-students) level of education. Although 57-93 percent of respondents claimed to have received information on reproductive health, only 2-21 percent could identify the monthly fertile period. Thirty to 49 percent of females ages 14-17 years have sexual relations at least once a month; over 80 percent of female non-students ages 18-21 years are sexually active. Highest levels of current contraceptive use were reported for 18-21-year-old female students (51 percent). Never-use of contraception among sexually active respondents was 97 percent for 14-17-year-old non-student females with a low educational level. Insufficient information about family planning methods and inaccessibility were the main reasons cited for non-use. Half of females ages 14-21 years who are currently attending school have been pregnant, as have 67 percent of those not in school. These results indicate a substantial unmet need on the part of Liberian adolescents with respect to reproductive health knowledge, information, and access to contraceptive methods.

Puberty in the Girl Who is Retarded.

ERIC Educational Resources Information Center

Pattullo, Ann

Designed to help mothers of mentally retarded girls deal with the problems and concerns of puberty, the booklet provides information on physical and emotional changes, menstruation, masturbation, heterosexual behavior, contraception, protection against sexual aggression, the possibilities of marriage, and additional sources of information.…

Social Media Use and its Association with Sexual Risk and Parental Monitoring among a Primarily Hispanic Adolescent Population.

PubMed

Romo, Dina L; Garnett, Chelsea; Younger, Alayna P; Stockwell, Melissa S; Soren, Karen; Catallozzi, Marina; Neu, Natalie

2017-08-01

In this study we assessed the association between social media (SM) use with sexual risk, and with parental monitoring among Hispanic adolescents. Self-administered anonymous survey. Urban primary care clinics. Primarily Hispanic adolescents ages 13-21 years old. Chi-square and regression analyses controlling for age and gender were used to assess associations between SM use or sexting and sexual behaviors (kissing, touching genitals, vaginal oral, and anal sex), sexual risk (≥4 lifetime partners, >1 recent partner, inconsistent condom use, and history of sexually transmitted infection diagnosis) and contraceptive use. Similar analyses were used to assess relationships between adolescent-reported parental monitoring and SM use, and sexting. Participants with frequent SM use (social networking sites or apps) had greater odds of all sexual activity. Ever sexters had greater odds of penetrative sex only (oral, vaginal, and anal sex) as well as use of hormonal contraception (except long-acting reversible contraception). Approximately half of the participants reported parental access to profiles on SM. Female participants had higher odds of parental access to online profiles and having a parental discussion of privacy settings. Those having privacy discussions had greater odds of "private" profiles on SM and lower odds of ever sexting. Frequent SM use and sexting was associated with an increase in all types of sexual behaviors; sexting alone was associated with more lifetime and recent sexual partners. Parental discussion of privacy settings was found to be protective. Providers and parents should be aware of the effect of SM use on sexual behaviors. Copyright © 2017 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Human ecology and behavior and sexually transmitted bacterial infections.

PubMed Central

Holmes, K K

1994-01-01

The three direct determinants of the rate of spread of sexually transmitted diseases (STDs) are sexual behaviors, the mean duration of infectiousness, and the mean efficiency of sexual transmission of each STD. Underlying ecological and behavioral factors that operate through one or more of these direct determinants lie on a continuum, ranging from those most proximate back to those more remote (in time or mechanism) from the direct determinants. Most remote and least modifiable are the historical stages of economic development that even today conspicuously influence patterns of sexual behavior. Next are the distribution and changing patterns of climate, hygiene, and population density; the global population explosion and stages of the demographic transition; and ongoing changes in human physiology (e.g., menarche at younger age) and culture (e.g., later marriage). More proximate on the continuum are war, migration, and travel; and current policies for economic development and social welfare. Most recent or modifiable are technologic and commercial product development (e.g., oral contraceptives); circumcision, condom, spermicide, and contraception practices; patterns of illicit drug use that influence sexual behaviors; and the accessibility, quality, and use of STD health care. These underlying factors help explain why the curable bacterial STDs are epidemic in developing countries and why the United States is the only industrialized country that has failed to control bacterial STDs during the AIDS era. Images PMID:8146138

Interventions for Preventing Unintended, Rapid Repeat Pregnancy Among Adolescents: A Review of the Evidence and Lessons From High-Quality Evaluations

PubMed Central

Norton, Maureen; Chandra-Mouli, Venkatraman; Lane, Cate

2017-01-01

Background: In 2017, of the 22.5 million parenting adolescents (ages 15–19) in 60 countries, approximately 4.1 million gave birth to a second or higher-order child. Adolescent pregnancy in general, and rapid repeat pregnancies specifically, expose young mothers and their children to multiple health and socioeconomic risks. The purpose of this article is to review the impact of interventions designed to prevent unintended, rapid repeat pregnancies among adolescents, including those aimed at changing norms to postpone “intended” closely spaced pregnancies to promote healthy spacing. Methods: We searched PubMed and other databases for evaluations of interventions published in English from 1990 through 2016. We included evaluations that assessed a programmatic intervention specifically designed to prevent rapid repeat pregnancy (occurring less than 24 months after the index birth) or birth (occurring less than 33 months after the index birth), or that reported on contraceptive continuation for at least 2 years. We first assessed the quality of the evaluations, then ranked the interventions based on the quality of the evaluation and the level of impact on repeat pregnancy or birth (statistically significant impact, positive trends but not statistically significant, or no impact) to identify the most effective interventions. Finally, we extracted program design and implementation lessons from the interventions included in the high-quality evaluations. Results: Our search identified 2,187 articles, of which 40 evaluations met the inclusion criteria (24=high quality, 14=moderate quality, 2=less rigorous). We found 14 high-quality evaluations in which the intervention achieved a statistically significant impact on repeat pregnancy or birth. These interventions fell into 5 broad categories: (1) contraceptive services and information, with proactive monitoring of contraceptive use and outreach to families; (2) postpartum contraceptive counseling and services provided soon after delivery; (3) activities that help adolescents improve planning skills, including preparing contraceptive plans; (4) social and behavioral change activities that help adolescents understand the role contraception can play in determining positive life outcomes, and the implications of their reproductive health decisions for their future; and (5) activities that provide mentoring, goal setting, and motivation. Conclusion: Effective interventions that prevent rapid adolescent childbearing link clinical contraceptive services with non-clinical activities that build planning skills, enhance understanding of the role that contraceptives can play in determining positive life outcomes, and provide mentoring and goal setting. Recognizing potentially synergistic effects, we recommend testing various combinations of these interventions, with access to contraception as the foundational activity. PMID:29284694

Factors influencing use of family planning in women living in crisis affected areas of Sub-Saharan Africa: A review of the literature.

PubMed

Ackerson, Kelly; Zielinski, Ruth

2017-11-01

far too many women continue to die from pregnancy and childbirth related causes. While rates have decreased in the past two decades, some areas of the world such as sub-Saharan Africa continue to have very high maternal mortality rates. One intervention that has been demonstrated to decrease maternal mortality is use of family planning and modern contraception, yet rates of use in sub-Saharan countries with the highest rates of maternal death remain very low. to review available research and summarize the factors that inhibit or promote family planning and contraceptive use among refugee women and women from surrounding areas living in Sub-Saharan Africa. a review of the literature. Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), OVID, power search, and PubMed databases. studies included were: (1) published in English from 2007 to present; (2) primary research; and (3) focused on family planning and contraceptive use among refugee women and women in surrounding areas. Findings were discussed within the framework of the Interaction Model of Client Health Behavior. twelve studies met the inclusion criteria. Utilization of modern contraceptive methods was low. Women were socially influenced to avoid the use of contraceptives by husbands and others in the community. Reasons were a lack of trust in western medicine and the desire to have large families. Low socioeconomic status and proximity of family planning clinics were barriers to access. Women believed that health care providers were unqualified, many described being treated with disrespect in the health clinics. Knowledge and understanding of contraceptives was low; while most women knew different methods were available, there were many misconceptions. Believing that certain contraceptives cause death, infertility and side effects, contributed to fear of use. This lack of knowledge and fear, even with the desire to space and limit births, affected motivation to use contraception. developing new approaches to educating women, men (husbands), community leaders as well as healthcare providers is needed to address the multi-factorial issues that contribute to underuse of family planning services, thus contraceptive use. while lack of access to family planning is a barrier to use, interventions that improve access must be affordable and include education regarding contraceptive methods, preferably from those within the community. However, education and access is not sufficient unless the issue of disrespect by healthcare providers is addressed. Respectful and culturally sensitive care for all women, regardless of socio-economic status or country of origin, must be provided by midwives and other women health providers. Copyright © 2017 Elsevier Ltd. All rights reserved.

The influence of wives' and husbands' education levels on contraceptive method choice in Nepal, 1996-2006.

PubMed

Gubhaju, Bina

2009-12-01

The association between education level and fertility, contraceptive behavior and method choice has been extensively researched, but little is known about how the education differential between husbands and wives in Nepal may influence the choice of specific methods. Data collected from currently married, nonpregnant women aged 15-49 in the Nepal Demographic and Health Surveys of 1996, 2001 and 2006 were analyzed to identify shifts in the education levels of husbands and wives and the influence of those shifts on couples' current contraceptive method use over the past decade. Multinomial logistic regression models assessed associations between method choice and each partner's education level, the education differential between partners and a combined education measure. Although the wife's education level was associated with the type of method used by the couple, the husband's education level had more influence on the use of male sterilization and condoms. For example, men with any secondary or higher education were more likely than those with none to rely on either of these methods (relative risk ratios, 1.6-2.1). Furthermore, couples in which the husband had at least six more years of education than the wife also showed increased reliance on male sterilization or condoms (1.6-1.8). Differences in the use of any method of family planning by education level have narrowed considerably in the past decade, although differentials remain in the use of some methods. A better understanding of how wives' and husbands' relative educational attainment affects decisions on their contraceptive choices is needed, particularly when both education levels and contraceptive use are increasing.

A major challenge. Entrepreneurship characterizes the work of the Soviet Family Health Association.

PubMed

Manuilova, I A

1991-09-01

The work of the Soviet Family Health Association (SFHA) is described. Created in January, 1989, the organization boasts 25 state-paid workers, and as of June 1991, membership of 15,000 corporate and individual members. Individual annual membership fee is 5 rubles, and entitles members to counseling and family planning (FP) services. The SFHA works in cooperation with the Commission on Family Planning Problems of the USSR's Academy of Sciences, and has been a member of the International Planned Parenthood Federation (IPPF) since 1990. Association activities include lectures for students, newly-weds, adolescents, and working women on modern contraceptive methods; research on attitude regarding sex, sex behaviors, and the perceived need for effective contraception; clinical trials of contraceptive suitability for women; and the training of doctors in FP and contraceptives. Problems central to the SFHA's operations include insufficient service and examination equipment, a shortage of hard currency, and the small number of FP specialists in the country. Solutions to these obstacles are sought through collaboration with the government, non-governmental organizations in the Soviet Union, and international groups. The SFHA has a series of activities planned for 1991 designed to foster wider acceptance of FP. Increased FP services at industrial enterprises, establishing more FP centers throughout the Soviet Union, and studying FP programs in other countries are among Association targets for the year. Research on and promotion of contraceptives has been virtually stagnant since abortion was declared illegal in 1936. Catching up on these lost decades and remaining self-reliant are challenges to the SPHA.

[Sexual behaviors among students of the Medical University in Gdańsk].

PubMed

Grabowski, Karol; Wichowicz, Hubert M; Cubała, Wiesław Jerzy

2006-01-01

The aim of this study was to illustrate sexual behaviours, needs and expectations as well as attitudes towards contraception among students of the Faculty of Medicine, Medical University of Gdańsk. A group of 340 medical students aged 18 to 28 (195 females and 118 males) was examined with the questionnaire from October till December 2003. The examined group was representative for the investigated population (chi squared test: p> 0.005 for the entire group and both sexes). 313 questionnaires were qualified for further analysis. The questionnaire applied was composed of three groups of questions: questions concerning relationships and associated sexuality, questions concerning attitudes towards various aspects of sexuality and a set of questions dedicated to the role of sexology in the medical curriculum and general medical practice. The presented paper deals with the forms of sexual behaviours and attitudes towards contraception. The examined group is well educated in theoretical and practical aspects of sex-related phenomena. The efficient contraception methods are widely used in the studied population. A preferred form of contraception in the examined group is the use of condoms followed by oral contraceptives. The sexual initiation was mainly under the influence an emotional relationship. The examined individuals indicate love as the main factor positively influencing the quality of sexual life, followed by partner's loyalty and sexual satisfaction. The examined population has a positive attitude towards alternative forms of sexual practices. The students perceive sex as an important aspect of their functioning and are satisfied with their sexual partners.

Pregnancy risk among black, white, and Hispanic teen girls in New York City public schools.

PubMed

Waddell, Elizabeth Needham; Orr, Mark G; Sackoff, Judith; Santelli, John S

2010-05-01

Disparities in teen pregnancy rates are explained by different rates of sexual activity and contraceptive use. Identifying other components of risk such as race/ethnicity and neighborhood can inform strategies for teen pregnancy prevention. Data from the 2005 and 2007 New York City Youth Risk Behavior Surveys were used to model demographic differences in odds of recent sexual activity and birth control use among black, white, and Hispanic public high school girls. Overall pregnancy risk was calculated using pregnancy risk index (PRI) methodology, which estimates probability of pregnancy based on current sexual activity and birth control method at last intercourse. Factors of race/ethnicity, grade level, age, borough, and school neighborhood were assessed. Whites reported lower rates of current sexual activity (23.4%) than blacks (35.4%) or Hispanics (32.7%), and had lower predicted pregnancy risk (PRI = 5.4% vs. 9.0% and 10.5%, respectively). Among sexually active females, hormonal contraception use rates were low in all groups (11.6% among whites, 7.8% among blacks, and 7.5% among Hispanics). Compared to white teens, much of the difference in PRI was attributable to poorer contraceptive use (19% among blacks and 50% among Hispanics). Significant differences in contraceptive use were also observed by school neighborhood after adjusting for age group and race/ethnicity. Interventions to reduce teen pregnancy among diverse populations should include messages promoting delayed sexual activity, condom use and use of highly effective birth control methods. Access to long-acting contraceptive methods must be expanded for all sexually active high school students.

[Contraceptive practice in Mexico: two five-year periods, two different patterns (1976-1977 to 1987)].

PubMed

Llera, S

1990-01-01

This work uses data from the 1976-77 Mexican Fertility Survey, the 1982 National Demographic Survey, and the 1987 National Fertility and Health Survey to analyze fertility and contraceptive behavior among Mexican women in the 2 5-year periods from 1976-82 and 1982-87. The proportion of fertile-aged women in union using a method increased from 41.6% in 1976-77 to 58.8% in 1982 and 61.4% in 1989. The most significant gains in use of the more effective methods as in contraceptive prevalence occurred in the 1st 5-year period. The proportion of women sterilized increased from 3.73% in 1977 to 16.6% in 1982 and 21.7% in 1987, equivalent to increases over the 2 5-year periods of 345.7% and 30.7%. Female sterilization was the only method whose use increased constantly over the period. Use of the IUD was almost unchanged between 1977-82, while use of oral contraceptives and injectables both declined from 1982 to 1987 after increasing over the preceding 5 years. Contraceptive usage increased intensely in all subgroups of women studied between 1976-82, but in the 2nd period from 1982 to 1987 contraceptive usage declined significantly in some subgroups. Contraceptive prevalence among women in urban and metropolitan areas increased systematically after 1977. Rural women increased their use from 22.5% in 1977 to 48.6% in 1982. 5 years later the proportion of rural users had declined to 45.3% although it was still well above the level of 1976-77. The most significant increase in contraceptive usage among illiterate women and those with primary educations occurred from 1976 to 1982. In 1987 women with primary and higher levels of education demonstrated increases in contraceptive usage compared with 1982, but contraceptive usage among illiterate women declined from 40.8% in 1982 to 28.9% in 1987. Data from the 3 surveys demonstrate low but increasing rates of use among women 15-19 years old, who may be in the process of developing a new fertility pattern characterized by longer birth intervals. Women in the middle reproductive years had higher rates of use showing little change from 1982 to 1987 and unlikely to show great change in the future due to their already high level. Women aged 40-44 showed systematic increases in use from 1976 to 1987, but women aged 45-49 increased their use only from 32.6% in 1977 to 39.0% in 1987. The declines in age differentials in contraceptive prevalence from 1982 to 1987 demonstrate that age is losing weight as an explanatory factor. Between 1976-77 and 1982, women of all parities increased their contraceptive usage substantially. Women with 3 or fewer children continued to increase their usage through 1987, but usage among women with 4 or more children actually declined between 1982-87. The results suggest that a small proportion of rural, less educated, and high parity women may have returned to their former patterns of uncontrolled fertility. Nevertheless, fertility differentials were much smaller in 1987 than in 1976-77.

Parent-Adolescent Sexual Communication and Adolescent Safer Sex Behavior: A Meta-Analysis.

PubMed

Widman, Laura; Choukas-Bradley, Sophia; Noar, Seth M; Nesi, Jacqueline; Garrett, Kyla

2016-01-01

Parent-adolescent sexual communication has received considerable attention as a factor that can positively affect safer sex behavior among youth; however, the evidence linking such communication to youth contraceptive and condom use has not been empirically synthesized. To examine the effect of parent-adolescent sexual communication on safer sex behavior among youth and explore potential moderators of this association. A systematic search of studies published from database inception through June 30, 2014, using the MEDLINE, PsycINFO, and Communication & Mass Media Complete databases and relevant review articles yielded 5098 studies, of which 52 studies with 25,314 adolescents met the study eligibility criteria. Analysis was conducted from July 1, 2014, to July 27, 2015. Studies were included if they sampled adolescents (mean sample age ≤18 years), included an adolescent report of sexual communication with one or both parents, measured safer sex behavior, and were published in English. Correlation coefficients (r) and 95% CIs were computed from studies and meta-analyzed using random-effects models. Safer sex behavior, including use of contraceptives or condoms. Fifty-two articles, including 71 independent effects representing more than 3 decades of research on 25,314 adolescents (weighted mean age, 15.2 years) were synthesized. Across studies, there was a significant weighted mean effect (r = 0.10; 95% CI, 0.08-0.13) linking parent-adolescent sexual communication with safer sex behavior, which was statistically heterogeneous (Q = 203.50, P < .001, I2 = 65.60). Moderation analyses revealed larger effects for communication with girls (r = 0.12) than boys (r = 0.04) and among youth who discussed sex with their mothers (r = 0.14) compared with their fathers (r = 0.03). Effects did not differ for contraceptive vs condom use or among longitudinal vs cross-sectional studies, indicating that parent sexual communication had a similar effect across study designs and outcomes. Several methodological issues were identified in the literature; future studies can improve on these issues by measuring parent-adolescent communication with robust, multi-item measures, clearly specifying the target parent, and applying multimethod longitudinal designs. Sexual communication with parents, particularly mothers, plays a small protective role in safer sex behavior among adolescents; this protective effect is more pronounced for girls than boys. We discuss the implications for practice and make suggestions for future research on parent-adolescent sexual communication.

Understanding gender roles in teen pregnancy prevention among American Indian youth.

PubMed

Hanson, Jessica D; McMahon, Tracey R; Griese, Emily R; Kenyon, DenYelle Baete

2014-11-01

To examine the impact of gender norms on American Indian (AI) adolescents' sexual health behavior. The project collected qualitative data at a reservation site and an urban site through 24 focus groups and 20 key informant interviews. The reasons that AI youth choose to abstain or engage in sexual intercourse and utilize contraception vary based on gender ideologies defined by the adolescent's environment. These include social expectations from family and peers, defined roles within relationships, and gender empowerment gaps. Gender ideology plays a large role in decisions about contraception and sexual activity for AI adolescents, and it is vital to include redefinitions of gender norms within AI teen pregnancy prevention program.

Assessing predictors of contraceptive use and demand for family planning services in underserved areas of Punjab province in Pakistan: results of a cross-sectional baseline survey.

PubMed

Azmat, Syed Khurram; Ali, Moazzam; Ishaque, Muhammad; Mustafa, Ghulam; Hameed, Waqas; Khan, Omar Farooq; Abbas, Ghazunfer; Temmerman, Marleen; Munroe, Erik

2015-03-28

Although Pakistan was one of the first countries in Asia to launch national family planning programs, current modern contraceptive use stands at only 26% with a method mix skewed toward short-acting and permanent methods. As part of a multiyear operational research study, a baseline survey was conducted to understand the predictors of contraceptive use and demand for family planning services in underserved areas of Punjab province in Pakistan. This paper presents the baseline survey results; the outcomes of the intervention will be presented in a separate paper after the study has been completed. A cross-sectional baseline household survey was conducted with randomly selected 3,998 married women of reproductive age (MWRA) in the Chakwal, Mianwali, and Bhakkar districts of Punjab. The data were analyzed on SPSS 17.0 using simple descriptive and logistic regression. Most of the women had low socio-economic status and were younger than 30 years of age. Four-fifths of the women consulted private sector health facilities for reproductive health services; proximity, availability of services, and good reputation of the provider were the main predicators for choosing the facilities. Husbands were reported as the key decision maker regarding health-seeking and family planning uptake. Overall, the current contraceptive use ranged from 17% to 21% across the districts: condoms and female sterilization were widely used methods. Woman's age, husband's education, wealth quintiles, spousal communication, location of last delivery, and favorable attitude toward contraception have an association with current contraceptive use. Unmet need for contraception was 40.6%, 36.6%, and 31.9% in Chakwal, Mianwali, and Bhakkar, respectively. Notably, more than one fifth of the women across the districts expressed willingness to use quality, affordable long-term family planning services in the future. The baseline results highlight the need for quality, affordable long-term family planning services close to women's homes. Furthermore, targeted community mobilization and behavior change efforts can lead to increased awareness, acceptability, and use of family planning and birth spacing services.

Appropriate Sex Education for Black Teens.

ERIC Educational Resources Information Center

Banks, Ivan W.; Wilson, Patricia I.

1989-01-01

Conducted year-long study of 207 low-income Black youth to determine their perceptions of family relationships, thereby identifying family members who had most potential for encouraging contraceptive responsibility and for influencing adolescents' decisions about becoming sexually active. Also studied dating and sexual behavior, attitudes toward…

It Isn't Sex Education unless...

ERIC Educational Resources Information Center

Hacker, Sylvia S.

1981-01-01

An effective sex education curriculum deals with both feelings and behaviors. It must address decision making and problem solving in regard to relationship formation, readiness for intercourse, use of contraception, child rearing, and social responsibility and should be incorporated into education throughout the educational process. (JN)

Provider communication with adolescent and young females during sexual and reproductive health visits: findings from the 2011-2015 National Survey of Family Growth.

PubMed

Liddon, Nicole; Steiner, Riley J; Martinez, Gladys M

2018-01-01

This study assesses provider communication with adolescent and young women about birth control, emergency contraception and condoms during sexual and reproductive health visits. Using data from sexually active 15-24-year-old women in the 2011-2015 National Survey of Family Growth, we examined provider communication about contraception and condoms at sexual and reproductive health services in the past year and assessed differences by demographics, sexual behavior and source of care. Approximately two thirds of women received provider communication about condoms (65.0%) and birth control (64.0%-66.8%). Communication was higher among Title-X-funded clinic vs. private providers. Differences by age, race/ethnicity, mother's education, number of partners and condom use were also found. Most sexually active young women attending sexual and reproductive health visits received provider communication about condoms and birth control, but communication is not universal and varies by source of care, demographics and sexual behavior. Copyright © 2017. Published by Elsevier Inc.

Melatonin in humans: Possible involvement in SIDS, and use in contraceptives

NASA Technical Reports Server (NTRS)

Wurtman, Richard J.; Lynch, Harry J.; Sturner, William Q.

1991-01-01

Relatively few tools exist for assessing the possible involvement of melatonin in normal or abnormal physiologlcal and behavioral states. One cannot perform the classic ablation experiment of endocrinologists by cavalierly removing the human's pineal, nor derive the same effect pharmacologically by administering a drug which blocks the actions of the indole on its receptors (because no such drugs, demonstrated to work in humans, exist). About all that can be done is to administer the melatonin and see what happens, or measure its levels in a body fluid and determine whether its temporal patterns track those of the physiological or behavioral variable being examined. The clinical state of Sudden Infant Death Syndrome (SIDS) which apparently is associated with abnormalities in melatonin concentrations within body fluids obtained at autopsy is described. New data which suggest that exogenous melatonin has sufficient antigonadal potency to allow it to replace estrogen and, acting in combination with norethisterone, serve as a useful contraceptive agent is summarized.

Does Preconception Health Differ by Nativity?: Findings from the Los Angeles Mommy and Baby (LAMB) Study

PubMed Central

Chao, Shin M.; Wakeel, Fathima; Nazinyan, Yeghishe; Sun, Stacy

2016-01-01

Objectives To compare certain preconception health (PCH) behaviors and conditions among US-born (USB) and foreign-born (FB) mothers in Los Angeles County (LAC), regardless of race/ethnicity, and to determine if any identified differences vary among Asian/Pacific Islanders (API’s) and Hispanics. Methods Data are from the 2012 Los Angeles Mommy and Baby (LAMB) study (n=6,252). PCH behaviors included tobacco use, multivitamin use, unintended pregnancy, and contraception use. PCH conditions comprised being overweight/obese, diabetes, asthma, hypertension, gum disease, and anemia. The relationship between nativity and each PCH behavior/ condition was assessed using multivariable logistic regression models. Results USB women were more likely than FB women to smoke (AOR=2.12, 95% CI=1.49–3.00), be overweight/obese (AOR=1.57, 95% CI=1.30–1.90), and have asthma (AOR=2.04, 95% CI=1.35–3.09) prior to pregnancy. They were less likely than FB women to use contraception before pregnancy (AOR=0.59, 95% CI=0.49–0.72). USB Hispanics and API’s were more likely than their FB counterparts to be overweight/obese (AOR=1.57, 95% CI=1.23–2.01 and AOR=2.37, 95% CI=1.58–3.56, respectively) and less likely to use contraception (AOR=0.58, 95% CI=0.45–0.74 and AOR= 0.46, 95% CI=0.30–0.71, respectively). USB Hispanic mothers were more likely than their FB counterparts to smoke (AOR=2.47, 95% CI=1.46–4.17), not take multivitamins (AOR=1.30, 95% CI=1.02–1.66), and have asthma (AOR=2.35, 95% CI=1.32–4.21) before pregnancy. Conclusions US nativity is linked to negative PCH among LAC women, with many of these associations persisting among Hispanics and API’s. As PCH profoundly impacts maternal and child health across the lifecourse, culturally-appropriate interventions that maintain positive behaviors among FB reproductive-aged women and encourage positive behaviors among USB women should be pursued. PMID:26728899

A qualitative analysis of women's explanations for changing contraception: the importance of non-contraceptive effects.

PubMed

Wigginton, Britta; Harris, Melissa L; Loxton, Deborah; Lucke, Jayne C

2016-10-01

Women commonly report changing contraceptive methods because of side-effects. However, there is a lack of literature that has thoroughly examined women's perspectives, including why they changed contraception. Using qualitative data from a contraceptive survey of young Australian women, we explored women's explanations for their recent changes in contraception. A thematic analysis of 1051 responses to a question about why women recently changed contraception was conducted. Themes reflected reasons for changing contraception which included: both contraceptive and non-contraceptive (4%); relationship/sexual (9%); medical (11%); contraceptive (18%); non-contraceptive (41%). A minority of responses were uncoded (17%). Non-contraceptive effects (effects unrelated to pregnancy prevention) featured most frequently in women's reasons for changing contraception. While cessation of various contraceptives due to unwanted side-effects is a well-known phenomenon, this analysis provides evidence of the changing of contraception for its non-contraceptive effects and reframes the notion of 'side-effects'. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Does switching contraceptive from oral to a patch or vaginal ring change the likelihood of timely prescription refill?

PubMed

Law, Amy; Lee, Yi-Chien; Gorritz, Magdaliz; Plouffe, Leo

2014-08-01

This study evaluated contraceptive refill patterns of women insured commercially in the US who switched from oral contraceptives (OCs) to the patch or vaginal ring and assessed if switching contraceptive methods changes refill patterns. Women aged 15-44 with ≥2 patch or ring prescriptions and ≥2 OC prescriptions before the first patch/ring prescription were identified from the MarketScan® Commercial database (1/1/2002-6/30/2011). Refill patterns 1-year pre- and postindex date (first patch/ring prescription) were evaluated, and women were categorized as timely or delayed refillers on OCs and patch/ring. Regression modeling was used to investigate the association between refill patterns and contraceptive methods and switching effects on refill patterns. Of 17,814 women identified, 7901 switched to the patch, and 9913 switched to the ring. Among timely OC refillers, the percentage of timely refills decreased (patch: 95.6% to 79.4%, p<.001; ring: 96.5% to 74.3%, p<.001). However, among delayed OC refillers, the percentage of timely refills improved (patch: 47.9% to 72.2%, p<.001; ring: 50.4% to 64.0%, p<.001) during patch/ring use. Nonetheless, compared to timely OC refillers, women who were delayed OC refillers had 1.68-fold [95% confidence interval (CI): 1.52-1.84, p<.001] and 1.85-fold greater odds (CI: 1.69-2.02, p<.001) of being a delayed refiller while on the patch and ring, respectively. Switching to the patch or ring may improve refill behavior for women who have problems refilling OCs timely; however, the magnitude of the improvement may fail to improve ultimate contraceptive efficacy by simply switching to the patch or ring. The impact on timely refills of switching from OCs to either the patch or ring is complex and varies depending on the pattern of timely refills on OCs. Copyright © 2014 Elsevier Inc. All rights reserved.

Nicotine and estrogen synergistically exacerbate cerebral ischemic injury.

PubMed

Raval, A P; Hirsch, N; Dave, K R; Yavagal, D R; Bramlett, H; Saul, I

2011-05-05

The greater incidence of myocardial infarction, cardiac arrest, and ischemic stroke among women who smoke and use oral contraception (OC) compared to women who do not smoke and who do or do not use OC may be due in part to how nicotine influences endocrine function in women. For example, we recently demonstrated that chronic exposure to nicotine, the addictive agent in tobacco smoke responsible for the elevated risk of cardiac arrest, abolishes the endogenous or exogenous 17β-estradiol-conferred protection of the hippocampus against global cerebral ischemia (a potential outcome of cardiac arrest) in naive or ovariectomized female rats. In the current study we examined the hypotheses that (1) a synergistic deleterious effect of nicotine plus oral contraceptives exacerbates post-ischemic hippocampal damage in female rats, and (2) nicotine directly inhibits estrogen-mediated intracellular signaling in the hippocampus. To test first hypothesis and to simulate smoking behavior-induced nicotine levels in the human body, we implanted osmotic pumps containing nicotine in the female rats for 16 days. Furthermore, we mimicked the use of oral contraceptives in females by administering oral contraceptives orally to the rat. Rats exposed to either nicotine alone or in combination with oral contraceptives were subjected to an episode of cerebral ischemia and the resultant brain damage was quantified. These results showed for the first time that nicotine with oral contraceptives did indeed exacerbate post-ischemic CA1 damage as compared to nicotine alone in naive female rats. In ex vivo hippocampal slice cultures, we found that nicotine alone or with 17β-estradiol directly hinders estrogen receptors-mediated phosphorylation of cyclic-AMP element binding protein, a process required for neuronal survival and also exacerbates ischemic damage. Thus, nicotine can affect the outcome of cerebral ischemia by influencing brain endocrine function directly rather than through indirect systemic effects. Copyright © 2011 IBRO. Published by Elsevier Ltd. All rights reserved.

Impact of the sharp changes in the use of contraception in 2013 on the risk of pulmonary embolism in France.

PubMed

Tricotel, A; Collin, C; Zureik, M

2015-09-01

In late 2012, a national pill crisis led French women to promptly change their behavior regarding contraception, with a significant increase in the use of first-generation and second-generation combined oral contraceptives to the detriment of third-generation and fourth-generation products (C3Gs and C4Gs). To assess the impact of the sharp changes in 2013 on the rate of women hospitalized for pulmonary embolism in France. All hospitalized pulmonary embolisms in women aged 15-49 years, excluding those occurring during delivery stay, were identified from the French national hospital discharge databases from 2010 to 2013. Hospitalization rates, overall and by age group, were calculated. We compared rates in 2013 with those in 2012, and with mean rates over the preceding 3-year period (2010-2012). Two populations of non-users of contraceptives were used as control groups: men aged 15-49 years, and women aged 50-69 years. The expected reduction in pulmonary embolism incidence, estimated by modeling the number of expected cases based on modifications of combined oral contraceptive exposure, was also considered. In France, in 2013 as compared with 2012, the pulmonary embolism hospitalization incidence rate in women aged 15-49 years fell by 10.6%, corresponding to a reduction of 322 hospitalizations (95% confidence interval -468 to -156). The expected pulmonary embolism reduction is consistent with the observed reduction in hospitalization incidence rate (-10.2% and -10.6%, respectively). Such a pattern was not observed in the control groups. The sharp change in contraception methods, with decreased use of C3Gs and C4Gs, probably played a major role in the reduction in venous thromboembolism morbidity in France. © 2015 The Authors. Journal of Thrombosis and Haemostasis published by Wiley Periodicals, Inc. on behalf of International Society on Thrombosis and Haemostasis.

Intentional Teenage Pregnancy: Correlates of Children Who Want Children.

ERIC Educational Resources Information Center

Ruchman, Miriam Reitman; Jemmott, John B., III; Jemmott, Loretta Sweet

This study explored the differences between African American and Latina female adolescents who desire to become pregnant and those who do not. Five hundred and thirty-one sexually experienced, never pregnant adolescents completed surveys containing questions about demographics, sexual behavior and contraceptive use, sexual and contraceptive…

Mexican agencies reach teenagers.

PubMed

Brito Lemus, R; Beamish, J

1992-08-01

The Gente Joven project of the Mexican Foundation for Family Planning (MEXFAM) trains young volunteers in 19 cities to spread messages about sexually transmitted diseases and population growth to their peers. They also distribute condoms and spermicides. It also uses films and materials to spread its messages. The project would like to influence young men's behavior, but the Latin image of machismo poses a big challenge. It would like to become more responsible toward pregnancy prevention. About 50% of adolescents have sexual intercourse, but few use contraceptives resulting in a high adolescent pregnancy rate. Many of these pregnant teenagers choose not to marry. Adolescent pregnancy leads to girls leaving school, few marketable skills, and rearing children alone. Besides women who began childbearing as a teenager have 1.5 times more children than other women. Male involvement in pregnancy prevention should improve these statistics. As late as 1973, the Health Code banned promotion and sales of contraceptives, but by 1992 about 50% of women of reproductive age use contraceptives. The Center for the Orientation of Adolescents has organized 8 Young Men's Clubs in Mexico City to involve male teenagers more in family planning and to develop self-confidence. It uses a holistic approach to their development through discussions with their peers. A MEXFAM study shows that young men are not close with their fathers who tend to exude a machismo attitude, thus the young men do not have a role model for responsible sexual behavior. MEXFAM's work is cut out for them, however, since the same study indicates that 50% of the young men believe it is fine to have 1 girlfriend and 33% think women should earn more than men. A teenager volunteer reports, however, that more boys have been coming to him for contraception and information than girls in 1992 while in other years girls outnumbered the boys.

Contraceptive use and family planning after labor in the European part of the Russian Federation: 2-year monitoring.

PubMed

Vikhlyaeva, E; Nikolaeva, E; Brandrup-Lukanow, A

2001-12-01

To explore the main determinants of the reproductive behavior of nursing mothers, all inhabitants of the central part of the European region of the Russian Federation, their use of modern contraceptive methods and their attitude to future family planning. Open cohort multicenter study of 1200 nursing mothers aged 16-42 years interviewed at 3-5 days' postpartum, with subsequent longitudinal monitoring ofthe majority in the local family planning centers during the 2 years after labor. The main determinants of the reproductive behavior of this cohort of women are an early debut of sexual activity, several partners in their reproductive history, relatively early marriage with a motivation to have one child in their family and the tendency to use induced abortion as one of the methods of birth regulation. Our experience of postpartum counselling demonstrated positive changes in the women's attitudes to modern contraceptive methods. The data reveal that the induced abortion rate among 639 mothers regularly followed-up during the first year postpartum was 4.4%, and among 606 during the second year was 5.1%. The corresponding rates among 129 women who did not visit the family planning centers and who were only interviewed 2 years after labor were 9.3% and 8.5%, respectively. Our data show that the unmet needs are remarkably concentrated among women who have given birth within the last year or two, and who need augmented attention from the family planning and reproductive health services.

[ORAL CONTRACEPTIVES AND MOOD/SEXUAL DISORDERS IN WOMEN].

PubMed

Sirakov, M; Tomova, E

2015-01-01

Oral contraceptives are used since more than 50 years and are very popular due to offering more than 99% confidence in preventing pregnancy. Over 100 million women worldwide use oral contraceptives. In the UK 27% of women between 16 and 49 y. use pills. In the United States they are about 30%, in Germany - 40%, and in The Netherlands - 60%. According to a study by B. Pehlivanov, 2008, in Bulgaria only 4% of women use OC. (1) Despite the convenience and security, in the U.S.A. 29% of women taking OC interrupt prematurely their use (2), while the percentage of adolescents appears to be higher (3) Earlier studies of the reasons for refusal of OC focus on their influence on the menstrual cycle, as well as on some physical side effects such as the appearance of hair growth, weight gain, bloating etc. They paid very little attention to their impact on mood and sexual behavior of women (4). Newer studies suggest that the side effects associated with mood and sexual behavior proved more powerful factor leading to early termination of the use of OC (5). This paper is a review of the literature and evaluation of the facts presented in studies from different countries. They found a high incidence of symptoms such as anxiety, susceptibility to stress, mood changes, incl. depression, anxiety, increased irritability and affection of sexual desire of women. (6) There are many indications that OC-users are at increased risk of suicide and mental illnesses. (9).

[Sex education and sexual development of female adolescents].

PubMed

Barth, H; Döbler, T; Galletzki, R; Amon, K

1983-01-01

A questionnaire survey on sex knowledge of 930 female vocational students (17-18 year olds) was done to assess future needs in sex education. Main points in the questionnaire were sex upbringing and education received; peer groups, couple and contraceptive behavior; and attitude to family and family planning. Socioeconomic factors, parents' occupation, and size of residence were considered. Results showed: 70.4% had some kind of sex upbringing before age 12; 24.5% after age 12. Whereas up to 80% wanted sex education from parents, only about 55% actually received this (mothers mostly); 80% of actual sex information came from books and TV. Peers proved closer to the girls in confidence than parents. Although teachers were 3rd in line to provide actual sex education they were last as persons desired by the girls to provide this. Nearly 60% of the subjects desired more information in the areas of love and marriage, sex in adolescence, effects and side effects of the pill, general contraceptive methods and sex behavior. Conclusions from the survey point to the need to start sex education at an early age and extend it into adolescence and beyond; it should be direct, continuous and goal-oriented. Teenagers desire interpersonal dialogue with concerned adults. There should be cooperation in sex education between parents, teachers, and youth organizations. Teachers are insufficiently prepared to assume the role as sex educator. Teenagers need more factual information on conscious family planning and contraceptive methods.

Students’ Perceptions of Contraceptives in University of Ghana

PubMed Central

Kayi, Esinam Afi

2013-01-01

Objective This study sought to explore University of Ghana Business School diploma student's knowledge of contraceptives, types of contraceptives, attitudes towards contraceptive users, preference for contraceptives, benefits, and side-effects of contraceptives. Materials and methods Data was conducted with three sets of focus group discussions. Participants were systematically sampled from accounting and public administration departments. Results Findings showed that students had little knowledge of contraceptives. The male and female condoms were the main contraceptive types reported out of the many modern and traditional methods of contraceptives. The main benefits of contraceptives were; ability to protect against STIs, abortions, unwanted pregnancy and psychological trauma. Whilst most respondents preferred future use of pills, side-effects of contraceptives were mostly reported for condoms than other contraceptive methods. Results showed that participants had bad attitudes towards unmarried contraceptive users. Conclusion Generally, our findings show that detailed knowledge about contraceptives is low. There is a little gap of information on contraception knowledge, timing, and contraceptive types among university diploma students. Reproductive and maternal services should be available and accessible for tertiary students. PMID:24971101

The profile of women who seek emergency contraception from the family planning service.

PubMed

Lo, Sue S T; Ho, P C

2012-08-01

OBJECTIVES. To review the profile of emergency contraceptive users, their reasons for using emergency contraception, and whether they use it correctly. DESIGN. Retrospective analysis of medical records. SETTING. Six Birth Control Clinics and three Youth Health Care Centres of the Family Planning Association of Hong Kong. PARTICIPANTS. Women requesting emergency contraception between 2006 and 2008. MAIN OUTCOME MEASURES. Demographics of emergency contraception users, reasons for requesting emergency contraception, number of times the subject had unprotected intercourse before emergency contraception use, type of emergency contraception provided, coitus-treatment intervals, and outcomes. RESULTS. A total of 11 014 courses of emergency contraception were provided, which included 10 845 courses of levonorgestrel-only pills, 168 intrauterine contraceptive devices, and one course of pills plus an intrauterine contraceptive device. The mean age of the users was 30 years. Two thirds (65.6%) were nulliparous and 64.9% had not had a previous abortion. Their major reasons for requesting emergency contraception were: omission of contraceptive at the index intercourse (38.9%), condom accidents (38.0%), and non-use of any regular contraceptives (20.6%). Non-users of contraceptives were more likely to have had a previous abortion. In all, 97.9% of women took emergency contraception within 72 hours of their unprotected intercourse; 98% had had a single act of unprotected intercourse. None of the intrauterine contraceptive device users became pregnant. The failure rate for emergency contraceptive pills was 1.8%. CONCLUSIONS. Women requested emergency contraception because contraceptives were omitted or condom accidents. Health care providers should focus on motivating women with a history of abortion to use contraceptives, and ensure that condom users know how to use them correctly. Most women followed instructions on the use for emergency contraception and their outcomes were satisfactory.

A survey on the sexual and contraceptive behaviors in Chinese female college students.

PubMed

Li, Shiyue; Zuo, Dan; Xu, Delong; Xu, Xunyu; Zhang, Dongxian; Lu, Zuxun

2006-01-01

To get information in the sexual and contraceptive behaviors in Chinese female college students, a randomized cluster sampling was conducted in colleges and universities in Wuhan Area, China, in terms of types of colleges, subjects (literature, sciences, medicines, art etc), and grades etc. A total number of 2450 questionnaires were distributed, with 2365 questionnaires returned being valid. The return rate of valid questionnaires was 96.6%. The questionnaire investigation was conducted on a multiple-choice and anonymous basis. Data were input into computer and SPSS12.0 software package was employed for statistical analysis. Among the female students, 1196 had the experiences of hug and kiss (50.57%) and 423 (17.89%) had sexual experiences (sexual intercourse). The first sexual intercourse took place at the age of 19.23+/-1.74 y. There were significant differences in the sexual experiences among the majors of different subjects, with the rate of sexual experiences in art majors (43.17%) and high-grade students (34.31%) being the highest. The causes of the first sexual intercourse included sexual impulse, curiosity, intention to strengthen the relationship or to show loyalty to boyfriend and sometimes violence. While the motives of the sexual intercourse within the past one year before the investigation were to satisfy the sexual needs and to strengthen the relation with their boyfriends. With both first intercourse and sexual experiences within last one year, the partners of the sexual intercourse were mainly their boyfriends (95.7% and 97.3% respectively), but the partners also included acquaintances, "one night stand" partners and customers of sex trade. Some of them had multiple sexual partners, with the highest number of the sexual partners being 11. In the first sexual intercourse of the subjects, 44.0 % of them did not take any contraceptive measures; only 16.4% of them used condoms. In the sexual intercourse within the last one year, only 44.6% took contraceptive measures every time they had sexual intercourse. Among those who took contraceptive measures, 64.4% used condoms. Among those who had sexual intercourse, 101 persons got pregnant, with a rate of pregnancy being 4.3%, accounting for 23.9% of all who had sexual intercourse. Among those who got pregnant, 78 persons got pregnant once; the others became pregnant more than two times, the highest being 5 times. There were 122 persons who had inflammation of reproductive system, mostly vaginitis. Other conditions included venereal warts and herpes genitalis. It is concluded that the rate of sexual behaviors is high in female college students and there exist promiscuity, unexpected pregnancy and transmission of STD in the students.

Qualitative Inquiry into Premarital Sexual Behaviours and Contraceptive Use among Multiethnic Young Women: Implications for Education and Future Research

PubMed Central

Wong, Li Ping

2012-01-01

Background This study was a qualitative investigation into sexual attitudes and behaviours, and contraceptive use among Malaysian youth, based on constructs from the health belief model, theory of reasoned action, and problem behaviour theory. Methods A total of 34 focus group discussions with 185 participants were conducted among the Malay (35%), Chinese (34%), and Indian (31%) young females between November, 2010 and April, 2011. The participants were secondary school students and university undergraduates from Selangor and the Federal Territory of Kuala Lumpur. Results The study found a lack of knowledge about sexual issues and contraception among the participants. Many engaged in unprotected sexual intercourse and relied on periodic abstinence, natural methods, and traditional folk pregnancy preventive practices. The findings also revealed numerous categories of factors influencing sexual attitudes and behaviours: ethnic group and religion, level of religiosity, peer pressure and norms, and parental monitoring. With regard to condom use, factors such as embarrassment about condom acquisition, low perceived susceptibility to sexually transmitted infections (STIs), and perceived efficacy of traditional and folk methods of contraception, were uncovered from the discussions. Conclusion This study underscores the importance of development of culturally specific interventions that address the identified promoting factors of premarital sex. Behavioral interventions to promote condom use should increase awareness about condom effectiveness against not only unwanted pregnancies but also STIs. PMID:23272156

Qualitative inquiry into premarital sexual behaviours and contraceptive use among multiethnic young women: implications for education and future research.

PubMed

Wong, Li Ping

2012-01-01

This study was a qualitative investigation into sexual attitudes and behaviours, and contraceptive use among Malaysian youth, based on constructs from the health belief model, theory of reasoned action, and problem behaviour theory. A total of 34 focus group discussions with 185 participants were conducted among the Malay (35%), Chinese (34%), and Indian (31%) young females between November, 2010 and April, 2011. The participants were secondary school students and university undergraduates from Selangor and the Federal Territory of Kuala Lumpur. The study found a lack of knowledge about sexual issues and contraception among the participants. Many engaged in unprotected sexual intercourse and relied on periodic abstinence, natural methods, and traditional folk pregnancy preventive practices. The findings also revealed numerous categories of factors influencing sexual attitudes and behaviours: ethnic group and religion, level of religiosity, peer pressure and norms, and parental monitoring. With regard to condom use, factors such as embarrassment about condom acquisition, low perceived susceptibility to sexually transmitted infections (STIs), and perceived efficacy of traditional and folk methods of contraception, were uncovered from the discussions. This study underscores the importance of development of culturally specific interventions that address the identified promoting factors of premarital sex. Behavioral interventions to promote condom use should increase awareness about condom effectiveness against not only unwanted pregnancies but also STIs.

Comparison of scales for evaluating premenstrual symptoms in women using oral contraceptives.

PubMed

Coffee, Andrea L; Kuehl, Thomas J; Sulak, Patricia J

2008-05-01

To compare two scales used in research to evaluate daily premenstrual mood symptoms during use of a monophasic oral contraceptive. Subanalysis of data from a prospective study. University-affiliated medical center. SUBJECTS; One hundred two reproductive-aged (18-48 yrs) women taking a monophasic oral contraceptive containing ethinyl estradiol and drospirenone in the standard 21-7 fashion (21 days of hormones followed by 7 days of placebo), and who had self-identified premenstrual symptoms of headache, mood changes, or pelvic pain. Subjects completed a single-item questionnaire, the Scott & White Daily Diary of Symptoms, and a multiple-item questionnaire, the Penn State Daily Symptom Report (DSR), to assess their premenstrual symptoms. The Scott & White diary used a visual analog scale of 0-10 to assess pelvic pain, headache, and mood (a composite of anxiety, depression, and irritability). The Penn State DSR contained 17 items: 10 behavioral and seven physical components, each rated on a scale of 0-4, with one item that specifically rated mood swings. Scores from the two scales were compared by using Spearman correlation coefficients, the Kendall W for concordance, and linear regression of ranked sums for study cycles. The Scott & White mood score significantly correlated with the total of the 17 items on the Penn State DSR, as well as the 10 behavioral items, the seven physical items, and the single mood-swing item (p<0.0001); specific coefficients of concordance were 0.44, 0.23, 0.10, and 0.28, respectively, and R2 values were 0.39, 0.39, 0.30, and 0.34, respectively. The daily Scott & White mood score was positively correlated with all 17 elements of the Penn State DSR (0.25-0.57). The greatest correlation was seen with the mood-swing element. Both instruments demonstrated the same patterns during the 21-7 oral contraceptive cycle, with symptoms increasing immediately before and peaking during the 7-day hormone-free interval. A single-item daily mood score using a rating scale of 0-10 was concordant with a relatively complex 17-element symptom index and demonstrated the same pattern of change during cycles of oral contraception. The simple scoring system offers an advantage, especially in clinical studies of long duration.

Challenging the Courtesy Bias Interpretation of Favorable Clients' Perceptions of Family Planning Delivery

ERIC Educational Resources Information Center

Len, Federico R.; Lundgren, Rebecka; Huapaya, Ana; Sinai, Irit; Jennings, Victoria

2007-01-01

Favorable client perceptions of provider's interpersonal behavior in contraceptive delivery, documented in clinic exit questionnaires, appear to contradict results from qualitative evaluations and are attributed to clients' courtesy bias. In this study, trained simulated clients requested services from Ministry of Health providers in three…

Neighborhood, Family, and Work: Influences on the Premarital Behaviors of Adolescent Males.

ERIC Educational Resources Information Center

Ku, Leighton; And Others

1993-01-01

Analysis of national survey data suggests that level of sexual activity and likelihood of paternity among adolescent males are related to personal financial resources and employment but also to neighborhood unemployment. Discusses associations of sexual activity, contraceptive use, and paternity with personal and neighborhood race/ethnicity,…

Impact of the Family on the Sex Lives of Adolescents.

ERIC Educational Resources Information Center

Pick, Susan; Palos, Patricia Andrade

1995-01-01

Presents results of three studies as they relate to family influence on adolescents' sex lives. The studies' results support the hypothesis that the family has a substantial influence on adolescents' sexual and contraceptive behavior, justifying the incorporation of such issues as parent-child communication into sex education programs. (RJM)

Coital Behaviors, Attitudes, and Knowledge of Students Who Experience Early Coitus.

ERIC Educational Resources Information Center

Faulkenberry, J. Ron; And Others

1987-01-01

Surveyed 396 sexually experienced college students. Results indicated that, compared to early coital initiators, late coital initiators were more effective contraceptors during initial coitus, had more committed relationships with initial sex partners, engaged in more contraceptive use discussion and planning, and used more authoritative and…

Using Commercial Resources in Population Communications Programs.

ERIC Educational Resources Information Center

Sweeney, William O.

The author defines populations communications as all information, education, and other activities which can produce changes in attitudes and behavior towards contraception, family planning, and population growth. He discusses in this paper the effort made in 27 nations to utilize commercial, profit-making goods and services for the purpose of…

Missed conceptions or misconceptions: perceived infertility among unmarried young adults in the United States.

PubMed

Polis, Chelsea Bernhardt; Zabin, Laurie Schwab

2012-03-01

Perceived infertility is an individual's belief that she or he is unable to conceive or impregnate, regardless of whether this belief is medically accurate. This perception may lead to contraceptive nonuse, which may, in turn, lead to unintended pregnancy. Little research has examined perceived infertility among young adults, including potential associations with contraceptive behaviors. The frequency of perceived infertility among young adults was assessed using 2009 data from a nationally representative telephone survey of 1,800 unmarried men and women aged 18-29. Multinomial regression analyses assessed associations between respondents' perceived infertility and selected background, reproductive knowledge, sexual experience and contraceptive use characteristics. Overall, 19% of women and 13% of men believed that they were very likely to be infertile. Hispanic women and women who had received public assistance in the past year had elevated odds of perceived infertility (odds ratios, 3.4 and 3.0, respectively), as did Hispanic men and men of other racial or ethnic minorities, except blacks (2.5 and 6.1, respectively). Men who had some college education, had received sex education or were not in a current relationship had decreased odds of thinking they were very likely to be infertile (0.3-0.4). Among men, perceived infertility was associated with the belief that they were likely to have sex without using a contraceptive in the next three months (2.6). A substantial proportion of young adults believe they are infertile. Improved provider counseling and sex education may be useful in helping them to better understand their actual probability of infertility, and this knowledge may lead to improved contraceptive use. Copyright © 2012 by the Guttmacher Institute.

Parent-Adolescent Sexual Communication and Adolescent Safer Sex Behavior: A Meta-Analysis

PubMed Central

Widman, Laura; Choukas-Bradley, Sophia; Noar, Seth M.; Nesi, Jacqueline; Garrett, Kyla

2016-01-01

Importance Parent-adolescent sexual communication has received considerable attention as one factor that can positively impact safer sex among youth; however, the evidence linking communication to youth contraceptive and condom use has not been empirically synthesized. Objective This meta-analysis examined the effect of parent-adolescent sexual communication on youth safer sex behavior and explored potential moderators of this association. Data Sources A systematic search was conducted of studies published through June 2014 using Medline, PsycINFO, and Communication & Mass Media Complete databases and relevant review articles. Study Selection Studies were included if they: 1) sampled adolescents (mean sample age≤18); 2) included an adolescent report of sexual communication with parent(s); 3) measured safer sex behavior; and 4) were published in English. Data Extraction and Synthesis Correlation coefficients (r) and 95% confidence intervals (CIs) were computed from studies and meta-analyzed using random-effects models. Main Outcomes and Measures The primary outcome was safer sex behavior, including use of contraceptives/birth control or condoms. Results Seventy-one independent effects representing over three decades of research on 25,314 adolescents (mean age = 15.1) were synthesized. Across studies, there was a small, significant weighted mean effect (r = .10, [95% CI:0.08–0.13]) linking parent-adolescent sexual communication to safer sex behavior, which was statistically heterogeneous (Q = 203.50, p < .001, I2 = 65.60). Moderation analyses revealed larger effects for communication with girls (r = .12) than boys (r = .04), and among youth who discussed sex with mothers (r = .14) compared to fathers (r = .03). Effects did not differ for contraceptive versus condom use, or among longitudinal versus cross-sectional studies, indicating parent sexual communication had a similar impact across study designs and outcomes. Several methodological issues were identified in the literature; future studies can improve on these by measuring parent-adolescent communication with robust, multi-item measures, clearly specifying the target parent, and applying multi-method longitudinal designs. Conclusions and Relevance Sexual communication with parents, particularly mothers, plays a small protective role in adolescent safer sex behavior, and this protective effect is more pronounced for girls than boys. Implications for practice and suggestions for future research on parent-adolescent communication are discussed. PMID:26524189

Contraceptive Use Among Nonpregnant and Postpartum Women at Risk for Unintended Pregnancy, and Female High School Students, in the Context of Zika Preparedness - United States, 2011-2013 and 2015.

PubMed

Boulet, Sheree L; D'Angelo, Denise V; Morrow, Brian; Zapata, Lauren; Berry-Bibee, Erin; Rivera, Maria; Ellington, Sascha; Romero, Lisa; Lathrop, Eva; Frey, Meghan; Williams, Tanya; Goldberg, Howard; Warner, Lee; Harrison, Leslie; Cox, Shanna; Pazol, Karen; Barfield, Wanda; Jamieson, Denise J; Honein, Margaret A; Kroelinger, Charlan D

2016-08-05

Zika virus infection during pregnancy can cause congenital microcephaly and brain abnormalities (1,2). Since 2015, Zika virus has been spreading through much of the World Health Organization's Region of the Americas, including U.S. territories. Zika virus is spread through the bite of Aedes aegypti or Aedes albopictus mosquitoes, by sex with an infected partner, or from a pregnant woman to her fetus during pregnancy.* CDC estimates that 41 states are in the potential range of Aedes aegypti or Aedes albopictus mosquitoes (3), and on July 29, 2016, the Florida Department of Health identified an area in one neighborhood of Miami where Zika virus infections in multiple persons are being spread by bites of local mosquitoes. These are the first known cases of local mosquito-borne Zika virus transmission in the continental United States.(†) CDC prevention efforts include mosquito surveillance and control, targeted education about Zika virus and condom use to prevent sexual transmission, and guidance for providers on contraceptive counseling to reduce unintended pregnancy. To estimate the prevalence of contraceptive use among nonpregnant and postpartum women at risk for unintended pregnancy and sexually active female high school students living in the 41 states where mosquito-borne transmission might be possible, CDC used 2011-2013 and 2015 survey data from four state-based surveillance systems: the Behavioral Risk Factor Surveillance System (BRFSS, 2011-2013), which surveys adult women; the Pregnancy Risk Assessment Monitoring System (PRAMS, 2013) and the Maternal and Infant Health Assessment (MIHA, 2013), which surveys women with a recent live birth; and the Youth Risk Behavior Survey (YRBS, 2015), which surveys students in grades 9-12. CDC defines an unintended pregnancy as one that is either unwanted (i.e., the pregnancy occurred when no children, or no more children, were desired) or mistimed (i.e., the pregnancy occurred earlier than desired). The proportion of women at risk for unintended pregnancy who used a highly effective reversible method, known as long-acting reversible contraception (LARC), ranged from 5.5% to 18.9% for BRFSS-surveyed women and 6.9% to 30.5% for PRAMS/MIHA-surveyed women. The proportion of women not using any contraception ranged from 12.3% to 34.3% (BRFSS) and from 3.5% to 15.3% (PRAMS/MIHA). YRBS data indicated that among sexually active female high school students, use of LARC at last intercourse ranged from 1.7% to 8.4%, and use of no contraception ranged from 7.3% to 22.8%. In the context of Zika preparedness, the full range of contraceptive methods approved by the Food and Drug Administration (FDA), including LARC, should be readily available and accessible for women who want to avoid or delay pregnancy. Given low rates of LARC use, states can implement strategies to remove barriers to the access and availability of LARC including high device costs, limited provider reimbursement, lack of training for providers serving women and adolescents on insertion and removal of LARC, provider lack of knowledge and misperceptions about LARC, limited availability of youth-friendly services that address adolescent confidentiality concerns, inadequate client-centered counseling, and low consumer awareness of the range of contraceptive methods available.

Understanding Gender Roles in Teen Pregnancy Prevention among American Indian Youth

PubMed Central

Hanson, Jessica D.; McMahon, Tracey R.; Griese, Emily R.; Kenyon, DenYelle Baete

2014-01-01

Objectives To examine the impact of gender norms on American Indian (AI) adolescents' sexual health behavior. Methods The project collected qualitative data at a reservation site and an urban site through 24 focus groups and 20 key informant interviews. Results The reasons that AI youth choose to abstain or engage in sexual intercourse and utilize contraception vary based on gender ideologies defined by the adolescent's environment. These include social expectations from family and peers, defined roles within relationships, and gender empowerment gaps. Conclusions Gender ideology plays a large role in decisions about contraception and sexual activity for AI adolescents, and it is vital to include re-definitions of gender norms within AI teen pregnancy prevention program. PMID:25207506

Emergency contraception.

PubMed

2012-12-01

Despite significant declines over the past 2 decades, the United States continues to have teen birth rates that are significantly higher than other industrialized nations. Use of emergency contraception can reduce the risk of pregnancy if used up to 120 hours after unprotected intercourse or contraceptive failure and is most effective if used in the first 24 hours. Indications for the use of emergency contraception include sexual assault, unprotected intercourse, condom breakage or slippage, and missed or late doses of hormonal contraceptives, including the oral contraceptive pill, contraceptive patch, contraceptive ring (ie, improper placement or loss/expulsion), and injectable contraception. Adolescents younger than 17 years must obtain a prescription from a physician to access emergency contraception in most states. In all states, both males and females 17 years or older can obtain emergency contraception without a prescription. Adolescents are more likely to use emergency contraception if it has been prescribed in advance of need. The aim of this updated policy statement is to (1) educate pediatricians and other physicians on available emergency contraceptive methods; (2) provide current data on safety, efficacy, and use of emergency contraception in teenagers; and (3) encourage routine counseling and advance emergency-contraception prescription as 1 part of a public health strategy to reduce teen pregnancy. This policy focuses on pharmacologic methods of emergency contraception used within 120 hours of unprotected or underprotected coitus for the prevention of unintended pregnancy. Emergency contraceptive medications include products labeled and dedicated for use as emergency contraception by the US Food and Drug Administration (levonorgestrel and ulipristal) and the "off-label" use of combination oral contraceptives.

Kinsey revisited, Part I: Comparisons of the sexual socialization and sexual behavior of white women over 33 years.

PubMed

Wyatt, G E; Peters, S D; Guthrie, D

1988-06-01

This research compared data from two studies of women's sexual behavior--one conducted in the 1940s, the other in the 1980s. The first sample included 3952 white women, ages 18 to 36, drawn from the larger sample of women who participated in the original Kinsey study. The second comprised 122 white women, in the same age range, who had taken part in a recent study of sexual socialization and experiences among women in Los Angeles County, CA. Log-linear analyses were used to control for differences between the samples on age, education, and marital status. Comparisons were conducted in the areas of childhood family characteristics; sexual socialization and education; sexual behavior in childhood, adolescence, and adulthood; contraceptive practices; and child sexual abuse. Results tended to reflect changes that have taken place in society and in patterns of sexual behavior. Differences in sexual socialization pointed to the increased role of the media and the schools and to more relaxed attitudes about nudity in the home. Shifts in sexual behavior were particularly dramatic. As compared to women in the Kinsey sample, the newer subjects began intercourse earlier, were less likely to have a fiance or husband as their first partner, reported a higher number of sexual partners, and participated in a broader range of sexual behaviors. Contraceptive practices differed considerably, especially among never-married women. Women in the new study were also more likely to report instances of child sexual abuse. Methodological and social factors contributing to the findings are discussed.

Impact of male partner's awareness and support for contraceptives on female intent to use contraceptives in southeast Nigeria.

PubMed

Ezeanolue, Echezona E; Iwelunmor, Juliet; Asaolu, Ibitola; Obiefune, Michael C; Ezeanolue, Chinenye O; Osuji, Alice; Ogidi, Amaka G; Hunt, Aaron T; Patel, Dina; Yang, Wei; Ehiri, John E

2015-09-10

Despite the growing body of evidence on use of modern contraceptives among women in sub-Saharan African countries, little is known about the broader context in which female decision-making concerning contraceptive use occurs, particularly the role of their male partners' awareness and support of modern contraceptives. We conducted a cross-sectional survey of 2468 pregnant women and their male partners enrolled in the Healthy Beginning Initiative (HBI), an intervention to increase HIV testing among pregnant women in Enugu, southeast Nigeria. The aims of this study were to determine: 1) male partners' awareness of, and support for, female contraceptive methods, and 2) influence of male partners' contraceptive awareness and support on pregnant women's expressed desire to use contraception. We used logistic regression models to examine the association between male partners' awareness and support of modern contraceptives on their spouses' desire to use contraceptives. Men's awareness of, and support for, use of modern contraceptives were significantly associated with their female partners' desire to use contraception. A majority of the men who were aware of modern contraceptives (66.5 %) and those who supported their spouses' use of contraception (72.5 %) had partners who expressed a desire to use contraception. Men who were aware of female contraception were 3 times more likely to have spouses who desired to use contraception (AOR = 3.17, 95 % C.I: 2.70-3.75). In addition, men who showed support for their spouses' use of contraception were over 5 times more likely to have spouses who indicated a desire to use contraception (AOR = 5.76, 95 % C.I: 4.82-6.88). Living in a household of 5 or more people (AOR = 1.45, 95 % C.I: 1.23-1.72) and residing in an urban area (AOR = 0.81, 95 % C.I: 0.67-0.97) were also significantly associated with women's expressed desire to use modern contraception. Men's awareness of, and support for, use of modern contraceptives were markedly associated with their spouses' desire to use contraception. This underscores the need for men's involvement in programs that seek to address women's uptake of contraception in low and middle income countries.

Forgettable contraception.

PubMed

Grimes, David A

2009-12-01

The term "forgettable contraception" has received less attention in family planning than has "long-acting reversible contraception." Defined here as a method requiring attention no more often than every 3 years, forgettable contraception includes sterilization (female or male), intrauterine devices, and implants. Five principal factors determine contraceptive effectiveness: efficacy, compliance, continuation, fecundity, and the timing of coitus. Of these, compliance and continuation dominate; the key determinants of contraceptive effectiveness are human, not pharmacological. Human nature undermines methods with high theoretical efficacy, such as oral contraceptives and injectable contraceptives. By obviating the need to think about contraception for long intervals, forgettable contraception can help overcome our human fallibility. As a result, all forgettable contraception methods provide first-tier effectiveness (

Contraceptive use and pregnancies in adolescents' romantic relationships: role of relationship activities and parental attitudes and communication.

PubMed

Amialchuk, Aliaksandr; Gerhardinger, Laura

2015-01-01

In a unified framework, the authors estimate whether romantic relationship activities and parental attitudes predict contraception use and consistency, and whether contraception use and consistency predict pregnancy risk among male and females adolescents in the United States. Data on 3717 participants of the first 2 waves of the National Longitudinal Study of Adolescent Health (Add Health) who were sexually experienced in their recent romantic relationship were analyzed to examine how presex activities in the romantic relationship and parental attitudes and communication are associated with contraception choices and how contraception choices are associated with pregnancies. In multivariate logistic regression analysis, only some relationship activities and parental communication about contraception were significant predictors of contraception, and their influence differed by gender. Going out with the partner increased contraception consistency among males (odds ratio, 2.04). Discussing contraception with the partner before having first sex increased the odds of ever using contraception for both genders (2.61 for females and 1.59 for males) and increased the odds of consistent contraception for females (1.505). Discussing contraception with parent increased the odds of consistent contraception among females (1.383). Merely, using contraception was not a significant predictor of the risk of pregnancy, whereas using contraception consistently significantly reduced the odds of getting partner pregnant for males (0.413) and the odds of pregnancy of females (0.343). Contraception and pregnancy education programs should take into account qualities of romantic relationship and emphasize consistent use of contraception and communication about contraception between partners and with parents.

The influence of nurse home visits, including provision of 3 months of contraceptives and contraceptive counseling, on perceived barriers to contraceptive use and contraceptive use self-efficacy.

PubMed

Melnick, Alan L; Rdesinski, Rebecca E; Creach, E Dawn; Choi, Dongseok; Harvey, S Marie

2008-01-01

To identify the influence of a community health nurse (CHN) home visit on perceived barriers to contraceptive access and contraceptive use self-efficacy. We enrolled 103 women into two groups in a randomized trial evaluating the influence of contraceptive dispensing and family planning counseling during home visits on perceived barriers to accessing contraceptives and contraceptive use self-efficacy. Both groups received counseling by a CHN about sexually transmitted disease and pregnancy prevention, and a resource card listing phone numbers of family planning clinics. After randomization, the CHN dispensed three months of hormonal contraception to the intensive intervention group and advised the minimal intervention group to schedule an appointment at a family planning clinic. Data collection at baseline and 12 months included demographic, reproductive and other health-related information as well as quantitative assessments of information on perceived barriers to contraceptive access and contraceptive use self-efficacy. The mean age of participants was 24.7 years. Three-fourths had household incomes under $25,000. We found significant reductions in three perceived barriers to contraceptive access for both groups, as well as significant increases in two measures of contraceptive use self-efficacy at twelve months compared to baseline. Nurse home visits involving family planning counseling might be effective in reducing perceived barriers to contraceptive access and increasing contraceptive use self-efficacy.

Sexual behavior of adolescent students in Chandigarh and their perceptions regarding family life education.

PubMed

Kumar, Dinesh; Goel, Naveen Krishan; Bakshi, Ravleen Kaur; Sharma, Manoj Kumar; Ghosh, Abhik K

2017-01-01

With rapidly changing lifestyle and exposure to the Internet and mass media, lifestyle and sexual behavior of adolescent students are also changing rapidly. To investigate the sexual behavior of adolescent students and to study misconceptions prevailing among them. A cross-sectional survey of 1022 adolescent students aged 14-19 years as a part of an Indian Council of Medical Research sponsored survey. Sexual behavior explored by interview method. Logistic regression analysis for finding correlates. Intimate friendship was reported by 19.2% respondents. The sexual behavior included 89% exposure to sex-related material, 74.7% were aware of sexual intercourse. Awareness regarding at least one contraceptive was found among 95.5% (94.5% of condoms and 67.2% of emergency contraception). About 6% respondents reported some sex-related problems and 2.5% of all respondents consulted some doctors for these problems. Awareness of HIV/AIDS was quite high (about 99%), and 96.4% of them were of the opinion that it is spread through sexual intercourse. Knowledge regarding transmission of sexually transmitted infections (STIs) through sexual contact was found among 89.2% respondents. Avoidance/abstinence from sex (84.7%), faithful to one partner (81.7), and use of barrier methods (90.3%) was main reported preventive measures for STI's. About 33% want that the discussion about sex should be open and frank, and 69.4% showed the need of sex education in the schools mostly by doctors. Sexual behavior of adolescent students is changing, and awareness about sex acts is also increasing. There is likelihood of indulging in risky behavior by adolescents. Family life education was felt necessary mainly by qualified medical staff.

Sexual behavior of adolescent students in Chandigarh and their perceptions regarding family life education

PubMed Central

Kumar, Dinesh; Goel, Naveen Krishan; Bakshi, Ravleen Kaur; Sharma, Manoj Kumar; Ghosh, Abhik K.

2017-01-01

Background: With rapidly changing lifestyle and exposure to the Internet and mass media, lifestyle and sexual behavior of adolescent students are also changing rapidly. Objectives: To investigate the sexual behavior of adolescent students and to study misconceptions prevailing among them. Methods: A cross-sectional survey of 1022 adolescent students aged 14–19 years as a part of an Indian Council of Medical Research sponsored survey. Sexual behavior explored by interview method. Logistic regression analysis for finding correlates. Results: Intimate friendship was reported by 19.2% respondents. The sexual behavior included 89% exposure to sex-related material, 74.7% were aware of sexual intercourse. Awareness regarding at least one contraceptive was found among 95.5% (94.5% of condoms and 67.2% of emergency contraception). About 6% respondents reported some sex-related problems and 2.5% of all respondents consulted some doctors for these problems. Awareness of HIV/AIDS was quite high (about 99%), and 96.4% of them were of the opinion that it is spread through sexual intercourse. Knowledge regarding transmission of sexually transmitted infections (STIs) through sexual contact was found among 89.2% respondents. Avoidance/abstinence from sex (84.7%), faithful to one partner (81.7), and use of barrier methods (90.3%) was main reported preventive measures for STI's. About 33% want that the discussion about sex should be open and frank, and 69.4% showed the need of sex education in the schools mostly by doctors. Conclusions: Sexual behavior of adolescent students is changing, and awareness about sex acts is also increasing. There is likelihood of indulging in risky behavior by adolescents. Family life education was felt necessary mainly by qualified medical staff. PMID:29302554

The role of previous contraception education and moral judgment in contraceptive use.

PubMed

Bader, Valerie; Kelly, Patricia J; Cheng, An-Lin; Witt, Jackie

2014-01-01

The knowledge and attitudes that lead to nonuse of contraception are not well understood. The goal of this study was to determine whether an association exists between contraceptive use and specific knowledge and attitudinal factors. We conducted a secondary analysis of data from a nationally representative telephone survey of 897 unmarried women aged 18 to 29 years to examine the relationship between contraceptive use and comprehensive sex education, attitude toward pregnancy prevention, perceived infertility, distrust toward the health care system or contraception, and moral attitude toward contraception. Both ever having made a visit to a physician or clinic for women's health care and ever having used any method of contraception to prevent pregnancy were significantly impacted by more comprehensive sex education and less likelihood to view contraception as morally wrong. Consistent with other research, we found no association between the desire to avoid pregnancy and contraceptive use. We found an association between health system distrust and contraceptive use, but health system distrust did not predict contraceptive use. Our findings show that contraceptive use among a sample of young women is influenced by previous contraceptive education and moral attitudes toward contraception. Clinicians should be cognizant of these realities, which may need to be addressed in both clinical and nonclinical venues. © 2014 by the American College of Nurse-Midwives.

Contraceptive knowledge and attitudes among 14-24-year-olds in New South Wales, Australia.

PubMed

Ritter, Todd; Dore, Anne; McGeechan, Kevin

2015-06-01

To investigate correlates of contraceptive knowledge and attitudes and describe differences in contraceptive knowledge by contraceptive category among young people in New South Wales. A total of 119 young people aged 14 to 24, recruited from youth centres, completed a contraceptive knowledge and attitude survey. Overall contraceptive knowledge was low. Females had significantly better knowledge than males. There was high knowledge about condoms and withdrawal and low knowledge about shorter-term hormonal methods (oral contraceptive pill and vaginal ring) and long-acting reversible contraceptive (LARC) methods. Nearly half of respondents agreed that 'contraceptives make sex seem less romantic', while 58% agreed that 'contraceptives are difficult to use'. Despite this, both genders had positive attitudes to contraception, with females' attitudes significantly more positive than males. While young people, particularly young women, expressed attitudes conducive to contraceptive use, many are unaware of basic facts about methods, including highly effective LARC. Our findings reflect the modest reproductive and sexual health education received by Australian young people and cultural norms of condoms and oral contraceptives as default methods and highlight the need to improve knowledge, among young men, in particular, about the most effective contraceptive methods. © 2015 Public Health Association of Australia.

Committee Opinion No 707: Access to Emergency Contraception.

PubMed

2017-07-01

Emergency contraception refers to contraceptive methods used to prevent pregnancy in the first few days after unprotected intercourse, sexual assault, or contraceptive failure. Although the U.S. Food and Drug Administration approved the first dedicated product for emergency contraception in 1998, numerous barriers to emergency contraception remain. The purpose of this Committee Opinion is to examine barriers to the use of emergency contraception, emphasize the importance of increasing access, and review new methods of emergency contraception and limitations in efficacy in special populations.

Committee Opinion No. 707 Summary: Access to Emergency Contraception.

PubMed

2017-07-01

Emergency contraception refers to contraceptive methods used to prevent pregnancy in the first few days after unprotected intercourse, sexual assault, or contraceptive failure. Although the U.S. Food and Drug Administration approved the first dedicated product for emergency contraception in 1998, numerous barriers to emergency contraception remain. The purpose of this Committee Opinion is to examine barriers to the use of emergency contraception, emphasize the importance of increasing access, and review new methods of emergency contraception and limitations in efficacy in special populations.

A Belief-Behavior Gap? Exploring Religiosity and Sexual Activity among High School Seniors

ERIC Educational Resources Information Center

Leonard, Kathleen Cobb; Scott-Jones, Diane

2010-01-01

Religiosity, sexual activity, and contraception were examined via questionnaires and interviews in a diverse sample of 118 high school seniors. The majority reported religion to be important; importance and frequency ratings declined from private (e.g., prayer) to public (e.g., group activities) components of religion. Most were sexually active…

Defining Sexuality among Female Black Inner-City Young Adolescents.

ERIC Educational Resources Information Center

Gershenson, Harold P.; Handler, Arden

Adolescents are able to respond correctly to questions about pregnancy risk and contraceptive use, yet still engage in risk-taking behavior. One explanation for this phenomenon may be the existence of a personal fable. To explore the existence of the personal fable in inner-city female adolescents, 22 eighth grade black females in Chicago…

Parental Sexual Attitudes, Family Sexual Communication, and Adolescent Sexual Behavior.

ERIC Educational Resources Information Center

Fisher, Terri D.

Some researchers have reported that when parents are the main source of sex education, their adolescent children are less likely to engage in premarital sexual activity and are more likely to use effective contraception. This study used the variables of gender and parental sexual attitudes (liberal or conservative) to categorize 349 college…

Understanding Adolescents' Motivation To Prevent Pregnancy: A Literature Review.

ERIC Educational Resources Information Center

Sugland, Barbara W.; Wilder, Kathleen J.; Chandra, Anita

Recent efforts targeting teenage pregnancy in the United States have marked a renewed conviction to reduce the level of childbearing among adolescents. Some of the behavioral, psychosocial, and ethnographic studies that explore the underlying motivation to delay sex and to effectively use contraception are the focus of this literature review.…

Social Context and Adolescent Behavior: The Impact of Community on the Transition to Sexual Activity.

ERIC Educational Resources Information Center

Brewster, Karin L.; And Others

1993-01-01

Analysis of aggregate- and individual-level data for a national sample of white women suggest that adolescent nonmarital sexual activity and contraceptive use are shaped by the local opportunity structure and normative environment. Social disintegration, socioeconomic status, and availability of employment opportunities for women emerged as…

The Meaning of Children for Hispanic Women.

ERIC Educational Resources Information Center

Marin, Gerardo; And Others

A random sample of 100 Hispanic women waiting to receive birth control services at a low-cost community health center in East Los Angeles was interviewed to learn more about the fertility behavior, attitudes toward family size, and contraceptive use of barrio Hispanic women. The respondents were: young (averaging 27 years old), poorly educated…

The Role of Education in Production Within the Household. Final Report.

ERIC Educational Resources Information Center

Michael, Robert T.

This project is part of an ongoing study of the influence of schooling on observed household behavior. The study has previously determined that more educated individuals behave as if they are more proficient consumers, and that, in particular, more educated couples systematically select more efficient contraceptive techniques. The recent research…

Premenstrual syndrome: A mini review.

PubMed

Ryu, Aeli; Kim, Tae-Hee

2015-12-01

Premenstrual syndrome (PMS) is characterized by recurrent, moderate-to-severe affective, physical, and behavioral symptoms that develop during the luteal menstrual cycle and disappear within a few days of menstruation. Premenstrual dysphoric disorder (PMDD) is a severe and disabling condition that can affect personal relationships and occupational activities. PMS occurs in 30-40% of reproductive-age females; PMDD affects 3-8% of this population. Although the etiology of PMS is unclear, several theories suggest increased sensitivity to normal hormonal changes and neurotransmitter abnormalities. The diagnostic method of PMS is the Daily Record of Severity of Problems, which women with PMS can use to self-report several symptoms and their severity. Although combined oral contraceptives and serotonergic antidepressants are effective drugs, each is a different option for treating PMS/PMDD. Serotonergic antidepressants are the drugs of choice for improving both physical and mood symptoms. Combined oral contraceptives appear to primarily improve physical symptoms. Clinicians should consider each patient's situation individually. Other treatment options include lifestyle modification, cognitive behavioral therapy, and herbal medicine (e.g., chasteberry). Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Incentives to promote family planning

PubMed Central

Heil, Sarah H.; Gaalema, Diann E.; Herrmann, Evan S.

2012-01-01

Objective Over the past 60 years, population control has become an increasingly urgent issue worldwide as a growing population strains already limited resources. The use of financial incentives to promote family planning is an innovative approach that has potential to make a contribution to efforts to better manage population growth. This report reviews eight studies that examined the effect of incentives on family planning. Method Published studies that tested the impact of incentives to promote some aspect of family planning and included an appropriate control or comparison condition were reviewed. Results Incentives have been used to promote attendance at contraceptive education sessions, adoption and continuation of contraceptive methods, sterilization, and to limit family size. All but one of the eight studies reviewed reported positive outcomes, but weaknesses in study design and execution limit the strength of the conclusions that can be drawn. Conclusion Review of this literature suggests that family planning behaviors, like other behaviors, are sensitive to incentives. Given the tremendous need for efficacious interventions in global efforts to manage population growth, further research on this topic using more rigorous experimental methods is warranted. PMID:22743293

Prospective study on sexual behavior of women using 30 microg ethinylestradiol and 3 mg drospirenone oral contraceptive.

PubMed

Caruso, Salvatore; Agnello, Carmela; Intelisano, Giorgia; Farina, Marco; Di Mari, Lucia; Sparacino, Lucia; Cianci, Antonio

2005-07-01

The aim of the study was to determine the changes, if any, on the sexual behavior of women using an oral contraceptive containing 30 microg ethinylestradiol (EE) and 3 mg drospirenone (DRSP). Eighty healthy volunteer women (age range, 19-31 years), with regular menstrual cycle length (mean 27.6+/-3.1) and ovulation, participated in this prospective study. Sexual behavior was assessed using the self-administered Personal Experience Questionnaire, at baseline and at 3, 6 and 9 cycles of pill use. Women reported increased (i) sexual enjoyment (p < .001), (ii) orgasm frequency (p < .05) and (iii) satisfaction with sexual activity (p < .05) during all periods of pill intake with respect to baseline. Both arousal and frequency of sexual activity improved at the sixth and ninth cycle of pill use (p < .05) with respect to baseline. Moreover, women reported decreased genital pain associated with intercourse during pill intake (p < .05). Desire did not change during the use of the pill (p = NS). The mild dose of EE may have improved vaginal lubrication, sexual arousal and decreased dyspareunia. Consequently, women may have experienced increased sexual performance. In addition, improved sexual activity could have been the result of the effects of DRSP, with its antimineralocorticoid effects which could improve pill compliance, with a more satisfied sexual life.

Practice Bulletin No. 152: Emergency Contraception.

PubMed

2015-09-01

Emergency contraception, also known as postcoital contraception, is therapy used to prevent pregnancy after an unprotected or inadequately protected act of sexual intercourse. Common indications for emergency contraception include contraceptive failure (eg, condom breakage or missed doses of oral contraceptives) and failure to use any form of contraception (). Although oral emergency contraception was first described in the medical literature in the 1960s, the U.S. Food and Drug Administration (FDA) approved the first dedicated product for emergency contraception in 1998. Since then, several new products have been introduced. Methods of emergency contraception include oral administration of combined estrogen-progestin, progestin only, or selective progesterone receptor modulators and insertion of a copper intrauterine device (IUD). Many women are unaware of the existence of emergency contraception, misunderstand its use and safety, or do not use it when a need arises (). The purpose of this Practice Bulletin is to review the evidence for the efficacy and safety of available methods of emergency contraception and to increase awareness of these methods among obstetrician-gynecologists and other gynecologic providers.

[Post-abortion contraception: effects of contraception services and reproductive intention].

PubMed

Borges, Ana Luiza Vilela

2016-02-01

Contraceptive counseling and the supply of contraceptive methods are part of post-abortion care and positively influence the subsequent use of contraceptive methods. Studies showing such evidence have been conducted predominantly in countries with no legal restrictions on abortion and with adequate care for women that terminate a pregnancy. However, little is known about contraceptive practices in contexts where abortion is illegal, as in Brazil, in which post-abortion contraceptive care is inadequate. The objective of this study was to analyze the effect of contraceptive care on male condom use and oral and injectable contraceptives in the six months post-abortion, considering reproductive intention. The results showed that contraceptive care only has a positive effect on the use of oral contraceptives in the first six months post-abortion, as long as the woman had a medical consultation in the same month in which she received information on contraception. One or the other intervention alone had no significant impact.

Use of Contraception and Attitudes towards Contraceptive Use in Swedish Women--A Nationwide Survey.

PubMed

Kopp Kallner, Helena; Thunell, Louise; Brynhildsen, Jan; Lindeberg, Mia; Gemzell Danielsson, Kristina

2015-01-01

To describe contraceptive use and attitudes towards contraceptive use in Sweden which has the highest abortion rate in Western Europe. Secondary objectives were to investigate knowledge of contraceptive methods and outcomes of unplanned and unwanted pregnancies. Telephone survey. National survey of women living in Sweden. Women between 16 and 49 years. The survey contained 22 questions with free text and multi choice answers on demographics, contraceptive use, knowledge of and attitudes towards contraception, the importance of monthly bleeding and experience of unintended pregnancy. Distribution of use of contraceptive methods and non-use of contraception among Swedish women. Prevalence and outcome of unintended pregnancies. A total of 1001 women participated in the survey. Of all women, 721/1001 (72.1%) currently used contraception whereas 268/1001 (26.8%) women did not. Long acting reversible contraception, (LARC; implant and intra uterine contraception) was used by 24.3% of women. The unmet need of contraception in Sweden was estimated at 8.9% (89/1001 women). A total of 781 (78%) women had never experienced an unintended pregnancy whereas 220 (22%) women had had at least one unintended pregnancy. Users and non-users alike stated that one of the most important characteristics of a contraceptive method is its effectiveness. Sweden has a large unmet need for contraception. Furthermore, a large proportion of women have experienced at least one unintended pregnancy. Increasing contraceptive use and promotion of LARC is a possible way forward in the effort to reduce the rates of unwanted pregnancies.

[Contraceptive practices among university students: the use of emergency contraception].

PubMed

Borges, Ana Luiza Vilela; Fujimori, Elizabeth; Hoga, Luiza Akiko Komura; Contin, Marcelo Vieira

2010-04-01

This study investigated contraceptive practices and especially the use of emergency contraception by 487 young students at a public university in São Paulo State. A structured questionnaire was sent by e-mail and completed online in December 2007. Contraceptive methods and use of emergency contraception were investigated. Female and male students reported a high proportion of contraceptive use, mainly condoms and the pill. Half of the students had already used emergency contraception, often when already using some other highly effective method. Among female students, multiple regression analysis showed that current age, age at sexual initiation, not having used condoms in sexual relations, condom failure, and knowing someone that has used emergency contraception were associated with use of the latter. The option for emergency contraception proved to be more closely related to inconsistencies in the use of regular methods than to lack of their use, and can thus be considered a marker for discontinuity in regular contraception.

Contraceptive counseling among pediatric primary care providers in Western Pennsylvania: A survey-based study.

PubMed

Papas, Beth Ann; Shaikh, Nader; Watson, Katherine; Sucato, Gina S

2017-01-01

Data suggest that adolescents in the United States receive inadequate contraceptive counseling. This study sought to determine factors affecting pediatricians' discussion of contraception with adolescent patients, with a specific focus on long-acting reversible contraception-implantable contraception and intrauterine devices. A cross-sectional survey was sent via email to a convenience sample of pediatric residents and pediatric primary care providers in Western Pennsylvania. Self-reported contraceptive counseling and prescribing practices in response to clinical vignettes were assessed. Of potential participants (287), 88 (31%) responded. Younger providers and providers who had received contraceptive training were significantly more likely to discuss long-acting reversible contraception methods. Discussion of contraceptive methods also varied by both the age and the sexual history of the patient. Variation in contraceptive counseling potentially results in missed opportunities to counsel about and provide the most effective contraceptive methods. More uniform, universal provider training might alleviate some of these inconsistencies.

Adolescent contraception: review and guidance for pediatric clinicians.

PubMed

Potter, J; Santelli, J S

2015-02-01

The majority of adolescents initiate sexual activity during their teenage years, making contraception an important aspect of routine adolescent health care. Despite common misperceptions, all available methods of reversible contraception are appropriate for adolescent use. Contraceptive side effects profiles and barriers to use of certain methods should be considered when providing contraceptives to adolescents. In particular, ease of use, confidentiality, and menstrual effects are main concerns of adolescents. Contraceptive counseling with adolescents should describe method efficacy, discuss user preferences, explore barriers to use, counsel regarding sexually transmitted infection prevention, and consider what to do if contraception fails. Emergency contraception should be widely discussed with adolescents, as it is appropriate for use during gaps in other contraceptive use, method failure, and adolescents who are not using another form of contraception. Dual method use (condom plus a highly effective method of contraception) is the gold standard for prevention of both pregnancy and sexually transmitted infections.

Influence of multiple antenatal counselling sessions on modern contraceptive uptake in Nigeria.

PubMed

Adanikin, Abiodun I; Onwudiegwu, Uche; Loto, Olabisi M

2013-10-01

To determine the influence of multiple contraceptive counselling sessions during antenatal care on use of modern postpartum contraception. A total of 216 eligible pregnant women were randomised into antenatal and postnatal counselling groups. The 'Antenatal group' received one-to-one antenatal contraceptive counselling on several occasions while the 'Postnatal group' received a single one-to-one contraceptive counselling session at the sixth week postnatal check, as is routinely practised. All participants were contacted six months postpartum by telephone or personal visit, and questioned about their contraceptive use, if any. More women who had multiple antenatal contraceptive counselling sessions used modern contraceptive methods than those who had a single postnatal counselling session (57% vs. 35%; p = 0.002). There was also a significantly more frequent use of contraception among previously undecided patients in the Antenatal group (p = 0.014). Multiple antenatal contraceptive counselling sessions improve the use of modern postpartum contraception.

[A sexual health study of high school students at the 3 high schools in Kitakyushu City].

PubMed

Tsurugi, Yoko; Yamamoto, Mieko; Matsuda, Shinya

2002-01-01

The purpose of this study was to clarify the actual sexual behavior and attitudes of high school students in Kitakyushu city, Fukuoka and then to develop effective sex education methods for high school students in this region. This study investigated the sexual behavior and attitudes of 1,297 high school students in Kitakyushu by self-administered questionnaire. The differences in their answers by sex, prevalence of sexual intercourse and change in sexual behavior and attitude before and after the sex education lecture were examined. 39.3% of the students had had sexual intercourse and 74.1% answered that they might have sex, if it were with a partner whom they loved. However, they did not have enough knowledge about contraception and sexually transmitted diseases. This result shows that they did not recognize the risks accompanying sexual intercourse. There are significant differences between male and female students in their sexual attitudes. Male students tend to permit premarital sexual intercourse, unfaithfulness, prostitution, hiring a prostitute and abortion. Male students tend to give more approval to the following opinions: both men and women should agree to sexual contact if the partner wants it; men should take the initiative in sexual contact; women should not talk about sex. Many female students answered that women should make their own decisions to have or not to have sex, however a considerable number of female students answered that for their first intercourse, they just agreed with their partner even though they really did not want to do so. After the sex education lecture, the students have more knowledge about contraception and STDs. However, there is no significant difference in their sexual attitudes before and after the lecture. In order to facilitate more desirable and safer sexual behavior among the younger generation, it is not enough to simply give them knowledge about contraception or STDs, etc. To organize more comprehensive sex education, it is also important to pay enough attention to gender problems and other social factors such as family background or regional background, etc.

Partner approval and intention to use contraception among Zanzibari women presenting for post-abortion care.

PubMed

Esber, Allahna; Foraker, Randi E; Hemed, Maryam; Norris, Alison

2014-07-01

We examined the effect of partner approval of contraception on intention to use contraception among women obtaining post-abortion care in Zanzibar. Our data source was a 2010 survey of 193 women obtaining post-abortion care at a large public hospital in Zanzibar. We used multivariable logistic regression analysis to assess associations between partner approval and intention to use contraception. Overall, 23% of participants had used a contraceptive method in the past, and 66% reported intending to use contraception in the future. We found that partner approval of contraception and ever having used contraception in the past were each associated with intending to use contraception in the future. In the multivariable model, adjusting for past contraception use, partner approval of contraception was associated with 20 times the odds of intending to use contraception (odds ratio, 20.25; 95% confidence interval, 8.45-48.56). We found a strong association between partner approval and intention to use contraception. Efforts to support contraceptive use must include both male and female partners. Public health and educational efforts to increase contraceptive use must include men and be targeted to both male and female partners. Given that male partners are often not present when women obtain health care, creative efforts will be required to meet men in community settings. Copyright © 2014 Elsevier Inc. All rights reserved.

Factors associated with the content of sex education in U.S. public secondary schools.

PubMed

Landry, David J; Darroch, Jacqueline E; Singh, Susheela; Higgins, Jenny

2003-01-01

While sex education is almost universal in U.S. schools, its content varies considerably. Topics such as abstinence, and basic information on HIV and other sexually transmitted diseases (STDs), are commonly taught; birth control and how to access STD and contraceptive services are taught less often. Factors potentially associated with these variations need to be examined. Data on 1,657 respondents to a 1999 national survey of teachers providing sex education in grades 7-12 were assessed for variation in topics covered. Logistic regression was used to ascertain factors associated with instruction on selected topics. The content of sex education varied by region and by instructors' approach to teaching about abstinence and contraception. For example, teaching abstinence as the only means of pregnancy and STD prevention was more common in the South than in the Northeast (30% vs. 17%). Emphasizing the ineffectiveness of contraceptives was less common in the Northeast (17%) than in other regions (27-32%). Instructors teaching that methods are ineffective and presenting abstinence as teenagers' only option had significantly reduced odds of teaching various skills and topics (odds ratios, 0.1-0.5). Instructors' approach to teaching about methods is a very powerful indicator of the content of sex education. Given the well-documented relationship between what teenagers learn about safer sexual behavior and their use of methods when they initiate sexual activity, sex education in all U.S. high schools should include accurate information about condoms and other contraceptives.

Parental involvement laws and fertility behavior.

PubMed

Levine, Phillip B

2003-09-01

This paper considers the impact of the introduction of laws requiring parental involvement in a minor's decision to abort a pregnancy. State-level data over the 1985-1996 period are used to examine abortion, birth, and pregnancy outcomes, while microdata from the 1988 and 1995 National Surveys of Family Growth (NSFG) are utilized to examine sexual activity and contraception. Quasi-experimental methods are employed that examine whether minors' fertility outcomes were affected in those locations that introduced these laws following their introduction and occurred for minors but not other women. I find that parental involvement laws resulted in fewer abortions for minors resulting from fewer pregnancies; there is no statistically significant impact on births. The reduction in pregnancy seems to be attributable to increased use of contraception rather than a reduction in sexual activity.

MSW student perceptions of sexual health as relevant to the profession: Do social work educational experiences matter?

PubMed

Winter, Virginia Ramseyer; O'Neill, Elizabeth; Begun, Stephanie; Kattari, Shanna K; McKay, Kimberly

2016-09-01

Many social work clients are at an increased risk for negative outcomes related to sexual behavior, including unwanted pregnancies and sexually transmitted infections (STIs). However, there is a dearth of literature on social work student experiences with these topics in social work classrooms and their perceptions about the topic's relevance to their practice. The purpose of this study is to explore relationships between experiences with STIs and contraception as topics in social work education and practica experiences on student perceptions toward sexual health as a relevant topic for social work. Among a national sample of MSW students (N = 443), experiences with STIs and contraception as topics in practica was significantly related to perceptions toward sexual health's relevance to social work. Findings and implications are discussed.

Young women's accounts of factors influencing their use and non-use of emergency contraception: in-depth interview study

PubMed Central

Free, Caroline; Lee, Raymond M; Ogden, Jane

2002-01-01

Objectives To explore young women's accounts of their use and non-use of emergency contraception. Design Qualitative study using in-depth interviews. Participants 30 women aged 16-25; participants from socially deprived inner city areas were specifically included. Setting Community, service, and educational settings in England. Results Young women's accounts of their non-use of emergency contraception principally concerned evaluations of the risk conferred by different contraceptive behaviours, their evaluations of themselves in needing emergency contraception, and personal difficulties in asking for emergency contraception. Conclusions The attitudes and concerns of young women, especially those from disadvantaged backgrounds, may make them less able or willing than others to take advantage of recent increases in access to emergency contraception. Interventions that aim to increase the use of emergency contraception need to address the factors that influence young women's non-use of emergency contraception. What is already known on this topicLimited knowledge of, or poor access to, emergency contraception, and concerns about side effects and moral issues may reduce the use of emergency contraception in women at riskYoung people can be embarrassed about using contraception servicesInterventions to increase knowledge of and access to emergency contraception have had limited success among teenagersWhat this study addsPerceptions of low vulnerability to pregnancy, negative self evaluations about the need for such contraception, and concerns about what others think deter young women from using emergency contraceptionThese women find it difficult to ask for emergency contraceptionThe attitudes and concerns of young women, especially those from deprived inner city areas, may render them least willing and able to obtain emergency contraception PMID:12480855

Repeat induced abortions in Georgia, characteristics of women with multiple pregnancy terminations: secondary analysis of the Reproductive Health Survey 2010.

PubMed

Pestvenidze, Ekaterine; Berdzuli, Nino; Lomia, Nino; Gagua, Tinatin; Umikashvili, Lia; Stray-Pedersen, Babill

2016-10-01

To examine the multi-faceted characteristics of women with repeat induced abortions and assess post-abortion family planning service provision in Georgia. We performed secondary analysis of the data from the Georgian Reproductive Health Survey 2010. A logistic regression model was used to assess the socio-demographic and behavioral factors, contraceptive practices in relation to repeat induced abortions for 2203 women of reproductive age with at least one induced abortion. The Chi-Square test was used to evaluate provision of post-abortion family planning services. Among the targeted women, 70% (n=1539) had repeat induced abortions. The odds of terminating pregnancy raised exponentially with age (OR 3.12, 95% CI: 2.11-4.61), number of complete pregnancies (3 vs. 0-1 complete pregnancies: OR 3.25, 95% CI: 2.36-4.48) and lower education (OR 1.38, 95% CI: 1.10-1.73). The current use of contraception had a protective effect on the occurrence of repeat induced abortions (OR 0.69, 95% CI: 0.53-0.89 for modern and OR 0.68, 95% CI: 0.50-0.92 for traditional methods). The contraceptive counseling and family planning method was provided only to 32% and 6% of post-abortion women, respectively before discharge from the clinic. Repeat induced abortions were found to be significantly more common (P<0.05) among women who did not receive any post-abortion contraceptive at the site of care (n=1627/1929) compared to those who left the abortion facility with family planning method (n=94/125). Low education, higher age, high parity and non-usage of contraceptives carry an increased risk of repeat induced abortions. Post-abortion family planning service delivery is limited in Georgia. Mandating provision of universal post-abortion contraception at the sites of care has a potential to reduce repeat induced abortions and should become a standard of practice for all clinics providing abortion services in Georgia. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Use of Contraception and Attitudes towards Contraceptive Use in Swedish Women - A Nationwide Survey

PubMed Central

Kopp Kallner, Helena; Thunell, Louise; Brynhildsen, Jan; Lindeberg, Mia; Gemzell Danielsson, Kristina

2015-01-01

Objective To describe contraceptive use and attitudes towards contraceptive use in Sweden which has the highest abortion rate in Western Europe. Secondary objectives were to investigate knowledge of contraceptive methods and outcomes of unplanned and unwanted pregnancies. Design Telephone survey. Setting National survey of women living in Sweden. Population Women between 16 and 49 years. Methods The survey contained 22 questions with free text and multi choice answers on demographics, contraceptive use, knowledge of and attitudes towards contraception, the importance of monthly bleeding and experience of unintended pregnancy. Main Outcome Measures Distribution of use of contraceptive methods and non-use of contraception among Swedish women. Prevalence and outcome of unintended pregnancies. Results A total of 1001 women participated in the survey. Of all women, 721/1001 (72.1%) currently used contraception whereas 268/1001 (26.8%) women did not. Long acting reversible contraception, (LARC; implant and intra uterine contraception) was used by 24.3% of women. The unmet need of contraception in Sweden was estimated at 8.9% (89/1001 women). A total of 781 (78%) women had never experienced an unintended pregnancy whereas 220 (22%) women had had at least one unintended pregnancy. Users and non-users alike stated that one of the most important characteristics of a contraceptive method is its effectiveness. Conclusions Sweden has a large unmet need for contraception. Furthermore, a large proportion of women have experienced at least one unintended pregnancy. Increasing contraceptive use and promotion of LARC is a possible way forward in the effort to reduce the rates of unwanted pregnancies. PMID:25992901

A mixed-methods exploration of the contraceptive experiences of female teens with epilepsy.

PubMed

Manski, Ruth; Dennis, Amanda

2014-09-01

We explored the contraceptive experiences of female teens with epilepsy, including their knowledge and perceptions of interactions between antiepileptic drugs and hormonal contraception and contraceptive decision-making processes. From November 2012 to May 2013, we conducted one online survey (n=114) and 12 online focus group discussions (n=26) with female teens with epilepsy about their contraceptive experiences and unmet needs. Survey data were analyzed using descriptive statistics and focus group transcripts were analyzed thematically using modified grounded theory methods. Both survey and focus group participants reported believing that interactions between epilepsy medications and hormonal contraceptives could lead to reductions in contraceptive efficacy and seizure control. However, their knowledge about these types of medication interactions was often incomplete. Many study participants viewed contraceptive decision making as a difficult process, and some participants reported avoiding hormonal contraceptives because of potential interactions with antiepileptic drugs. Study participants reported relying on health care providers and parents for contraceptive decision-making support. Focus group participants also reported they wanted health care providers to provide more in-depth and comprehensive counseling about contraception, and that they desired peer support with contraceptive decisions. The ability to make informed contraceptive decisions is important for teens with epilepsy as interactions between anti-epileptic drugs and hormonal contraceptives can impact seizure occurrence and lead to an increased risk of unplanned pregnancy. Guidance for providers offering contraceptive care to this population is needed, as well as a contraceptive support tool that empowers teens with epilepsy to advocate for desired health care. Copyright © 2014 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Practice Bulletin Summary No. 152: Emergency Contraception.

PubMed

2015-09-01

Emergency contraception, also known as postcoital contraception, is therapy used to prevent pregnancy after an unprotected or inadequately protected act of sexual intercourse. Common indications for emergency contraception include contraceptive failure (eg, condom breakage or missed doses of oral contraceptives) and failure to use any form of contraception (1-3). Although oral emergency contraception was first described in the medical literature in the 1960s, the U.S. Food and Drug Administration (FDA) approved the first dedicated product for emergency contraception in 1998. Since then, several new products have been introduced. Methods of emergency contraception include oral administration of combined estrogen-progestin, progestin only, or selective progesterone receptor modulators and insertion of a copper intrauterine device (IUD). Many women are unaware of the existence of emergency contraception, misunderstand its use and safety, or do not use it when a need arises (4-6). The purpose of this Practice Bulletin is to review the evidence for the efficacy and safety of available methods of emergency contraception and to increase awareness of these methods among obstetrician-gynecologists and other gynecologic providers.

Ongoing contraception after use of emergency contraception from a specialist contraceptive service.

PubMed

Cameron, Sharon T; Glasier, Anna; Johnstone, Anne; Rae, Leanne

2011-10-01

A consultation for emergency contraception (EC) gives way to an opportunity to provide women with an ongoing effective method of contraception. A review of the case notes of women seeking EC from a large family planning clinic in Edinburgh, Scotland, was conducted to determine what percentage of women were provided with an effective method of ongoing contraception. Case notes of 460 women presenting for EC over a 2-year period were reviewed. Women were of mean age 26 years (range 15-49 years) and presented because they had used no contraception (47%), experienced condom failure (42%) or missed oral contraceptive pills (9%). Only 2% (n=11) were given an intrauterine device for EC. All women who had missed contraceptive pills prior to taking EC opted to continue this method. Only 23% (n=89) of women using no method or condoms at EC received supplies of an effective contraceptive method (pills, patch, injectable). Two thirds (n=263) of the women chose condoms for ongoing contraception. Research is required to develop strategies to improve the uptake of effective contraception after EC. Copyright © 2011 Elsevier Inc. All rights reserved.

Contraceptive choice and acceptability: the future for STI risk in Kelantan, Malaysia.

PubMed

Shiely, Frances; Saifuddin, Mohammed Syafiek

2014-03-01

More than 150 million women become pregnant in developing countries annually and an estimated 287,000 die from pregnancy-related causes. Contraception is vital to prevent unnecessary maternal deaths, as well as sexually transmitted infections. The objective of this study was to investigate preferred contraceptive methods and the factors that influence contraceptive choice among women in Kelantan, Malaysia. A cross-sectional study using interview-based questionnaires was conducted, during July and August 2009, in local family planning clinics in Kelantan. The questionnaire was administered to adult women (age 20-50). Prevalence of unplanned pregnancies was high (48%). Contraceptive preference was Depo contraceptive injection (32%), oral contraceptive pills (27%), intrauterine devices (15%) and contraceptive implants (12%); 9% used condoms. Only 2% used contraception to protect against sexually transmitted infections or HIV/AIDS. Younger women (OR 0.90; 95% CI 0.807-0.993) were more likely to use contraception. In conclusion, non-interrupted contraceptive methods were preferred. More than 60% would stop using contraception if it interrupted intercourse. From both a public health and infectious disease perspective, this is extremely worrying.

Canadian Contraception Consensus (Part 1 of 4).

PubMed

Black, Amanda; Guilbert, Edith; Costescu, Dustin; Dunn, Sheila; Fisher, William; Kives, Sari; Mirosh, Melissa; Norman, Wendy V; Pymar, Helen; Reid, Robert; Roy, Geneviève; Varto, Hannah; Waddington, Ashley; Wagner, Marie-Soleil; Whelan, Anne Marie; Ferguson, Carrie; Fortin, Claude; Kielly, Maria; Mansouri, Shireen; Todd, Nicole

2015-10-01

To provide guidelines for health care providers on the use of contraceptive methods to prevent pregnancy and on the promotion of healthy sexuality. Guidance for Canadian practitioners on overall effectiveness, mechanism of action, indications, contraindications, non-contraceptive benefits, side effects and risks, and initiation of cited contraceptive methods; family planning in the context of sexual health and general well-being; contraceptive counselling methods; and access to, and availability of, cited contraceptive methods in Canada. Published literature was retrieved through searches of Medline and The Cochrane Database from January 1994 to January 2015 using appropriate controlled vocabulary (e.g., contraception, sexuality, sexual health) and key words (e.g., contraception, family planning, hormonal contraception, emergency contraception). Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies published in English from January 1994 to January 2015. Searches were updated on a regular basis and incorporated in the guideline to June 2015. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. The quality of the evidence in this document was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care (Table). Chapter 1: Contraception in Canada Summary Statements 1. Canadian women spend a significant portion of their lives at risk of an unintended pregnancy. (II-2) 2. Effective contraceptive methods are underutilized in Canada, particularly among vulnerable populations. (II-2) 3. Long-acting reversible contraceptive methods, including contraceptive implants and intrauterine contraception (copper-releasing and levonorgestrel-releasing devices/systems), are the most effective reversible contraceptive methods and have the highest continuation rates. (II-1) 4. Canada currently does not collect reliable data to determine the use of contraceptive methods, abortion rates, and the prevalence of unintended pregnancy among reproductive-age women. (II-2) 5. A universal subsidy for contraceptive methods as provided by many of Canada's peer nations and a few Canadian provinces may produce health system cost-savings. (II-2) 6. Health Canada approval processes for contraceptives have been less efficient than those of other drug approval agencies and Health Canada processes for other classes of pharmaceuticals. (II-2) 7. It is feasible and safe for contraceptives and family planning services to be provided by appropriately trained allied health professionals such as midwives, registered nurses, nurse practitioners, and pharmacists. (II-2) Recommendations 1. Contraceptive counselling should include a discussion of typical use failure rates and the importance of using the contraceptive method consistently and correctly in order to avoid pregnancy. (II-2A) 2. Women seeking contraception should be counselled on the wide range of effective methods of contraception available, including long-acting reversible contraceptive methods (LARCs). LARCs are the most effective methods of reversible contraception, have high continuation rates, and should be considered when presenting contraceptive options to any woman of reproductive age. (II-2A) 3. Family planning counselling should include counselling on the decline of fertility associated with increasing female age. (III-A) 4. Health policy supporting a universal contraception subsidy and strategies to promote the uptake of highly effective methods as cost-saving measures that improve health and health equity should be considered by Canadian health decision makers. (III-B) 5. Canadian health jurisdictions should consider expanding the scope of practice of other trained professionals such as nurses, nurse practitioners, midwives, and pharmacists and promoting task-sharing in family planning. (II-2B) 6. The Canadian Community Health Survey should include adequate reproductive health indicators in order for health care providers and policy makers to make appropriate decisions regarding reproductive health policies and services in Canada. (III-B) 7. Health Canada processes and policies should be reviewed to ensure a wide range of modern contraceptive methods are available to Canadian women. (III-B) Chapter 2: Contraceptive Care and Access Summary Statements 8. Although there are many contraceptive options in Canada, only a narrow range of contraceptive methods are commonly used by those of reproductive age. (II-3) 9. Condom use decreases with longer relationship tenure and when the sexual partner is considered to be the main partner, likely due to a lower perceived risk of sexually transmitted infection in that relationship. Condom use may also decrease markedly as an unintended consequence when an effective non-barrier method, such as hormonal contraception or intrauterine contraception, is initiated. (II-3) 10. Family planning counselling provides a natural segue into screening for concerns about sexual function or intimate partner violence. (III) 11. Well-informed and well-motivated individuals who have developed skills to practise safer sex behaviours are more likely to use contraceptive and safer sex methods effectively and consistently. (II-2) Recommendations 8. Comprehensive family planning services, including abortion services, should be accessible to all Canadians regardless of geographic location. These services should be confidential, non-judgemental, and respectful of individuals' privacy and cultural contexts. (III-A) 9. A contraceptive visit should include history taking, screening for contraindications, dispensing or prescribing a method of contraception, and exploring contraceptive choice and adherence in the broader context of the individual's sexual behaviour, reproductive health risk, social circumstances, and relevant belief systems. (III-B) 10. Health care providers should provide practical information on the wide range of contraceptive options and their potential non-contraceptive benefits and assist women and their partners in determining the best user-method fit. (III-B) 11. Health care providers should assist women and men in developing the skills necessary to negotiate the use of contraception and the correct and consistent use of a chosen method. (III-B) 12. Contraceptive care should include discussion and management of the risk of sexually transmitted infection, including appropriate recommendations for condom use and dual protection, STI screening, post-exposure prophylaxis, and Hepatitis B and human papillomavirus vaccination. (III-B) 13. Health care providers should emphasize the use of condoms not only for protection against sexually transmitted infection, but also as a back-up method when adherence to a hormonal contraceptive may be suboptimal. (I-A) 14. Health care providers should be aware of current media controversies in reproductive health and acquire relevant evidence-based information that can be briefly and directly communicated to their patients. (III-B) 15. Referral resources for intimate partner violence, sexually transmitted infections, sexual dysfunction, induced abortion services, and child protection services should be available to help clinicians provide contraceptive care in the broader context of women's health. (III-B) Chapter 3: Emergency Contraception Summary Statements 12. The copper intrauterine device is the most effective method of emergency contraception. (II-2) 13. A copper intrauterine device can be used for emergency contraception up to 7 days after unprotected intercourse provided that pregnancy has been ruled out and there are no other contraindications to its insertion. (II-2) 14. Levonorgestrel emergency contraception is effective up to 5 days (120 hours) after intercourse; its effectiveness decreases as the time between unprotected intercourse and ingestion increases. (II-2) 15. Ulipristal acetate for emergency contraception is more effective than levonorgestrel emergency contraception up to 5 days after unprotected intercourse. This difference in effectiveness is more pronounced as the time from unprotected intercourse increases, especially after 72 hours. (I) 16. Hormonal emergency contraception (levonorgestrel emergency contraception and ulipristal acetate for emergency contraception) is not effective if taken on the day of ovulation or after ovulation. (II-2) 17. Levonorgestrel emergency contraception may be less effective in women with a body mass index > 25 kg/m2 and ulipristal acetate for emergency contraception may be less effective in women with a body mass index > 35 kg/m2. However, hormonal emergency contraception may still retain some effectiveness regardless of a woman's body weight or body mass index. (II-2) 18. Hormonal emergency contraception is associated with higher failure rates when women continue to have subsequent unprotected intercourse. (II-2) 19. Hormonal contraception can be initiated the day of or the day following the use of levonorgestrel emergency contraception, with back-up contraception used for the first 7 days. (III) 20. Hormonal contraception can be initiated 5 days following the use of ulipristal acetate for emergency contraception, with back-up contraception used for the first 14 days. (III) Recommendations 16. All emergency contraception should be initiated as soon as possible after unprotected intercourse. (II-2A) 17. Women should be informed that the copper intrauterine device (IUD) is the most effective method of emergency contraception and can be used by any woman with no contraindications to IUD use. (II-3A) 18.

ACOG Committee Opinion Number 542: Access to emergency contraception.

PubMed

2012-11-01

Emergency contraception includes contraceptive methods used to prevent pregnancy in the first few days after unprotected intercourse, sexual assault, or contraceptive failure. Although the U.S. Food and Drug Administration approved the first dedicated product for emergency contraception in 1998, numerous barriers to access to emergency contraception remain. The purpose of this Committee Opinion is to examine the barriers to the use of oral emergency contraception methods and to highlight the importance of increasing access.

Contraceptive knowledge, perceptions, and concerns among men in Uganda.

PubMed

Thummalachetty, Nityanjali; Mathur, Sanyukta; Mullinax, Margo; DeCosta, Kelsea; Nakyanjo, Neema; Lutalo, Tom; Brahmbhatt, Heena; Santelli, John S

2017-10-10

Low contraceptive uptake and high unmet need for contraception remain significant issues in Uganda compared to neighboring countries such as Kenya, Ethiopia, and Rwanda. Although prior research on contraceptive uptake has indicated that male partners strongly influence women's decisions around contraceptive use, there is limited in-depth qualitative research on knowledge and concerns regarding modern contraceptive methods among Ugandan men. Using in-depth interviews (N = 41), this qualitative study investigated major sources of knowledge about contraception and perceptions of contraceptive side effects among married Ugandan men. Men primarily reported knowledge of contraceptives based on partner's experience of side effects, partner's knowledge from health providers and mass media campaigns, and partner's knowledge from her peers. Men were less likely to report contraceptive knowledge from health care providers, mass media campaigns, or peers. Men's concerns about various contraceptive methods were broadly associated with failure of the method to work properly, adverse health effects on women, and severe adverse health effects on children. Own or partner's human immunodeficiency virus (HIV) status did not impact on contraceptive knowledge. Overall, we found limited accurate knowledge about contraceptive methods among men in Uganda. Moreover, fears about the side effects of modern contraceptive methods appeared to be common among men. Family planning services in Uganda could be significantly strengthened by renewed efforts to focus on men's knowledge, fears, and misconceptions.

Family Planning and the Burden of Unintended Pregnancies

PubMed Central

Tsui, Amy O.; McDonald-Mosley, Raegan; Burke, Anne E.

2010-01-01

Family planning is hailed as one of the great public health achievements of the last century, and worldwide acceptance has risen to three-fifths of exposed couples. In many countries, however, uptake of modern contraception is constrained by limited access and weak service delivery, and the burden of unintended pregnancy is still large. This review focuses on family planning's efficacy in preventing unintended pregnancies and their health burden. The authors first describe an epidemiologic framework for reproductive behavior and pregnancy intendedness and use it to guide the review of 21 recent, individual-level studies of pregnancy intentions, health outcomes, and contraception. They then review population-level studies of family planning's relation to reproductive, maternal, and newborn health benefits. Family planning is documented to prevent mother-child transmission of human immunodeficiency virus, contribute to birth spacing, lower infant mortality risk, and reduce the number of abortions, especially unsafe ones. It is also shown to significantly lower maternal mortality and maternal morbidity associated with unintended pregnancy. Still, a new generation of research is needed to investigate the modest correlation between unintended pregnancy and contraceptive use rates to derive the full health benefits of a proven and cost-effective reproductive technology. PMID:20570955

Social marketing -- playing an important role in public health.

PubMed

1997-01-01

Over the past few years, social marketing has grown dramatically in importance throughout the world for its comprehensive approach of creating both demand and supply for essential health products for maternal and child health, AIDS prevention, and family planning for lower-income families in developing countries. The Society for Family Health (SFH) utilizes the techniques of social marketing to serve the health needs of Zambia. Social marketing involves the marketing of health products at affordable prices utilizing the existing wholesale and retail infrastructure. In this manner, health products can be accessed at thousands of outlets, and not just in clinics and hospitals, by encouraging clients who can afford to pay small amounts to obtain contraceptives from nearby chemists, private clinics, and other outlets at affordable prices. In this way, the activities carried out by SFH complement the programs of the Ministry of Health. A key ingredient of social marketing is the implementation of information, education, and communication (IEC) campaigns that motivate behavioral change. Hence, by the use of attractive packaging, persuasive communication, and the promise of high-quality contraceptives at an affordable price, social marketing encourages contraceptive usage. Therefore, social marketing creates demand for essential health products while ensuring their constant availability at affordable prices.

Sexual development and behaviour issues in Polish teenage magazines.

PubMed

Kopacz, Marek S

2006-12-01

Adolescents often look to mass media for information regarding issues of sexuality. As one form of media, teenage magazines have long constituted a pervasive and effective element of adolescent media exposure. Teenage magazines discuss a number of aspects concerning adolescent sexuality. Considering their potential impact on health related behaviors, the information they provide and the message(s) they send warrant attention. The aim of this study is to perform a content analysis of sexual development and behavior information presented in Polish teenage magazines. Social Cognitive Theory was used as a theoretical basis for this analysis. The media chosen for this study were general-themed publications targeting an adolescent female audience: Bravo Girl!, Filipinka and Dziewczyna. Each entry was analyzed using a structured key. The specific categories of behavior and development used for this study are: biological information, pedagogic instruction, topics of moral-ethical concern, results of sexual activity, and interpersonal relationships. Each category was then subdivided into separate units. The findings indicate that Polish teenage magazines predominantly focus on relationships, contraception and sex education. Relationships were most often of a romantic nature and discussed sexual activity or the potential of sexual activity. Non-prescription contraceptive methods were most often discussed, with attention given to pregnancy prevention. Sex education offered detailed information on sexual practices and behaviors with much discussion on losing one's virginity. The general approach of the analyzed magazines is that adolescents currently are, or soon will be, sexually active. As a result, certain sexual behavior and development issues are discussed in great detail, while other topics are somewhat neglected. Accepting information-seeking during adolescence as commonplace, these findings suggest that teenage magazines hold the potential for influencing adolescent sexual behavior and development.

Long-acting reversible contraceptive acceptability and unintended pregnancy among women presenting for short-acting methods: a randomized patient preference trial.

PubMed

Hubacher, David; Spector, Hannah; Monteith, Charles; Chen, Pai-Lien; Hart, Catherine

2017-02-01

Measures of contraceptive effectiveness combine technology and user-related factors. Observational studies show higher effectiveness of long-acting reversible contraception compared with short-acting reversible contraception. Women who choose long-acting reversible contraception may differ in key ways from women who choose short-acting reversible contraception, and it may be these differences that are responsible for the high effectiveness of long-acting reversible contraception. Wider use of long-acting reversible contraception is recommended, but scientific evidence of acceptability and successful use is lacking in a population that typically opts for short-acting methods. The objective of the study was to reduce bias in measuring contraceptive effectiveness and better isolate the independent role that long-acting reversible contraception has in preventing unintended pregnancy relative to short-acting reversible contraception. We conducted a partially randomized patient preference trial and recruited women aged 18-29 years who were seeking a short-acting method (pills or injectable). Participants who agreed to randomization were assigned to 1 of 2 categories: long-acting reversible contraception or short-acting reversible contraception. Women who declined randomization but agreed to follow-up in the observational cohort chose their preferred method. Under randomization, participants chose a specific method in the category and received it for free, whereas participants in the preference cohort paid for the contraception in their usual fashion. Participants were followed up prospectively to measure primary outcomes of method continuation and unintended pregnancy at 12 months. Kaplan-Meier techniques were used to estimate method continuation probabilities. Intent-to-treat principles were applied after method initiation for comparing incidence of unintended pregnancy. We also measured acceptability in terms of level of happiness with the products. Of the 916 participants, 43% chose randomization and 57% chose the preference option. Complete loss to follow-up at 12 months was <2%. The 12-month method continuation probabilities were 63.3% (95% confidence interval, 58.9-67.3) (preference short-acting reversible contraception), 53.0% (95% confidence interval, 45.7-59.8) (randomized short-acting reversible contraception), and 77.8% (95% confidence interval, 71.0-83.2) (randomized long-acting reversible contraception) (P < .001 in the primary comparison involving randomized groups). The 12-month cumulative unintended pregnancy probabilities were 6.4% (95% confidence interval, 4.1-8.7) (preference short-acting reversible contraception), 7.7% (95% confidence interval, 3.3-12.1) (randomized short-acting reversible contraception), and 0.7% (95% confidence interval, 0.0-4.7) (randomized long-acting reversible contraception) (P = .01 when comparing randomized groups). In the secondary comparisons involving only short-acting reversible contraception users, the continuation probability was higher in the preference group compared with the randomized group (P = .04). However, the short-acting reversible contraception randomized group and short-acting reversible contraception preference group had statistically equivalent rates of unintended pregnancy (P = .77). Seventy-eight percent of randomized long-acting reversible contraception users were happy/neutral with their initial method, compared with 89% of randomized short-acting reversible contraception users (P < .05). However, among method continuers at 12 months, all groups were equally happy/neutral (>90%). Even in a typical population of women who presented to initiate or continue short-acting reversible contraception, long-acting reversible contraception proved highly acceptable. One year after initiation, women randomized to long-acting reversible contraception had high continuation rates and consequently experienced superior protection from unintended pregnancy compared with women using short-acting reversible contraception; these findings are attributable to the initial technology and not underlying factors that often bias observational estimates of effectiveness. The similarly patterned experiences of the 2 short-acting reversible contraception cohorts provide a bridge of generalizability between the randomized group and usual-care preference group. Benefits of increased voluntary uptake of long-acting reversible contraception may extend to wider populations than previously thought. Copyright © 2016 Elsevier Inc. All rights reserved.

Are modern contraceptives acceptable to people and where do they source them from across Nigeria?

PubMed

Onwujekwe, Obinna E; Enemuoh, Jane C; Ogbonna, Chinwe; Mbachu, Chinyere; Uzochukwu, Benjamin Sc; Lawson, Agathe; Ndyanabangi, Bannet

2013-01-23

Understanding the extent that different modern contraceptives are acceptable to different populations groups and where they get the commodities from will help in developing specific interventions that will help to scale-up the availability of the contraceptives. The study took place in urban and rural sites in six states across Nigeria. Data on acceptability and sources of the contraceptives was collected from at least 770 randomly selected mostly female householders from each state respectively using a questionnaire. Acceptability of the different contraceptives was scored by the respondents on a scale of 1 (lowest) to 10 (highest). The relationships between acceptability and sources of the contraceptives with socio-economic status and geographic location of the respondents were examined. The use of modern contraceptives in general was acceptable to 87% of the respondents. Male condom was the most acceptable means of contraceptive with an average score of 5.0. It was followed by implants with and oral contraceptive pill with average scores of 4.0, whilst IUD was the least acceptable with an average score of 2.9. The private sector was the major source of contraceptives to different population groups. Both male and female condoms were mostly procured from patent medicine dealers (PMD) and pharmacy shops. Intra Uterine Devices (IUDs) and implants were mostly sourced from public and private hospitals in the urban areas, whilst injectibles were mostly sourced from private hospitals. Oral contraceptives were mostly sourced from pharmacy shops and patent medicine dealers. There were SES and geographic differences for both acceptability and sources of the contraceptives. Also, the sources of different contraceptives depended on the type of the contraceptive. The different contraceptives were acceptable to the respondents and the major source of the contraceptives was the private sector. Hence, public-private partnership arrangements should be explored so that universal coverage with contraceptives could be easily achieved. Interventions should be developed to eliminate the inequities in both acceptability and sources of different contraceptives. The acceptability of all the contraceptives should be enhanced with relevant behaviour change communication interventions especially in areas with the lowest levels of acceptability.

Are modern contraceptives acceptable to people and where do they source them from across Nigeria?

PubMed Central

2013-01-01

Background Understanding the extent that different modern contraceptives are acceptable to different populations groups and where they get the commodities from will help in developing specific interventions that will help to scale-up the availability of the contraceptives. Methods The study took place in urban and rural sites in six states across Nigeria. Data on acceptability and sources of the contraceptives was collected from at least 770 randomly selected mostly female householders from each state respectively using a questionnaire. Acceptability of the different contraceptives was scored by the respondents on a scale of 1 (lowest) to 10 (highest). The relationships between acceptability and sources of the contraceptives with socio-economic status and geographic location of the respondents were examined. Results The use of modern contraceptives in general was acceptable to 87% of the respondents. Male condom was the most acceptable means of contraceptive with an average score of 5.0. It was followed by implants with and oral contraceptive pill with average scores of 4.0, whilst IUD was the least acceptable with an average score of 2.9. The private sector was the major source of contraceptives to different population groups. Both male and female condoms were mostly procured from patent medicine dealers (PMD) and pharmacy shops. Intra Uterine Devices (IUDs) and implants were mostly sourced from public and private hospitals in the urban areas, whilst injectibles were mostly sourced from private hospitals. Oral contraceptives were mostly sourced from pharmacy shops and patent medicine dealers. There were SES and geographic differences for both acceptability and sources of the contraceptives. Also, the sources of different contraceptives depended on the type of the contraceptive. Conclusion The different contraceptives were acceptable to the respondents and the major source of the contraceptives was the private sector. Hence, public-private partnership arrangements should be explored so that universal coverage with contraceptives could be easily achieved. Interventions should be developed to eliminate the inequities in both acceptability and sources of different contraceptives. The acceptability of all the contraceptives should be enhanced with relevant behaviour change communication interventions especially in areas with the lowest levels of acceptability. PMID:23343579

Adjunctive social media for more effective contraceptive counseling: a randomized controlled trial.

PubMed

Kofinas, Jason D; Varrey, Aneesha; Sapra, Katherine J; Kanj, Rula V; Chervenak, Frank A; Asfaw, Tirsit

2014-04-01

To determine whether social media, specifically Facebook, is an effective tool for improving contraceptive knowledge. English-speaking women aged 18-45 years receiving care at an urban academic center obstetrics and gynecology clinic were included and randomized to a trial of standard contraceptive education and pamphlet (n=74) compared with standard contraceptive education and Facebook (n=69) information for contraception counseling. Contraceptive knowledge was evaluated preintervention and postintervention by the Contraceptive Knowledge Inventory. We evaluated the effect of the intervention by raw score and percent increase in Contraceptive Knowledge Inventory score, participant satisfaction with counseling method, and contraceptive preference postintervention. All analyses were stratified by age group. The median raw postintervention Contraceptive Knowledge Inventory score was significantly higher in the Facebook compared with the pamphlet group (15 compared with 12, P<.001) as was percentage increase in the Contraceptive Knowledge Inventory score (36% compared with 12%, P<.001). Participant satisfaction with counseling method was significantly higher in the Facebook group (median 10 compared with 6, P<.001). Participant contraceptive preference for long-acting reversible contraceptives (LARCs; intrauterine device or implant) postintervention was significantly greater in the Facebook compared with the pamphlet group (57% compared with 35%, P=.01). Among women currently using none or barrier contraception, contraceptive preference for implants was significantly greater in the Facebook compared with the pamphlet group (26% compared with 5%, P=.02), although, when analysis was extended to include implant or intrauterine device, LARCs were not significantly higher in the Facebook compared with the pamphlet group (48% compared with 33%, P=.19). Social media as an adjunct to traditional in-office counseling improves patient contraceptive knowledge and increases patient preference for LARCs. ClinicalTrials.gov, www.clinicaltrials.gov, NCT01994005.

Pre-exposure prophylaxis for HIV-1 prevention does not diminish the pregnancy prevention effectiveness of hormonal contraception.

PubMed

Murnane, Pamela M; Heffron, Renee; Ronald, Allan; Bukusi, Elizabeth A; Donnell, Deborah; Mugo, Nelly R; Were, Edwin; Mujugira, Andrew; Kiarie, James; Celum, Connie; Baeten, Jared M

2014-07-31

For women at risk of HIV-1, effective contraception and effective HIV-1 prevention are global priorities. In a clinical trial of pre-exposure prophylaxis (PrEP) for HIV-1 prevention in HIV-1-serodiscordant couples, we estimated the effectiveness of hormonal contraceptives (oral contraceptive pills, injectable depot medroxyprogesterone acetate, and hormonal implants) for pregnancy prevention relative to no contraception among 1785 HIV-1-uninfected women followed up to 36 months. We compared the effectiveness of each method among women assigned PrEP versus placebo. Contraception was not required for participation, but was offered on-site and was recorded monthly; incident pregnancy was determined by monthly urine testing. For women using no contraception, overall pregnancy incidence was 15.4% per year. Women reporting oral contraceptive use had comparable pregnancy incidence to women using no contraception, and this lack of contraceptive effectiveness was similar for those assigned PrEP and placebo (17.7 and 10.0% incidence per year, respectively; P-value for difference in effect by PrEP use = 0.24). Women reporting injectable contraception had reduced pregnancy incidence compared to those reporting no contraception, which did not differ by arm (PrEP 5.1%, placebo 5.3% per year; P-value for difference = 0.47). Contraceptive effectiveness was highest among women using implants (pregnancy incidence <1% per year in both arms). PrEP had no adverse impact on hormonal contraceptive effectiveness for pregnancy prevention. As seen previously in similar populations, women reporting contraceptive pill use had little protection from pregnancy, possibly due to poor adherence. Injectable or implantable hormonal contraception and PrEP provide effective prevention for pregnancy and HIV-1.

Update on emergency contraception.

PubMed

Fok, Wing Kay; Blumenthal, Paul D

2016-12-01

Emergency contraception provides a critical and time-sensitive opportunity for women to prevent undesired pregnancy after intercourse. Both access and available options for emergency contraception have changed over the last several years. Emergency contraceptive pills can be less effective in obese women. The maximum achieved serum concentration of levonorgestrel (LNG) is lower in obese women than women of normal BMI, and doubling the dose of LNG (3 mg) increases its concentration maximum, approximating the level in normal BMI women receiving one dose of LNG. Repeated use of both LNG and ulipristal acetate (UPA) is well tolerated. Hormonal contraception can be immediately started following LNG use, but should be delayed for 5 days after UPA use to avoid dampening the efficacy of UPA. The copper intrauterine device (IUD) is the only IUD approved for emergency contraception (and the most effective method of emergency contraception), but use of LNG IUD as emergency contraception is currently being investigated. Accurate knowledge about emergency contraception remains low both for patients and healthcare providers. Emergency contraception is an important yet underutilized tool available to women to prevent pregnancy. Current options including copper IUD and emergency contraceptive pills are safe and well tolerated. Significant gaps in knowledge of emergency contraception on both the provider and user level exist, as do barriers to expedient access of emergency contraception.

Partner Support for Family Planning and Modern Contraceptive Use in Luanda, Angola.

PubMed

Prata, Ndola; Bell, Suzanne; Fraser, Ashley; Carvalho, Adelaide; Neves, Isilda; Nieto-Andrade, Benjamin

2017-06-01

Husband's/partner's support for family planning may influence a women's modern contraceptive use. Socio-demographic factors, couple communication about family planning, and fertility preferences are known to play a role in contraceptive use. We conducted logistic regression analysis to investigate the relationship between perceived husband's/partner's approval and husband's/partner's encouragement of modern contraceptive use, adjusting for socio-demographic factors and recent couple communication about family planning. We also examined mediating roles potentially played by perceived contraceptive accessibility and contraceptive self-efficacy (using index created by principal component analysis). Perceived husband's/partner's approval was associated with triple the odds of women's modern contraceptive use and remained significantly associated with 1.6 times the odds, after controlling for contraceptive accessibility and contraceptive self-efficacy. Husband's/partner's encouragement, while initially significantly associated with contraceptive use, became non-significant after adjustments for socio-demographic factors and couple communication. Perceived husband's/partner's approval, separate from a woman's sense of self-efficacy and perceived accessibility of contraceptives, appears strongly and positively associated with current modern contraceptive use. Increased couple communication may help women identify their husband's/partner's approval. Difference between the meaning of approval and encouragement should be explored. Interventions involving information education and communication campaigns geared to men and promoting male involvement in family planning could increase contraceptive prevalence.

'Stratified Contraception': Emergency Contraceptive Pills and Women's Differential Experiences in Contemporary India.

PubMed

Sheoran, Nayantara

2015-01-01

Available without prescriptions in India since 2005, emergency contraceptive pills (ECPs) and their advertisements have provided women with increased contraceptive options and a vocabulary to talk about their reproductive lives. I draw on long-term fieldwork with women in urban India about ECPs, demonstrating a new form of 'stratified contraception' enabled by these pills and their advertisements. I posit that there are within India spaces that replicate the luxuries and privileges of the global North. These material conditions, I suggest, are replicated when it comes to contraception as there are hubs of women consumers of contraception and contraceptive advertising that participate in an 'imagined cosmopolitanism' within the global South in close proximity to 'contraceptive ghettos.' Moving beyond simplistic binaries, I outline three major stratifications along which women experience this medical technology and outline the implications for women and their contraceptive choices when notions of northern privilege exist in the 'South.'

The contraception needs of the perimenopausal woman.

PubMed

Hardman, Sarah M R; Gebbie, Ailsa E

2014-08-01

Perimenopausal women have low fertility but must still be advised to use contraception until natural sterility is reached if they are sexually active. Patterns of contraceptive use vary in different countries worldwide. Long-acting reversible contraceptive methods offer reliable contraception that may be an alternative to sterilisation. Hormonal methods confer significant non-contraceptive benefits, and each individual woman should weigh up the benefits and risks of a particular method. No method of contraception is contraindicated by age alone, although combined hormonal contraception and injectable progestogens are not recommended for women over the age of 50 years. The intrauterine system has particular advantages as a low-dose method of effective hormonal contraception, which also offers control of menstrual dysfunction and endometrial protection in women requiring oestrogen replacement. Condoms are recommended for personal protection against sexually transmitted infections in new relationships. Standard hormone replacement therapy is not a method of contraception. Copyright © 2014 Elsevier Ltd. All rights reserved.

Beyond the Condom: Frontiers in Male Contraception

PubMed Central

Roth, Mara Y.; Amory, John K.

2016-01-01

Nearly half of all pregnancies worldwide are unplanned, despite numerous contraceptive options available. No new contraceptive method has been developed for men since the invention of condom. Nevertheless, more than 25% of contraception worldwide relies on male methods. Therefore, novel effective methods of male contraception are of interest. Herein we review the physiologic basis for both male hormonal and nonhormonal methods of contraception. We review the history of male hormonal contraception development, current hormonal agents in development, as well as the potential risks and benefits of male hormonal contraception options for men. Nonhormonal methods reviewed will include both pharmacological and mechanical approaches in development, with specific focus on methods which inhibit the testicular retinoic acid synthesis and action. Multiple hormonal and nonhormonal methods of male contraception are in the drug development pathway, with the hope that a reversible, reliable, safe method of male contraception will be available to couples in the not too distant future. PMID:26947703

Aqueous exposure to the progestin, levonorgestrel, alters anal fin development and reproductive behavior in the eastern mosquitofish (Gambusia holbrooki)

USGS Publications Warehouse

Frankel, Tyler E.; Meyer, Michael T.; Orlando, Edward F.

2016-01-01

Endogenous progestogens are important regulators of vertebrate reproduction. Synthetic progestins are components of human contraceptive and hormone replacement pharmaceuticals. Both progestogens and progestins enter the environment through a number of sources, and have been shown to cause profound effects on reproductive health in various aquatic vertebrates. Progestins are designed to bind human progesterone receptors, but they also have been shown to strongly activate androgen receptors in fish. Levonorgestrel (LNG) activates fish androgen receptors and induces development of male secondary sex characteristics in females of other species. Although behavior has been postulated to be a sensitive early indicator of exposure to certain environmental contaminants, no such research on the reproductive behavior of gestagen-exposed fish has been conducted to date. The goal of our study was to examine the exposure effects of a human contraceptive progestin, LNG, on the reproductive development and behavior of the viviparous eastern mosquitofish (Gambusia holbrooki). Internal fertilization is a requisite characteristic of viviparous species, and is enabled by an androgen driven elongation of the anal fin into the male gonopodium (i.e., phallus). In this study, we exposed adult mosquitofish to ethanol (EtOH control), 10 ng/L, and 100 ng/L LNG for 8 d using a static replacement exposure design. After 8 d, a subset of males and females from each treatment were examined for differences in the 4:6 anal fin ratio. In addition, paired social interaction trials were performed using individual control males and control females or females treated 10 ng/L or 100 ng/L LNG. Female mosquitofish exposed to LNG were masculinized as evidenced by the elongation of the anal fin rays, a feature normal to males and abnormal to females. LNG caused significant increases in the 4:6 anal fin ratios of female mosquitofish in both the 10 ng/L and 100 ng/L treatments, although these differences were not significant between the two treatments. LNG caused significant increases in the 4:6 anal fin ratio of males exposed to 100 ng/L, with no effects observed in the 10 ng/L treatment. In addition, the reproductive behavior of control males paired with female mosquitofish exposed to 100 ng/L LNG was also altered, for these males spent more time exhibiting no reproductive behavior, had decreased attending behavior, and a lower number of gonopodial thrusts compared to control males paired to control female mosquitofish. Given the rapid effects on both anal fin morphology and behavior observed in this study, the mosquitofish is an excellent sentinel species for the detection of exposure to LNG and likely other 19-nortestosterone derived contraceptive progestins in the environment.

An Application of the Learning Cycle in Health Education: HIV/AIDS Prevention

ERIC Educational Resources Information Center

Basta, Tania Barman; Barman, Charles R.

2008-01-01

Objectives: At the conclusion of this lesson, students will be able to (1) identify methods of contraception that are the least/most effective for HIV/AIDS prevention, (2) describe modes of HIV/AIDS transmission, (3) demonstrate proper condom use, and (4) describe the consequences of unprotected sexual behavior. Target Audience: Students enrolled…

Extended Axiomatic Conjoint Measurement: A Solution to a Methodological Problem in Studying Fertility-Related Behaviors.

ERIC Educational Resources Information Center

Nickerson, Carol A.; McClelland, Gary H.

1988-01-01

A methodology is developed based on axiomatic conjoint measurement to accompany a fertility decision-making model. The usefulness of the model is then demonstrated via an application to a study of contraceptive choice (N=100 male and female family-planning clinic clients). Finally, the validity of the model is evaluated. (TJH)

The Relationship of Sexual Knowledge to Sexual Behavior among University Students.

ERIC Educational Resources Information Center

Pollack, Robert H.; Brown, Idalyn S.

Current data on the widespread nature of sexual activity among unmarried teenagers and young adults and the rise in unplanned pregnancy among these groups offer evidence of a lack of knowledge about reproduction and contraception. Male (N=75) and female (N=78) university students participated in a study of the effects of authoritarianism,…

The Impact of Mother-Daughter Communication on Daughter's Sexual Knowledge, Behavior and Contraceptive Use.

ERIC Educational Resources Information Center

Fox, Greer Litton; Inazu, Judith K.

Family background variables such as race, religion, and gender of household head emerged as significant predictors of communication about sex in interviews conducted with a sample of mothers and teenage daughters. A suprising finding was a strong positive association between family religion and early sexual communication, although this may reflect…

Longitudinal Effects of Perceived Maternal Approval on Sexual Behaviors of Asian and Pacific Islander (API) Young Adults

ERIC Educational Resources Information Center

Hahm, Hyeouk; Lee, Jieha; Zerden, Lisa; Ozonoff, Al; Amodeo, Maryann; Adkins, Chris

2008-01-01

Data were obtained from the National Longitudinal Study of Adolescent Health to examine the longitudinal association between Asian and Pacific Islander (API) adolescents' perceptions of maternal approval of their sexual activity and contraception use, and four sexual outcomes during young adulthood. The study includes a nationally representative…

Twelve-month contraceptive continuation among women initiating short- and long-acting reversible contraceptives in North Kivu, Democratic Republic of the Congo.

PubMed

Casey, Sara E; Cannon, Amy; Mushagalusa Balikubirhi, Benjamin; Muyisa, Jean-Bosco; Amsalu, Ribka; Tsolka, Maria

2017-01-01

Despite the inclusion of sexual and reproductive health (SRH) services in the minimum standards of health care in humanitarian settings, access to SRH services, and especially to contraception, is often compromised in war. Very little is known about continuation and switching of contraceptive methods in these settings. An evaluation of a contraceptive services program in North Kivu, Democratic Republic of the Congo (DRC) was conducted to measure 12-month contraceptive continuation by type of contraceptive method (short-acting or long-acting). A stratified systematic sample of women who initiated a contraceptive method 12-18 months prior to data collection was selected retrospectively from facility registers. A total of 548 women was interviewed about their contraceptive use: 304 who began a short-acting method (pills, injectables) and 244 who began a long-acting method (intra-uterine devices, implants). Key characteristics of short-acting method versus long-acting method acceptors were compared using chi-square statistics for categorical data and t-tests for continuous data. Unadjusted and adjusted Cox proportional hazard ratios were estimated to assess factors associated with discontinuation. At 12 months, 81.6% women reported using their baseline contraceptive method continuously, with more long-acting than short-acting contraceptive acceptors (86.1% versus 78.0%, p = .02) continuing contraceptive use. Use of a short-acting method (Hazard ratio (HR) 1.74 [95%CI 1.13-2.67]) and desiring a child within two years (HR 2.58 [95%CI 1.45-4.54]) were associated with discontinuation within the first 12 months of use. The vast majority (88.3%) of women reported no prior contraceptive use. This is the first study of contraceptive continuation in a humanitarian setting. The high percentages of women continuing contraceptive use found here demonstrates that women will choose to initiate and continue use of their desired contraceptive method, even in a difficult, unstable and low contraceptive prevalence setting like North Kivu.

Pregnancy Intention and Contraceptive Use among Women by Class of Obesity: Results from the 2006-2010 and 2011-2013 National Survey of Family Growth.

PubMed

Nguyen, Brian T; Elia, Jennifer L; Ha, Cathrine Y; Kaneshiro, Bliss E

Conflicting research findings on the association of obesity and pregnancy intention may be due to their collective definition of obesity at a body mass index of 30 kg/m 2 or greater. However, obese women with a BMI of 40 kg/m 2 or greater may be both behaviorally and clinically different from obese women with a lower BMI. This study reexamines this relationship, stratifying by class of obesity; the study also explores variations in contraceptive use by class of obesity given their potential contribution to the incidence of unintended or unwanted pregnancy. This study combined data from the 2006 through 2010 and 2011 through 2013 US National Survey of Family Growth. Pregnancy intention (intended, mistimed, unwanted) and current contraceptive use (no method, barrier, pill/patch/ring/injection, long-acting reversible contraceptive, sterilization) were compared across body mass index categories: normal (18.5-24.9 kg/m kg/m 2 ), overweight (25.0-29.9), obese class 1 (30.0-34.9 kg/m 2 ), class 2 (35.0-39.9 kg/m 2 ), and class 3 (≥40 kg/m 2 , severe obesity). Weighted multinomial logistic regressions were refined to determine independent associations of body mass index class and pregnancy intention, as well as contraceptive method, controlling for demographic, socioeconomic, and reproductive factors. Body mass index data were available for 9,848 nonpregnant, sexually active women who reported not wanting to become pregnant. Women with class 3 obesity had significantly greater odds of mistimed (adjusted odd ratio [aOR], 1.67; 95% confidence interval [CI], 1.02-2.75) or unwanted (aOR, 1.96; 95% CI, 1.15-3.32) pregnancy compared with normal weight women. Women with class 2 or 3 obesity were more likely to not be using contraception (aOR, 1.53-1.62; 95% CI, 1.04-2.29). Although women with class 2 obesity were more likely to be using long-acting reversible contraceptive methods and sterilization over short-acting hormonal methods (aOR, 1.67; 95% CI, 1.08-2.57; aOR, 2.05; 95% CI,1.44-2.91), this association was not observed among women with class 3 obesity. Women with class 3 obesity are at greater risk of unintended pregnancy and are less likely to be using contraception than normal weight women. Whether these findings are related to patient and/or provider barriers that are not as visible among women with class 1 and class 2 obesity warrants further investigation. Copyright © 2017 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Contraceptive discontinuation and switching among couples receiving integrated HIV and family planning services in Lusaka, Zambia.

PubMed

Haddad, Lisa; Wall, Kristin M; Vwalika, Bellington; Khu, Naw Htee; Brill, Ilene; Kilembe, William; Stephenson, Rob; Chomba, Elwyn; Vwalika, Cheswa; Tichacek, Amanda; Allen, Susan

2013-10-01

To describe predictors of contraceptive method discontinuation and switching behaviours among HIV-positive couples receiving couples' voluntary HIV counselling and testing services in Lusaka, Zambia. Couples were randomized in a factorial design to two-family planning educational intervention videos, received comprehensive family planning services and were assessed every 3 months for contraceptive initiation, discontinuation and switching. We modelled factors associated with contraceptive method upgrading and downgrading via multivariate Andersen-Gill models. Most women continued the initial method selected after randomization. The highest rates of discontinuation/switching were observed for injectable contraceptive and intrauterine device users. Time to discontinuing the more effective contraceptive methods or downgrading to oral contraceptives or condoms was associated with the women's younger age, desire for more children within the next year, heavy menstrual bleeding, bleeding between periods and cystitis/dysuria. Health concerns among women about contraceptive implants and male partners not wanting more children were associated with upgrading from oral contraceptives or condoms. HIV status of the woman or the couple was not predictive of switching or stopping. We found complicated patterns of contraceptive use. The predictors of contraception switching indicate that interventions targeted to younger couples that address common contraception-related misconceptions could improve effective family planning utilization. We recommend these findings be used to increase the uptake and continuation of contraception, especially long-acting reversible contraceptive (LARC) methods, and that fertility goal based, LARC-focused family planning be offered as an integral part of HIV prevention services.

Are there unmet needs in contraceptive counselling and choice? Findings of the European TANCO Study.

PubMed

Merki-Feld, G S; Caetano, C; Porz, T C; Bitzer, J

2018-05-22

Effective use of contraception requires women to make an informed choice about methods that match their individual needs and expectations. The European Thinking About Needs in Contraception (TANCO) study is a quantitative, online survey of healthcare provider and women's views on aspects of counselling around contraception and contraceptive use. Healthcare providers and women attending their practices for contraceptive counselling were invited to complete online questionnaires. The women's survey explored knowledge and use of contraceptive methods, satisfaction with current method, and interest in receiving more information about all methods. Healthcare provider views were gathered in parallel. A total of 676 healthcare providers and 6027 women completed the online surveys in 11 countries. There was a high prevalence of contraceptive use and general satisfaction with current method across the countries. Fifty-five percent of women were using short-acting contraception (SAC) methods; 19% were using a long-acting reversible contraception (LARC) method. Sixty percent of women were interested in receiving more information about all methods; 73% of women said they would consider LARC if they received more comprehensive information. Healthcare providers tend to underestimate women's interest in receiving information on contraception in general and, more specifically, LARC methods. Despite high levels of use and satisfaction with current methods, women were interested in receiving more information about all contraceptive methods. Greater exploration of women's views on their needs and expectations of contraception could lead to increased knowledge, more effective discussions with healthcare providers and the greater likelihood of informed contraceptive choice.

Counseling in the clinical setting to prevent unintended pregnancy: an evidence-based research agenda.

PubMed

Moos, Merry K; Bartholomew, Neva E; Lohr, Kathleen N

2003-02-01

Unintended pregnancies account for about half of all pregnancies in the United States and, in 1995, numbered nearly 3 million pregnancies. They pose appreciable medical, emotional, social and financial costs on women, their families and society. The US is not attaining national goals to decrease unintended pregnancies, and little is known about effective means for reducing unintended pregnancy rates in adults or adolescents.To examine the evidence about the effectiveness, benefits and harms of counseling in a clinical setting to prevent unintended pregnancy in adults and adolescents and to use the evidence to propose a research agenda.We identified English-language articles from comprehensive searches of the MEDLINE, CINAHL, PsychLit and other databases from 1985 through May 2000; the main clinical search terms included pregnancy (mistimed, unintended, unplanned, unwanted), family planning, contraceptive behavior, counseling, sex counseling, and knowledge, attitudes and behavior. We also used published systematic reviews, hand searching of relevant articles, the second Guide to Clinical Preventive Services and extensive peer review to identify important articles not otherwise found and to assure completeness. Of 673 abstracts examined, we retained 354 for full article review; of these, we used 74 for the systematic evidence review and abstracted data from 13 articles for evidence tables. Four studies addressed the effectiveness of counseling in a clinical setting in changing knowledge, skills and attitudes about contraception and pregnancy; all had poor internal validity and generalizability and collectively did not provide definitive guidance about effective counseling strategies. Nine studies (three in teenage populations) addressed the relationship of knowledge on contraceptive use and adherence. Knowledge of correct contraceptive methods may be positively associated with appropriate use, but reservations about the method itself, partner support of the method, and women's beliefs about their own fertility are important determinants of method adherence that may attenuate the knowledge effect. Many factors influence contraceptive use and adherence; among them are age, marital status, ambivalence about becoming pregnant, attitudes of partner, side effects, satisfaction with provider and costs; however, the impact of such factors may not be consistent across populations defined by cultural, age or other factors. The studies themselves differed materially in outcome variables, populations and methodologies and did not yield a body of work that can reliably identify specific influences on contraceptive use and adherence. No literature reports on harms of counseling or on the costs or cost-effectiveness of different approaches to counseling about unintended conceptions in the primary care setting. Virtually no experimental or observational literature reliably answers questions about the effectiveness of counseling in the clinical setting to reduce rates of unintended (unwanted, mistimed) pregnancies in this country. Existing studies suffer from appreciable threats to internal validity and loss to follow-up and are extremely heterogeneous in terms of populations studied and outcomes measured. The quality of the existing research does not provide strong guidance for recommendations about clinical practice but does suggest directions for future investigations. Numerous issues warrant rigorous investigation.

Comparative effects of a contraceptive vaginal ring delivering a nonandrogenic progestin and continuous ethinyl estradiol and a combined oral contraceptive containing levonorgestrel on hemostasis variables.

PubMed

Rad, Mandana; Kluft, Cornelis; Ménard, Joël; Burggraaf, Jacobus; de Kam, Marieke L; Meijer, Piet; Sivin, Irving; Sitruk-Ware, Regine L

2006-07-01

This study aimed to compare the effects on hemostasis variables of a contraceptive vaginal ring with those of an oral contraceptive. Twenty-three and 22 healthy premenopausal women were randomized to the contraceptive vaginal ring (150 microg Nestorone and 15 microg ethinyl estradiol) or Stediril 30 during 3 cycles. Analysis of covariance was performed with baseline values as covariate. The contraceptive vaginal ring changed most hemostasis variables similarly but raised (95% confidence intervals of percent treatment differences) Factor VIIt (28% to 49%), extrinsic activated protein C resistance (14% to 65%), and sex hormone-binding globulin (117% to 210%) and lowered Protein S (-32% to -16%) and the global activated partial thromboplastin time-based activated protein C resistance (-12% to -2%) more than the oral contraceptive. The contraceptive vaginal ring affected some measured hemostasis variables and sex hormone-binding globulin differently from the oral contraceptive, most likely because of difference in androgenicity of the progestins. The results suggest that the contraindications for oral contraceptive use would also apply to the tested contraceptive vaginal ring.

Emergency contraception: Focus on the facts.

PubMed

Najera, Deanna Bridge

2016-01-01

Significant progress on contraception, and in particular emergency contraception, has been made in the past decade. Emergency contraception was first introduced as a stand-alone prescription in 1998, and the interaction of politics and medicine meant a tumultuous course to the drug becoming available over the counter. This article reviews how emergency contraception works, the effectiveness of different methods, pros and cons, and the history of emergency contraception.

Use of contraceptive methods and contraceptive recommendations among health care providers actively involved in contraceptive counseling -- results of an international survey in 10 countries.

PubMed

Gemzell-Danielsson, Kristina; Cho, SiHyun; Inki, Pirjo; Mansour, Diana; Reid, Robert; Bahamondes, Luis

2012-12-01

This study was conducted to determine the personal choices of contraceptive methods among an international sample of contraception health care professionals (HCPs) and to determine if these choices are concordant with their recommendations to women. In an anonymous online survey, 1001 HCPs actively involved in contraceptive counseling [obstetrician/gynecologists (OB/GYNs), general practitioners (GPs) and midwives (only in Sweden)] from 10 countries (Australia, Brazil, Canada, France, Germany, Korea, Mexico, Spain, Sweden and the United Kingdom) were asked about their personal use of contraceptive methods and their recommendations to women in two different clinical scenarios: for spacing between children (Group A) and after completion of the family (Group B). The largest HCP group was OB/GYNs (67.1%), followed by GPs (31.4%) and midwives (1.5%). A total of 42.7% of respondents were male, and 57.3% were female. The majority of respondents were aged 36-45 years (38.9%) or 46-55 years (42.8%), 79.7% had children, and 53.9% were currently using contraception (by themselves or by their partners). Among 540 contraceptive users, the three most common methods were the levonorgestrel-releasing intrauterine system (LNG-IUS; 29.3%), combined oral contraceptives (COCs; 20.0%) and condoms (17.0%). OB/GYNs were more likely to be using the LNG-IUS than GPs (p=.014). Gender did not seem to influence contraceptive preference. Reasons for these choices were largely influenced by family situation and high contraceptive efficacy (for the LNG-IUS) or side effects caused by other methods (for condoms). The top contraceptive recommendation was COCs for Group A and the LNG-IUS for Group B. HCPs currently using COCs and the LNG-IUS were more likely to recommend these methods than other contraceptive methods for Group A and Group B, respectively. The most popular contraceptive method in this sample of HCPs was the LNG-IUS. Choice of contraceptive method was driven by family situation, age and profession. It appears that, in this sample, personal contraceptive use influences contraceptive recommendations. Copyright © 2012 Elsevier Inc. All rights reserved.

Contraception usage and timing of pregnancy among pregnant teenagers in Cape Town, South Africa.

PubMed

Vollmer, Linda R; van der Spuy, Zephne M

2016-06-01

To evaluate knowledge and use of contraception among pregnant teenagers in the Cape Town metropolitan area. A cross-sectional study enrolled women aged 16 to 19 years who were pregnant and attending prenatal clinics, and prenatal and labor wards at regional hospitals and midwife-run obstetric clinics in the Cape Town area between March 1, 2011 and September 30, 2011. Data were collected using an administered questionnaire. The study enrolled 314 participants. Of the participants, 240 (76.4%) felt their pregnancies had occurred at the "wrong time" but only 38 (12.1%) were using contraception at the time of conception. The form of contraception that participants most commonly had knowledge of was injectable hormonal contraception (274 [87.3%]). Contraception use was low, with 126 (40.1%) participants having never used contraception. The forms of contraception used most commonly were the male condom (106 [33.8%]) and injectable contraception (98 [31.2%]). The majority of participants found it easy to get contraception (192 [61.1%]) and felt that information regarding contraception was readily available (233 [74.2%]). Contraception use is suboptimal but this may not simply be a reflection of ineffective family-planning services. Further research is needed to fully explain the lack of contraceptive use in this population. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

The 1998 Canadian Contraception Study.

ERIC Educational Resources Information Center

Fisher, William A.; Boroditsky, Richard; Bridges, Martha L.

1999-01-01

Describes the 1998 Canadian Contraception Study, a mailed survey which asked women about contraceptive practices past, present, and future (including use of oral contraceptives, condoms, and sterilization); familiarity with and opinion about different contraception methods; and general sexual and reproductive health. The paper also examines…

The Male Role in Contraception: Implications for Health Education.

ERIC Educational Resources Information Center

Chng, Chwee Lye

1983-01-01

Many males still perceive contraception as a woman's responsibility. This paper describes male contraceptives and their effectiveness and draws implications for school and community health education professionals. More equitable sharing of the responsibility for contraception might result in more effective contraception. (PP)

[The efficiency of oral contraception containing drospirenone in treating symptoms of premenstrual syndrome or premenstrual dysphoric disorder in gyneacology practice].

PubMed

Svojanovská, K

2010-10-01

The efficiency of oral contraception containing drospirenone in treating symptoms of premenstrual dysphoric disorder (PMDD) was demonstrated in a number of studies. The objective of this observation was to use the "Premenstrual Symptoms Screening Tool" (PSST) to identify women who suffer from severe premenstrual syndrome (PMS) or PMDD and evaluate the benefits of their treatment through using the oral contraceptive containing drospirenone in regime 24/4 in gyneacology practice. The retrospective study was conducted from September 2008 to August 2009. Fifty-one women met by the PSST (Premenstrual Symptoms Screening Tool, Steiner et. al., 2003) the criteria of severe PMS/PMDD. Twenty-eight women took no contraception at the start of the evaluation and twenty-three already took oral contraceptives before changing to the oral contraceptive with drospirenone. The women completed the PSST and in the case of severe PMS/PMDD started treatment with the oral contraceptive containing 20 microg ethinylestradiol /EE/ + 3 mg drospirenone /drsp/ in regime 24/4. The next evaluation was conducted by the same PSST after 3 or 4 months of treatment with this oral contraceptive. The study involved 51 women between the ages of 15 and 44 years (average 25.7 years), who completed the PSST before and after 3 or 4 months of treatment with the oral contraceptive containing drospirenone. The summary score of all subjects significantly decreased from 24.6 before they started using the oral contraceptive with drospirenone to 7,2 after 3 or 4 months of treatment with this oral contraceptive. Significant declines in summary scores have been shown in both groups (in the group without oral contraception from 24.9 at the start of the observation to 8.2 after 3 or 4 months of using this oral contraceptive with drospirenone; and from 24.3 to 6.0 in the group with the change from using various oral contraceptives to using the contraceptive containing drospirenone). The application of PSST for detection of severe premenstrual symptoms facilitates route identification diagnosis of severe PMS/PMDD in practice and also allows the evaluation of treatment. Both in the group of women without oral contraceptive at the start of the evaluation and in the group of women who changed to the oral contraceptive, symptoms significantly decreased after 3 or 4 months of treatment with the oral contraceptive containing drospirenone and severe PMS and PMDD was practically eliminated. In the case of diagnosis of severe PMS/PMDD in women wishing to use an oral contraceptive, it is important to start treatment with the oral contraceptive containing drospirenone and for women with severe PMS/PMDD symptoms when using different oral contraceptives, it is important to change to the contraception with drospirenone.

Impact of having a high-risk pregnancy on future postpartum contraceptive method choice.

PubMed

Kiykac Altinbas, Sadiman; Bayoglu Tekin, Yesim; Dilbaz, Berna; Kilic, Selim; Khalil, Susan S; Kandemir, Omer

2014-12-01

To compare the knowledge and preference of preconceptional contraception to future postpartum contraceptive method choice in high-risk pregnancies. Does a high-risk pregnancy condition affect future postpartum contraceptive method choice? Women hospitalised at the High Risk Pregnancy unit of a tertiary research and training hospital were asked to complete a self-reported questionnaire that included demographic characteristics, presence of unintended pregnancy, contraceptive method of choice before the current pregnancy, plans for contraceptive use following delivery and requests for any contraceptive counselling in the postpartum period. A total of 655 pregnant women were recruited. The mean age, gravidity and parity of the women were 27.48 ± 6.25 years, 2.81 ± 2.15 and 1.40 ± 1.77, respectively. High-risk pregnancy indications included 207 (31.6%) maternal, 396 (60.5%) foetal and 52 (7.9%) uterine factors. All postpartum contraceptive choices except for combined oral contraceptives (COCs) usage were significantly different from preconceptional contraceptive preferences (p<0.001). High-risk pregnancy indications, future child bearing, ideal number of children, income and education levels were the most important factors influencing postpartum contraceptive choices. While the leading contraceptive method in the postpartum period was long-acting reversible contraceptive methods (non-hormonal copper intrauterine device Cu-IUD, the levonorgestrel-releasing intrauterine system (LNG-IUS) (40%), the least preferred method was COCs use (5.2%) and preference of COCs use showed no difference between the preconceptional and postpartum periods (p=0.202). Overall 73.7% of the women wanted to receive contraceptive counselling before their discharge. A high-risk pregnancy condition may change the opinion and preference of contraceptive use, and also seems to affect the awareness of family planning methods. Copyright © 2014 Australian College of Midwives. All rights reserved.

Contraceptive usage patterns in North American medical students

PubMed Central

Rowen, Tami S.; Smith, James F.; Eisenberg, Michael L.; Breyer, Benjamin N.; Drey, Eleanor A.; Shindel, Alan W.

2013-01-01

Background Previous studies indicate that the sexual beliefs and mores of students in medical professions may influence their capacity to care for patients’ sexuality and contraception issues. Students also represent a large sample of reproductive-age individuals. In this study, we examined contraceptive usage patterns in North American medical students. Study Design Students using online medical student social and information networks enrolled in allopathic and osteopathic medical schools in North America between February and July of 2008 were invited to participate via email and published announcements in an Internet-based survey consisting of a questionnaire that assessed ethnodemographic factors, year in school and sexual history. We also collected information about current use of contraceptive and barrier methods. Descriptive statistics and logistic regression were utilized to analyze responses. Results Among our 2269 complete responses, at least one form of contraception was being utilized by 71% of men and 76% of women. Condoms were the most popular form of contraceptive, utilized by 1011 respondents (50% of men and 40% of women). Oral contraceptive pills were the contraceptive of choice for 34% of men and 41% of women. Decreased rates of contraception use were associated with being black or Asian, not being in a relationship and having more sexual dysfunction in female respondents. Students who reported comfort discussing sexual issues with patients were more likely to use effective contraceptive methods themselves. Ten percent of this of sexually active medical students was not currently using contraception. Conclusions There are significant differences in contraceptive use based on demographics, even at the highest education levels. The personal contraception choices of medical students may influence their ability to accurately convey information about contraception to their patients. In addition, medical students may personally benefit from improved knowledge of effective contraceptive practices. PMID:21477690

Contraceptive usage patterns in North American medical students.

PubMed

Rowen, Tami S; Smith, James F; Eisenberg, Michael L; Breyer, Benjamin N; Drey, Eleanor A; Shindel, Alan W

2011-05-01

Previous studies indicate that the sexual beliefs and mores of students in medical professions may influence their capacity to care for patients' sexuality and contraception issues. Students also represent a large sample of reproductive-age individuals. In this study, we examined contraceptive usage patterns in North American medical students. Students using online medical student social and information networks enrolled in allopathic and osteopathic medical schools in North America between February and July of 2008 were invited to participate via email and published announcements in an Internet-based survey consisting of a questionnaire that assessed ethnodemographic factors, year in school and sexual history. We also collected information about current use of contraceptive and barrier methods. Descriptive statistics and logistic regression were utilized to analyze responses. Among our 2269 complete responses, at least one form of contraception was being utilized by 71% of men and 76% of women. Condoms were the most popular form of contraceptive, utilized by 1011 respondents (50% of men and 40% of women). Oral contraceptive pills were the contraceptive of choice for 34% of men and 41% of women. Decreased rates of contraception use were associated with being black or Asian, not being in a relationship and having more sexual dysfunction in female respondents. Students who reported comfort discussing sexual issues with patients were more likely to use effective contraceptive methods themselves. Ten percent of this of sexually active medical students was not currently using contraception. There are significant differences in contraceptive use based on demographics, even at the highest education levels. The personal contraception choices of medical students may influence their ability to accurately convey information about contraception to their patients. In addition, medical students may personally benefit from improved knowledge of effective contraceptive practices. Copyright © 2011 Elsevier Inc. All rights reserved.

Is there a need for better sexual education of young men? Sexual behaviour and reproductive health in Swiss university students: a questionnaire-based pilot study.

PubMed

Merki-Feld, Gabriele Susanne; Felder, Stephanie; Roelli, Conrad; Imthurn, Bruno; Stewart, Mary; Bateson, Deborah

2018-04-01

There is evidence that men's perception of contraceptive methods and of their effectiveness and health risks have a major impact on couples contraceptive choices. Engaging men in decision making improves reproductive health outcomes. If they are better informed, men can potentially contribute to more effective use of contraception, thus reducing the rate of sexually transmitted infections and abortion. In Central European countries, few data are available on male contraceptive knowledge and behaviour. To collect more data we conducted an anonymous survey among young men studying at Zürich University in Switzerland. A questionnaire was distributed to 1500 male students which included a broad range of items addressing sexual behaviour, condom use and knowledge, and attitudes regarding contraceptive methods. Three hundred and sixty-one questionnaires were eligible for evaluation. Condoms and the combined oral contraceptive pill were the most frequently used methods. However, at last intercourse 15.6% of respondents had not used any method of contraception. Many respondents (37%) had had a one-night stand without protection. Contraceptive methods most regarded as unhealthy for women were the combined oral contraceptive pill, progestin-only methods, intrauterine devices (IUDs) and emergency contraception. Characteristics considered by young men to be important in determining contraceptive method choice were: efficacy, partner satisfaction and no impact on fertility and libido. Awareness among male Swiss students about contraceptive methods is high, but in-depth knowledge is limited. Myths were expressed about the combined oral contraceptive pill, progestin-only methods, IUDs and the emergency contraceptive pill. High-risk behaviour occurs frequently. The internet was reported to be the most important source of information about contraception.

Knowledge, attitude and practice of emergency contraceptive among women who seek abortion care at Jimma University specialized hospital, southwest Ethiopia.

PubMed

Tesfaye, Tatek; Tilahun, Tizta; Girma, Eshetu

2012-03-12

In Ethiopia maternal mortality rate is very high more than one in five women die from pregnancy or pregnancy related causes. The use of contraceptives to prevent unwanted pregnancies and unsafe abortion is an important strategy to minimize maternal mortality rate. Among various forms of contraception, emergency contraceptives are the only one that can be used after sexual intercourse offering chance to prevent unwanted pregnancy. The aim of this study was to assess the knowledge, attitude and practice of emergency contraceptive among women who seek abortion care at Jimma University specialized hospital (JUSH). Institution base cross-sectional study on knowledge, attitude and practice of emergency contraceptive was conducted at JUSH from April to June, 2011 Data was collected using structured questionnaire and analyzed using SPSS version 17.0. In this study 89 women were interviewed. More than half of them (48) were from urban area and 41 were from rural area.46 (51.7%) of them were single. Of all the respondents only nine women had awareness about emergency contraceptive. Seven of the women mentioned pills as emergency contraception and only two of them mentioned both pills and injectable as emergency contraception. All of them have positive attitude towards emergency contraception but none of them have ever used emergency contraceptives. The finding revealed pregnancy among women of 15-19 years was very common. The knowledge and practice of emergency contraception is very low. But there is high positive attitude towards emergency contraceptives. Since there is much deficit on knowledge of women on emergency contraceptives, in addition to making them accessible; programs targeted at promotion and education of emergency contraceptives is helpful to prevent unwanted pregnancy.

Factors associated with the use of irreversible contraception and continuous use of reversible contraception in a cohort of HIV-positive women.

PubMed

Kancheva Landolt, Nadia; Ramautarsing, Reshmie Ashmanie; Phanuphak, Nittaya; Teeratakulpisarn, Nipat; Pinyakorn, Suteeraporn; Rodbamrung, Piyanee; Chaithongwongwatthana, Surasith; Ananworanich, Jintanat

2013-07-01

Effective contraception can be lifesaving by reducing maternal mortality linked to childbirth and unsafe abortion and by reducing vertical and horizontal transmission of HIV, in the case of an HIV-positive woman. This study is a secondary analysis of a prospective cohort study. We assessed factors associated with the use of irreversible contraception and the continuous use of reversible contraception in HIV-positive Thai women. We used descriptive statistics to present baseline characteristics and logistic regression to assess the association between contraceptive use and factors in the study. Of 196 women included in the analysis, 87% self-reported always using male condoms and 56% continuously using another effective contraceptive method during the period of the study (12-18 months). The choice of effective contraceptive methods was suboptimal--42% were sterilized, 14% used hormonal contraception and no participant reported the use of an intrauterine device. Sexual activity and past contraceptive use were factors associated positively with current continuous contraceptive use. Live births and lower levels of education were additional factors associated positively with sterilization. Despite high contraceptive use, there are still uncovered contraceptive needs among HIV-positive women in Thailand. HIV-positive women need established specialized family planning services, offering an optimal variety of contraceptive choices and tailored to their individual needs. As sterilization is an irreversible choice, it cannot be a viable alternative for every woman. Due to the positive trend between current and past contraceptive use, we consider that it may be possible to improve family planning programs if they start as early as possible in a woman's life and are continued throughout her sexually active and reproductive years. Copyright © 2013 Elsevier Inc. All rights reserved.

Contraceptive behaviour of Christian and Muslim teenagers at the time of abortion and post-abortion in Thrace, Greece.

PubMed

Tsikouras, Panagiotis; Koukouli, Zacharoula; Psarros, Nikolaos; Manav, Bachar; Tsagias, Nikolaos; Galazios, Georgios

2016-12-01

The aims of the study were to compare the contraceptive behaviour of Christian and Muslim adolescents who had an abortion in Thrace, Greece, and to examine whether extensive contraceptive counselling at the time of abortion modified their subsequent contraceptive practices. Adolescents, aged 14-19 years, who had undergone an elective abortion in our department, were included in a prospective 12-year study. Extensive contraceptive counselling was offered before discharge from the hospital. Attitudes to contraception were assessed by means of a simple questionnaire at the time of abortion and at 1-year follow-up. The study population comprised of 95 Christian Orthodox adolescents (Group A) and 79 Muslim adolescents (Group B). At the time of abortion, contraceptive behaviour differed significantly between the two groups (p = .004). Contraceptive methods used in Group A in comparison with Group B were as follows: oral contraceptives (27.4% vs. 12.7%), condoms (22.1% vs. 38.0%), interrupted coitus (18.9% vs. 20.3%), periodic abstinence (16.8% vs. 25.3%) and emergency contraception (14.7% vs. 3.8%). The commonest source of information on contraception in Group A was the gynaecologist (17.9%) and family planning clinic (15.8%), whereas in Group B it was the individual's partner (25.3%) and parents (16.4%). Contraceptive behaviour was significantly modified in both groups at post-abortion follow-up (both p < .001). The original difference between the groups, however, persisted (p = .006). In Group A, oral contraceptives were the dominant method (48.4%), followed by condoms (30.5%), whereas in Group B, the order was still the reverse (24.1% and 46.8%, respectively). Cultural differences significantly affect the contraceptive behaviour. Nevertheless, interventions that promote contraception can still be successful in different populations.

Current methods and attitudes of women towards contraception in Europe and America.

PubMed

Johnson, Sarah; Pion, Christine; Jennings, Victoria

2013-02-05

The choice of available contraceptive methods has increased in recent years; however, recent data on women's awareness of methods and reasons for their method choice, or reasons for changing methods, is limited. The aim of this study was to examine the use and awareness of contraceptive methods in the USA, UK, Germany, Italy and Spain. Quantitative survey of heterosexual women aged 25-44 years (n=2544), with no known infertility. Questions related to knowledge and use of contraceptive methods, reasons for choice and for changing methods, and sources of advice. There was generally good awareness of most forms of contraception in all five countries. Awareness and current usage was greatest for the contraceptive pill (awareness >98%, usage varied from 35% [Spain] to 63% [Germany]); and male condom (awareness >95%, usage varied from 20% [Germany] to 47% [Spain]); awareness of other methods varied between countries. Doctors have the greatest influence on women's choice of contraceptive method (>50% for all countries), and are most likely to suggest the contraceptive pill or male condom.Women's contraceptive needs change; 4-36% of contraceptive pill users were likely to change their method within 12 months. For previous contraceptive pill users (n=377), most common reason for change was concern about side effects (from 26% [Italy] to 10% [UK]); however, awareness of many non-hormonal contraceptive methods was low. Women aged 25-44 are aware of a wide variety of contraceptive methods, but knowledge and usage of the contraceptive pill and condoms predominates. Changing contraception method is frequent, occurring for a variety of reasons, including change in life circumstances and, for pill users, concerns about side effects.

Low Level of Knowledge of Contraceptive Methods among Pregnant Teens in Brazil.

PubMed

Brito, Milena Bastos; Alves, Fernanda Scoppetta Sampaio; Souza, Marlene Quadro; Requião, Samara Rezende

2018-06-01

To describe knowledge and use of contraceptive methods among pregnant teens in Brazil. A cross-sectional survey. A tertiary care center in Bahia, Brazil. Pregnant teens 10-19 years old. Participants were asked about contraceptive knowledge and previous contraceptive use. Contraceptive knowledge, previous contraceptive use, and contraceptive intentions for after pregnancy. Other survey topics included demographic characteristics, school attendance, and sexual history. A total of 90 participants wereincluded in the study, with an average age of 15.4 ± 1.7 years, and a mean age at first sexual intercourse of 13.8 ± 1.2 years. Most participants were unmarried (58/90), of mixed race (57/90), had a household income below minimum wage (59/83), lived with their parents (54/90), and unemployment (81/90). More than 80% were not using contraception or were using it irregularly whenthey became pregnant. Most participants reported knowledge of condoms (82/90), of the combined oral contraceptive pill (75/90) and of injectable contraceptives (68/90). However, less than half reported knowledge oflong-acting reversible contraceptive methods. In terms of contraceptive intentions after pregnancy, the most commonly cited methods were the contraceptive injection (36/90), the intrauterine device (17/90) and the combined pill (9/90). In this study we found a low level of knowledge of contraceptive methods, and especially of long-acting reversible contraceptive methods, among pregnant teens in Northeast Brazil. Low socioeconomic status and high rates of unplanned pregnancy might be reasons for insufficient sexual and reproductive health counseling in this population. Copyright © 2017 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Canadian Contraception Consensus (Part 2 of 4).

PubMed

Black, Amanda; Guilbert, Edith; Costescu, Dustin; Dunn, Sheila; Fisher, William; Kives, Sari; Mirosh, Melissa; Norman, Wendy V; Pymar, Helen; Reid, Robert; Roy, Geneviève; Varto, Hannah; Waddington, Ashley; Wagner, Marie-Soleil; Whelan, Anne Marie; Ferguson, Carrie; Fortin, Claude; Kielly, Maria; Mansouri, Shireen; Todd, Nicole

2015-11-01

To provide guidelines for health care providers on the use of contraceptive methods to prevent pregnancy and on the promotion of healthy sexuality. Guidance for Canadian practitioners on overall effectiveness, mechanism of action, indications, contraindications, non-contraceptive benefits, side effects and risks, and initiation of cited contraceptive methods; family planning in the context of sexual health and general well-being; contraceptive counselling methods; and access to, and availability of, cited contraceptive methods in Canada. Published literature was retrieved through searches of Medline and The Cochrane Database from January 1994 to January 2015 using appropriate controlled vocabulary (e.g., contraception, sexuality, sexual health) and key words (e.g., contraception, family planning, hormonal contraception, emergency contraception). Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies published in English from January 1994 to January 2015. Searches were updated on a regular basis and incorporated in the guideline to June 2015. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. The quality of the evidence in this document was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care (Table). Chapter 1: Contraception in Canada Summary Statements  1. Canadian women spend a significant portion of their lives at risk of an unintended pregnancy. (II-2)  2. Effective contraceptive methods are underutilized in Canada, particularly among vulnerable populations. (II-2)  3. Long-acting reversible contraceptive methods, including contraceptive implants and intrauterine contraception (copper-releasing and levonorgestrel-releasing devices/systems), are the most effective reversible contraceptive methods and have the highest continuation rates. (II-1)  4. Canada currently does not collect reliable data to determine the use of contraceptive methods, abortion rates, and the prevalence of unintended pregnancy among reproductive-age women. (II-2)  5. A universal subsidy for contraceptive methods as provided by many of Canada's peer nations and a few Canadian provinces may produce health system cost-savings. (II-2)  6. Health Canada approval processes for contraceptives have been less efficient than those of other drug approval agencies and Health Canada processes for other classes of pharmaceuticals. (II-2)  7. It is feasible and safe for contraceptives and family planning services to be provided by appropriately trained allied health professionals such as midwives, registered nurses, nurse practitioners, and pharmacists. (II-2) Recommendations 1. Contraceptive counselling should include a discussion of typical use failure rates and the importance of using the contraceptive method consistently and correctly in order to avoid pregnancy. (II-2A) 2. Women seeking contraception should be counselled on the wide range of effective methods of contraception available, including long-acting reversible contraceptive methods (LARCs). LARCs are the most effective methods of reversible contraception, have high continuation rates, and should be considered when presenting contraceptive options to any woman of reproductive age. (II-2A) 3. Family planning counselling should include counselling on the decline of fertility associated with increasing female age. (III-A) 4. Health policy supporting a universal contraception subsidy and strategies to promote the uptake of highly effective methods as cost-saving measures that improve health and health equity should be considered by Canadian health decision makers. (III-B) 5. Canadian health jurisdictions should consider expanding the scope of practice of other trained professionals such as nurses, nurse practitioners, midwives, and pharmacists and promoting task-sharing in family planning. (II-2B) 6. The Canadian Community Health Survey should include adequate reproductive health indicators in order for health care providers and policy makers to make appropriate decisions regarding reproductive health policies and services in Canada. (III-B) 7. Health Canada processes and policies should be reviewed to ensure a wide range of modern contraceptive methods are available to Canadian women. (III-B) Chapter 2: Contraceptive Care and Access Summary Statements  8. Although there are many contraceptive options in Canada, only a narrow range of contraceptive methods are commonly used by those of reproductive age. (II-3)  9. Condom use decreases with longer relationship tenure and when the sexual partner is considered to be the main partner, likely due to a lower perceived risk of sexually transmitted infection in that relationship. Condom use may also decrease markedly as an unintended consequence when an effective non-barrier method, such as hormonal contraception or intrauterine contraception, is initiated. (II-3) 10. Family planning counselling provides a natural segue into screening for concerns about sexual function or intimate partner violence. (III) 11. Well-informed and well-motivated individuals who have developed skills to practise safer sex behaviours are more likely to use contraceptive and safer sex methods effectively and consistently. (II-2) Recommendations 8. Comprehensive family planning services, including abortion services, should be accessible to all Canadians regardless of geographic location. These services should be confidential, non-judgemental, and respectful of individuals' privacy and cultural contexts. (III-A) 9. A contraceptive visit should include history taking, screening for contraindications, dispensing or prescribing a method of contraception, and exploring contraceptive choice and adherence in the broader context of the individual's sexual behaviour, reproductive health risk, social circumstances, and relevant belief systems. (III-B) 10. Health care providers should provide practical information on the wide range of contraceptive options and their potential non-contraceptive benefits and assist women and their partners in determining the best user-method fit. (III-B) 11. Health care providers should assist women and men in developing the skills necessary to negotiate the use of contraception and the correct and consistent use of a chosen method. (III-B) 12. Contraceptive care should include discussion and management of the risk of sexually transmitted infection, including appropriate recommendations for condom use and dual protection, STI screening, post-exposure prophylaxis, and Hepatitis B and human papillomavirus vaccination. (III-B) 13. Health care providers should emphasize the use of condoms not only for protection against sexually transmitted infection, but also as a back-up method when adherence to a hormonal contraceptive may be suboptimal. (I-A) 14. Health care providers should be aware of current media controversies in reproductive health and acquire relevant evidence-based information that can be briefly and directly communicated to their patients. (III-B) 15. Referral resources for intimate partner violence, sexually transmitted infections, sexual dysfunction, induced abortion services, and child protection services should be available to help clinicians provide contraceptive care in the broader context of women's health. (III-B) Chapter 3: Emergency Contraception Summary Statements 12. The copper intrauterine device is the most effective method of emergency contraception. (II-2) 13. A copper intrauterine device can be used for emergency contraception up to 7 days after unprotected intercourse provided that pregnancy has been ruled out and there are no other contraindications to its insertion. (II-2) 14. Levonorgestrel emergency contraception is effective up to 5 days (120 hours) after intercourse; its effectiveness decreases as the time between unprotected intercourse and ingestion increases. (II-2) 15. Ulipristal acetate for emergency contraception is more effective than levonorgestrel emergency contraception up to 5 days after unprotected intercourse. This difference in effectiveness is more pronounced as the time from unprotected intercourse increases, especially after 72 hours. (I) 16. Hormonal emergency contraception (levonorgestrel emergency contraception and ulipristal acetate for emergency contraception) is not effective if taken on the day of ovulation or after ovulation. (II-2) 17. Levonorgestrel emergency contraception may be less effective in women with a body mass index > 25 kg/m2 and ulipristal acetate for emergency contraception may be less effective in women with a body mass index > 35 kg/m2. However, hormonal emergency contraception may still retain some effectiveness regardless of a woman's body weight or body mass index. (II-2) 18. Hormonal emergency contraception is associated with higher failure rates when women continue to have subsequent unprotected intercourse. (II-2) 19. Hormonal contraception can be initiated the day of or the day following the use of levonorgestrel emergency contraception, with back-up contraception used for the first 7 days. (III) 20. Hormonal contraception can be initiated 5 days following the use of ulipristal acetate for emergency contraception, with back-up contraception used for the first 14 days. (III) Recommendations 16. All emergency contraception should be initiated as soon as possible after unprotected intercourse. (II-2A) 17. Women should be informed that the copper intrauterine device (IUD) is the most effective method of emergency contraception and can be used by any woman with no contraindications to IUD use. (II-3A) 18.

Contraception for adolescents.

PubMed

2014-10-01

Contraception is a pillar in reducing adolescent pregnancy rates. The American Academy of Pediatrics recommends that pediatricians develop a working knowledge of contraception to help adolescents reduce risks of and negative health consequences related to unintended pregnancy. Over the past 10 years, a number of new contraceptive methods have become available to adolescents, newer guidance has been issued on existing contraceptive methods, and the evidence base for contraception for special populations (adolescents who have disabilities, are obese, are recipients of solid organ transplants, or are HIV infected) has expanded. The Academy has addressed contraception since 1980, and this policy statement updates the 2007 statement on contraception and adolescents. It provides the pediatrician with a description and rationale for best practices in counseling and prescribing contraception for adolescents. It is supported by an accompanying technical report. Copyright © 2014 by the American Academy of Pediatrics.

Contraceptive counseling among pediatric primary care providers in Western Pennsylvania: A survey-based study

PubMed Central

Papas, Beth Ann; Shaikh, Nader; Watson, Katherine; Sucato, Gina S

2017-01-01

Objectives: Data suggest that adolescents in the United States receive inadequate contraceptive counseling. This study sought to determine factors affecting pediatricians’ discussion of contraception with adolescent patients, with a specific focus on long-acting reversible contraception—implantable contraception and intrauterine devices. Methods: A cross-sectional survey was sent via email to a convenience sample of pediatric residents and pediatric primary care providers in Western Pennsylvania. Self-reported contraceptive counseling and prescribing practices in response to clinical vignettes were assessed. Results: Of potential participants (287), 88 (31%) responded. Younger providers and providers who had received contraceptive training were significantly more likely to discuss long-acting reversible contraception methods. Discussion of contraceptive methods also varied by both the age and the sexual history of the patient. Conclusion: Variation in contraceptive counseling potentially results in missed opportunities to counsel about and provide the most effective contraceptive methods. More uniform, universal provider training might alleviate some of these inconsistencies. PMID:28959447

Beyond the Condom: Frontiers in Male Contraception.

PubMed

Roth, Mara Y; Amory, John K

2016-05-01

Nearly half of all pregnancies worldwide are unplanned, despite numerous contraceptive options available. No new contraceptive method has been developed for men since the invention of condom. Nevertheless, more than 25% of contraception worldwide relies on male methods. Therefore, novel effective methods of male contraception are of interest. Herein we review the physiologic basis for both male hormonal and nonhormonal methods of contraception. We review the history of male hormonal contraception development, current hormonal agents in development, as well as the potential risks and benefits of male hormonal contraception options for men. Nonhormonal methods reviewed will include both pharmacological and mechanical approaches in development, with specific focus on methods which inhibit the testicular retinoic acid synthesis and action. Multiple hormonal and nonhormonal methods of male contraception are in the drug development pathway, with the hope that a reversible, reliable, safe method of male contraception will be available to couples in the not too distant future. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Contraception among young women attending high school in rural Nova Scotia.

PubMed

Langille, Donald B; Hughes, Jean; Murphy, Gail Tomblin; Rigby, Janet A

2002-01-01

To examine contraceptive methods used by rural adolescent women and socio-demographic factors associated with not using effective contraception. Students in three Nova Scotia high schools participated in a survey concerning sexual activity, behaviours, and contraception used at last intercourse. Proportions using no effective contraception were examined with respect to socio-demographic variables. The overall response rate was 80%; 46% of 922 young women aged 15-19 had had intercourse in the previous year. Of these, 87% used effective contraception at last intercourse. Average school mark < 80%, and having a father with less than high school education were associated with not using effective contraception. Mother's education and employment, family structure, age of first intercourse and importance of religion were not associated with lack of contraception. Using no, or ineffective, contraception at last intercourse was seen in fewer young women than has been seen in other Canadian studies. In addition to examining use of contraception in rural Canadian adolescents, the study provides evidence concerning factors for consideration in targeted interventions.

Contraceptive use among low-income urban married women in India.

PubMed

Kumar, Manisha; Meena, Jyoti; Sharma, Sumedha; Poddar, Anju; Dhalliwal, Vikas; Modi-Satish Chander Modi, S C; Singh, Kamlesh

2011-02-01

The reports of a rise in contraceptive practices have not been matched by a similar decrease in population, so there is a need to look into the causes of this discrepancy. To obtain information from low-income urban married women regarding their contraceptive knowledge, practices, and utilization of the services. Percentage of low-income urban married women using contraception, different types of contraception used, influence of education on choice of contraception. All nonpregnant married women between the ages of 18 and 45 years, belonging to low-income groups were selected for study. Statistical analysis was done using EPI Info ver-5.0. Chi square test was used to test the significance of data. Contraceptive use among these women was 52%; the most common method was tubal ligation. Educated women used spacing methods more often than uneducated women. Women had adequate awareness regarding type of contraceptives available but had no idea about the timing of starting contraception after delivery and about emergency contraception. The low-income urban population is aware of the importance of limiting the family size and has family planning facilities yet has less contraceptive usage because of low level of education, increased rate of discontinuation, and lack of proper knowledge of the use of contraception. © 2010 International Society for Sexual Medicine.

Usage patterns and attitudes towards emergency contraception: the International Emergency Contraception Research Initiative.

PubMed

Krassovics, Miklós; Virágh, Gabriella

2016-08-01

The aim of the survey was to gain understanding of women's usage patterns and attitudes towards emergency contraception (i.e., the 'morning after pill') and to gain insight into the role and attitudes of pharmacists as providers of emergency contraception. As part of the International Emergency Contraception Research Initiative, approximately 6500 women (15-49 years) and nearly 500 pharmacists from 14 countries in Western, Central and Eastern Europe, and Central Asia completed questionnaires via web-based interrogation or computer-assisted/paper-assisted personal interviews. Common to almost all countries and cultures was that, while awareness of emergency contraception was high (≥84% of respondents, except in Kazakhstan), usage was generally low (4-18%). In Austria, the Czech Republic, Spain, and the UK, better underlying protection with hormonal contraceptives or male condoms would have meant less need for emergency contraception. In Bulgaria, Lithuania, Romania, and Russia, greater dependence on less reliable contraceptive methods such as calendar + withdrawal was associated with higher use of the emergency contraceptive pill (11-18%) but also with higher abortion rates (19-21%). Overt rejection of emergency contraception in the event of an accident was low, except in countries (e.g., Austria, Poland) where the misperception that it acts as an abortifacient was common. Except for Bulgaria, pharmacists elsewhere tended to have limited knowledge and moralistic attitudes towards emergency contraception. Improved educational efforts, probably country-specific, are required to increase the use of highly effective methods of regular contraception and overcome barriers to acceptance of emergency contraception as a suitable postcoital solution to avoid unwanted pregnancy or abortion.

Copper intrauterine device for emergency contraception: clinical practice among contraceptive providers.

PubMed

Harper, Cynthia C; Speidel, J Joseph; Drey, Eleanor A; Trussell, James; Blum, Maya; Darney, Philip D

2012-02-01

The copper intrauterine device (IUD) is the most effective emergency contraceptive available but is largely ignored in clinical practice. We examined clinicians' recommendations of the copper IUD for emergency contraception in a setting with few cost obstacles. We conducted a survey among clinicians (n=1,246; response rate 65%) in a California State family planning program, where U.S. Food and Drug Administration-approved contraceptives are available at no cost to low-income women. We used multivariable logistic regression to measure the association of intrauterine contraceptive training and evidence-based knowledge with having recommended the copper IUD for emergency contraception. The large majority of clinicians (85%) never recommended the copper IUD for emergency contraception, and most (93%) required two or more visits for an IUD insertion. Multivariable analyses showed insertion skills were associated with having recommended the copper IUD for emergency contraception, but the most significant factor was evidence-based knowledge of patient selection for IUD use. Clinicians who viewed a wide range of patients as IUD candidates were twice as likely to have recommended the copper IUD for emergency contraception. Although more than 93% of obstetrician-gynecologists were skilled in inserting the copper IUD, they were no more likely to have recommended it for emergency contraception than other physicians or advance practice clinicians. Recommendation of the copper IUD for emergency contraception is rare, despite its high efficacy and long-lasting contraceptive benefits. Recommendation would require clinic flow and scheduling adjustments to allow same-day IUD insertions. Patient-centered and high-quality care for emergency contraception should include a discussion of the most effective method. III.

The role of contraceptive attributes in women's contraceptive decision making.

PubMed

Madden, Tessa; Secura, Gina M; Nease, Robert F; Politi, Mary C; Peipert, Jeffrey F

2015-07-01

Contraceptive methods have differing attributes. Women's preferences for these attributes may influence contraceptive decision making. Our objective was to identify women's contraceptive preferences among women initiating a new contraceptive method. We conducted a cross-sectional, self-administered survey of women's contraceptive preferences at the time of enrollment into the Contraceptive CHOICE Project. Participants were asked to rank the importance of 15 contraceptive attributes on a 3-point scale (1 = not at all important, 2 = somewhat important, and 3 = very important) and then to rank the 3 attributes that were the most important when choosing a contraceptive method. The survey also contained questions about prior contraceptive experience and barriers to contraceptive use. Information about demographic and reproductive characteristics was collected through the CHOICE Project baseline survey. There were 2590 women who completed the survey. Our sample was racially and socioeconomically diverse. Method attributes with the highest importance score (mean score [SD]) were effectiveness (2.97 [0.18]), safety (2.96 [0.22]), affordability (2.61 [0.61]), whether the method is long lasting (2.58 [0.61]), and whether the method is "forgettable" (2.54 [0.66]). The attributes most likely to be ranked by respondents among the top 3 attributes included effectiveness (84.2%), safety (67.8%), and side effects of the method (44.6%). Multiple contraceptive attributes influence decision making and no single attribute drives most women's decisions. Tailoring communication and helping women make complex tradeoffs between attributes can better support their contraceptive decisions and may assist them in making value-consistent choices. This process could improve continuation and satisfaction. Copyright © 2015 Elsevier Inc. All rights reserved.

Use of contraception among women who request first trimester pregnancy termination in Norway.

PubMed

Strøm-Roum, Ellen Marie; Lid, Julie; Eskild, Anne

2016-08-01

Among women requesting pregnancy termination, we studied the proportion of women who reported having used contraception when they became pregnant and the contraceptive method that they had used. We included all requests for pregnancy termination in Norway during the years 2007-2011 (n=80,346) by obtaining information from the Norwegian Registry of Pregnancy Termination. By using a logistic regression model, we estimated odds ratios for using any contraceptive method associated with the woman's age, previous childbirth, previous pregnancy termination, marital status, employment status and educational level. In total, 36.5% of the women who requested pregnancy termination (29,305/80,346) reported having used contraception when they became pregnant. Of all women, 16.6% reported having used the combined contraceptive pill/progestin pill, 11.5% the condom and 1.1% long-acting reversible contraceptives (1.0% intrauterine contraception). Overall, 38.9% of women 20-24years old had used contraception, compared to 29.9% of women 40-44years old (odds ratio 0.55, 95% confidence interval 0.51-0.60). Previous childbirth, previous pregnancy termination and high educational level were also associated with contraceptive use. Among women who requested pregnancy termination in Norway, 36.5% reported having used contraception when they became pregnant. Contraception use was associated with young age and having previously been pregnant. A large proportion of women who request pregnancy termination have experienced contraceptive failure. Women who are fertile and do not wish to become pregnant should be offered a contraceptive method that carries low risk of incorrect use. Copyright © 2016 Elsevier Inc. All rights reserved.

Barriers and facilitators to implementing a patient-centered model of contraceptive provision in community health centers.

PubMed

Politi, Mary C; Estlund, Amy; Milne, Anne; Buckel, Christina M; Peipert, Jeffrey F; Madden, Tessa

2016-01-01

The Contraceptive CHOICE Project developed a patient-centered model for contraceptive provision including: (1) structured, evidence-based counseling; (2) staff and health care provider education; and (3) removal of barriers such as cost and multiple appointments to initiate contraception. In preparation for conducting a research study of the CHOICE model in three community health settings, we sought to identify potential barriers and facilitators to implementation. Using a semi-structured interview guide guided by a framework of implementation research, we conducted 31 qualitative interviews with female patients, staff, and health care providers assessing attitudes, beliefs, and barriers to receiving contraception. We also asked about current contraceptive provision and explored organizational practices relevant to implementing the CHOICE model. We used a grounded theory approach to identify major themes. Many participants felt that current contraceptive provision could be improved by the CHOICE model. Potential facilitators included agreement about the necessity for improved contraceptive knowledge among patients and staff; importance of patient-centered contraceptive counseling; and benefits to same-day insertion of long-acting reversible contraception (LARC). Potential barriers included misconceptions about contraception held by staff and providers; resistance to new practices; costs associated with LARC; and scheduling challenges required for same-day insertion of LARC. In addition to staff and provider training, implementing a patient-centered model of contraceptive provision needs to be supplemented by strategies to manage patient and system-level barriers. Community health center staff, providers, and patients support patient-centered contraceptive counseling to improve contraception provision if organizations can address these barriers.

Contraceptive Counseling by General Internal Medicine Faculty and Residents

PubMed Central

Shulman, Benjamin; Teal, Stephanie B.; Huebschmann, Amy G.

2014-01-01

Abstract Background: Almost half of US pregnancies are unintended, resulting in many abortions and unwanted or mistimed births. Contraceptive counseling is an effective tool to increase patients' use of contraception. Methods: Using an online 20-item questionnaire, we evaluated the frequency of contraceptive counseling provided to reproductive-age women during a prevention-focused visit by University of Colorado internal medicine resident and faculty providers. We also evaluated factors hypothesized to affect contraceptive counseling frequency. Results: Although more than 95% of the 146 medicine faculty and resident respondents agreed that contraceptive counseling is important, only one-quarter of providers reported providing contraceptive counseling “routinely” (defined as ≥80% of the time) to reproductive-age women during a prevention-focused visit. Providing contraceptive counseling routinely was strongly associated with taking an abbreviated sexual history “often”/“routinely” (odds ratio [OR]=11.6 [3.3 to 40.0]) and with high self-efficacy to provide contraceptive counseling (OR=6.5 [1.5 to 29.0]). However, fewer than two-thirds of providers reported taking an abbreviated sexual history “often”/“routinely.” More than 70% of providers reported inadequate knowledge of contraceptive methods as a contraceptive counseling barrier. However, providers' perceived inadequate knowledge was not associated with traditional educational exposures, such as lectures and women's health electives. Conclusions: In prevention-focused visits with reproductive-age women, a minority of internal medicine faculty and residents reported routine contraceptive counseling. Future efforts to increase contraceptive counseling among internists should include interventions that increase provider contraceptive counseling self-efficacy and ensure that providers obtain an abbreviated sexual history. PMID:24766414

Comparison of contraceptive method chosen by women with and without a recent history of induced abortion.

PubMed

Madden, Tessa; Secura, Gina M; Allsworth, Jenifer E; Peipert, Jeffrey F

2011-12-01

Women undergoing induced abortion may be more motivated to choose long-acting reversible contraception (LARC), including the intrauterine device (IUD) and implant, than women without a history of abortion. Our objective was to determine whether the contraceptive method chosen is influenced by a recent history of induced abortion and access to immediate postabortion contraception. This was a subanalysis of the Contraceptive CHOICE Project. We compared contraception chosen by women with a recent history of abortion to women without a recent history. Participants with a recent history of abortion were divided into immediate postabortion contraception and delayed-start contraception groups. Data were available for 5083 women: 3410 women without a recent abortion history, 937 women who received immediate postabortion contraception and 736 women who received delayed-start postabortion contraception. Women offered immediate postabortion contraception were more than three times as likely to choose an IUD [adjusted relative risk (RR(adj)) 3.30, 95% confidence interval (CI) 2.67-4.85] and 50% more likely to choose the implant (RR(adj) 1.51, 95%CI 1.12-2.03) compared to women without a recent abortion. There was no difference in contraceptive method selected among women offered delayed-start postabortion contraception compared to women without a recent abortion. Women offered immediate postabortion contraception are more likely to choose the IUD and implant than women without a recent abortion history. Increasing access to immediate postabortion LARC is essential to preventing repeat unintended pregnancies. Copyright © 2011 Elsevier Inc. All rights reserved.

Contraception and pregnancy then and now: examining the experiences of a cohort of mid-age Australian women.

PubMed

Read, Christine; Bateson, Deborah; Weisberg, Edith; Estoesta, Jane

2009-08-01

More than 50% of women who have an unplanned pregnancy report using a contraceptive method. Since the launch of the pill 50 years ago, a number of cross-sectional surveys have examined contraceptive use in the Australian context. There is, however, little data on contraceptive use and efficacy over a woman's reproductive years. To determine the pattern of contraceptive use of Australian women over their reproductive lifespan, with particular emphasis on the relationship between contraceptive use and pregnancy. One thousand women from the mid-age cohort of the Australian Women's Longitudinal Study were invited to participate in the Family Planning survey by completing a questionnaire about their reproductive histories. Completed questionnaires were received for 812 women. The contraceptive pill was the most commonly ever used contraceptive method at 94% and also the most commonly used method prior to all pregnancies. Contraceptive failure increased with increasing gravidity; 11.4% with the first pregnancy to 23.0% with the fourth pregnancy, while 28.8% of the respondents reported an 'accidental' pregnancy due to stopping contraception for reasons such as concern about long-term effects and media stories. While surveys indicate that 66-70% of Australian women use a contraceptive method, more than half of unplanned pregnancies apparently occur in women using contraception. The modern Australian woman, in common with her predecessors, still faces significant challenges in her fertility management. This survey provides a longitudinal perspective on contraceptive use in relation to pregnancy and highlights the issue of efficacy of contraceptives in real-life situations.

Contraceptive awareness and birth control selection in female kidney and liver transplant recipients.

PubMed

Szpotanska-Sikorska, Monika; Pietrzak, Bronislawa; Wielgos, Miroslaw

2014-10-01

Interest has increased regarding the issue of contraception in transplant recipients. The purpose of this study was to assess birth control selection and the role of contraceptive counseling sessions in female kidney transplant (KT) and liver transplant (LT) recipients. A cross-sectional single-center survey study of 217 female organ recipients (KT, 137 and LT, 80), aged 18-45 years, met the study criteria. Patients were asked 43 questions regarding their pre- and posttransplantation use of contraceptive methods, birth control awareness, contraception counseling and the factors determining the selection of effective contraception (hormonal contraception, intrauterine devices and female sterilization). Thirty-three percent (5/15) of patients who had undergone the transplantation within 1 year prior to study inclusion were unaware of the necessity to use contraception. Both of the groups studied did not differ significantly in terms of the rates of pre- and posttransplantation consultations on effective contraception (KT: 26% vs. 34%; p=0.153 and LT 38% vs. 35%; p=0.729). Effective posttransplantation contraception was used by one in three patients, as indicated by posttransplantation consultations (KT: 30% vs. LT: 29%; p=0.910). The following factors affected the posttransplantation use of effective contraception: the presence of posttransplantation counseling on effective contraception [odds ratio (OR): 6.67; 95% confidence interval (CI): 2.12-20.1] and infrequent sexual activity prior to transplantation (OR: 0.56; 95% CI: 0.35-0.89). The selection of effective contraception in KT and LT recipients remain suboptimal. Despite the low numbers of women who received contraceptive counseling in this study, consultation was nonetheless associated with choosing an effective method of contraception. Current literature and data regarding contraception among female organ transplant recipients remain limited and are predominantly limited to a single population. The purpose of the study was to assess the level of satisfaction and the reasons underlying birth control selection in female kidney and LT recipients. Copyright © 2014 Elsevier Inc. All rights reserved.

Contraception counselling of female soldiers in primary healthcare facilities.

PubMed

Crabb, Sarah L

2015-06-01

Effectiveness of barrier and oral contraceptive pills is dependent on daily adherence and consistency that cannot always be guaranteed by military lifestyle. Long-acting reversible contraceptive (LARC) methods could provide a good alternative to guarantee effective contraception in unpredictable scenarios, and recent studies have suggested they could provide wider non-contraceptive benefits. LARC has been proven to be more cost effective than the combined oral contraceptive pill. The National Institute of Health and Care Excellence (NICE) has released guidelines on contraception provision to ensure all women receive the contraception method that is most appropriate to the individual. A retrospective audit of 105 sets of primary healthcare notes of serving female soldiers was assessed to establish contraceptive choices and whether appropriate information had been provided within the last year of their last consultation. 100% had seen a healthcare provider capable of providing contraceptive advice in the last year. 69% documented as using some form of non-surgical contraception versus 58% quoted as national usage. 21% were using some form of LARC versus 8% national usage. 66% of eligible women had not had LARC discussed with them, and of these 50% did not have any contraceptive usage documented. Among other consultations, 41% had had a medical within the year period, of which over half had no documented contraceptive status. As military healthcare providers, we have more exposure to our patients than NHS equivalents and this small study suggests there is an increased demand for contraception. Contraceptive choice counselling should be a mandatory part of routine initial medicals. If the situation demands a medical for any other reason, a documented contraception status should form an important part of the risk assessment process. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Postpartum contraception utilization among low-income women seeking immunization for infants in Mumbai, India.

PubMed

Mody, Sheila K; Nair, Saritha; Dasgupta, Anindita; Raj, Anita; Donta, Balaiah; Saggurti, Niranjan; Naik, D D; Silverman, Jay G

2014-06-01

The objective was to examine postpartum contraception utilization among Indian women seeking immunization for their infants in three low-income communities in Mumbai, India. We conducted a cross-sectional questionnaire of low-income postpartum women seeking immunization for their infants at three large urban health centers in Mumbai. Contraceptive utilization data were collected as part of a larger study focused on the impact of postpartum domestic violence on maternal and infant health. Descriptive, bivariate and multivariate analyses were conducted to describe and identify predictors of postpartum contraceptive utilization. Postpartum women aged 17-45 years (N=1049) completed the survey; 44.5% (n=467) reported resuming sexual relations with their husbands. Among these women, the majority (65.3%; n=305) reported not currently using contraception. In multivariate analyses, women who did not discuss postpartum family planning with their husbands, had not used contraception previous to the recent birth, and had experienced physical violence or forced sex were more likely to not use postpartum contraception (adjusted odds ratios=1.47-1.77). Among the 162 women using contraception, the most common time to initiation of contraception was 5 weeks postpartum, and the most common method used was condoms 77.8% (n=126). Contraception nonuse was common among urban, low-income postpartum women in India. This study highlights the importance of developing interventions to increase use of highly effective contraceptive methods postpartum, and that spousal violence and lack of marital communication may present barriers to postpartum contraception utilization. Infant immunization may represent an opportunity for provision of contraceptives and contraceptive counseling. This original research study is a unique contribution to the literature because it presents data regarding the nonuse of postpartum contraception among women seeking immunizations for their infants in urban centers in a developing country. It also reveals barriers to not using postpartum contraception and provides data for future interventions. Copyright © 2014 Elsevier Inc. All rights reserved.

Postpartum contraception utilization among low-income women seeking immunization for infants in Mumbai, India

PubMed Central

Mody, Sheila K; Nair, Saritha; Dasgupta, Anindita; Raj, Anita; Donta, Balaiah; Saggurti, Niranjan; Naik, DD; Silverman, Jay G

2014-01-01

Objective To examine postpartum contraception utilization among Indian women seeking immunization for their infants in three low-income communities in Mumbai, India. Study Design We conducted a cross-sectional questionnaire of low-income postpartum women seeking immunization for their infants at three large urban health centers in Mumbai. Contraceptive utilization data was collected as part of a larger study focused on the impact of postpartum domestic violence on maternal and infant health. Descriptive, bivariate and multivariate analyses were conducted to describe and identify predictors of postpartum contraceptive utilization. Results Postpartum women aged 17–45 years (N=1049) completed the survey; 44.5% (n= 467) reported resuming sexual relations with their husbands. Among these women, the majority (65.3%; n=305) reported not currently using contraception. In multivariate analyses, women who did not discuss postpartum family planning with their husbands, had not used contraception previous to the recent birth, and who had experienced physical violence or forced sex were more likely to not use postpartum contraception (AORs = 1.47–1.77). Among the 162 women using contraception, the most common time to initiation of contraception was 5 weeks postpartum and the most common method used was condoms 77.8% (n=126). Conclusion Contraception non-use was common among urban, low-income postpartum women in India. This study highlights the importance of developing interventions to increase use of highly effective contraceptive methods postpartum, and that spousal violence and lack of marital communication may present barriers to postpartum contraception utilization. Infant immunization may represent an opportunity for provision of contraceptives and contraceptive counseling. Implications This original research study is a unique contribution to the literature because it presents data regarding the non-use of postpartum contraception among women seeking immunizations for their infants in urban centers in a developing country. It also reveals barriers to not using postpartum contraception and provides data for future interventions. PMID:24560478

Contraceptive Sterilization: Introducing A Couple Perspective to Examine Sociodemographic Differences in Use.

PubMed

Eeckhaut, Mieke C W

2017-09-01

Most studies of contraceptive use have relied solely on the woman's perspective, but because men's attitudes and preferences are also important, analytic approaches based on couples should also be explored. Data from the 2006-2010 and 2011-2013 rounds of the National Survey of Family Growth yielded a sample of 4,591 men and women who were married or cohabiting with an opposite-sex partner and who had completed their intended childbearing. Respondents' reports of both their own and their partners' characteristics and behaviors were employed in two sets of analyses examining educational and racial and ethnic differences in contraceptive use: an individualistic approach (using multinomial logistic regression) and a couple approach (using multinomial logistic diagonal reference models). In the full model using the individualistic approach, respondents with less than a high school education were less likely than those with at least a college degree to rely on male sterilization (odds ratios, 0.1-0.2) or a reversible method (0.4-0.5), as opposed to female sterilization. Parallel analyses limited to couples in which partners had the same educational levels (i.e., educationally homogamous couples) showed an even greater difference between those with the least and those with the most schooling (0.03 for male sterilization and 0.2 for a reversible method). When race and ethnicity, which had a much higher level of homogamy, were examined, the approaches yielded more similar results. Research on contraceptive use can benefit from a couple approach, particularly when focusing on partners' characteristics for which homogamy is relatively low. Copyright © 2017 by the Guttmacher Institute.

Reproductive health and family planning needs among HIV-infected women in Sub-Saharan Africa.

PubMed

Sarnquist, Clea C; Rahangdale, Lisa; Maldonado, Yvonne

2013-03-01

Review key topics and recent literature regarding reproductive health and family planning needs for HIV-infected women in Sub-Saharan Africa. Electronic searches performed in PubMed, JSTOR, and Web of Science; identified articles reviewed for inclusion. Most HIV-infected women in Sub-Saharan Africa bear children, and access to antiretroviral therapy may increase childbearing desires and/or fertility, resulting in greater need for contraception. Most contraceptive options can be safely and effectively used by HIV-infected women. Unmet need for contraception is high in this population, with 66- 92% of women reporting not wanting another child (now or ever), but only 20-43% using contraception. During pregnancy and delivery, HIV-infected women need access to prevention of mother-to-child transmission (PMTCT) services, a skilled birth attendant, and quality post-partum care to prevent HIV infection in the infant and maximize maternal health. Providers may lack resources as well as appropriate training and support to provide such services to women with HIV. Innovations in biomedical and behavioral interventions may improve reproductive healthcare for HIV-infected women, but in Sub-Saharan Africa, models of integrating HIV and PMTCT services with family planning and reproductive health services will be important to improve reproductive outcomes. HIV-infected women in Sub-Saharan Africa have myriad needs related to reproductive health, including access to high-quality family planning information and options, high-quality pregnancy care, and trained providers. Integrated services that help prevent unintended pregnancy and optimize maternal and infant health before, during and after pregnancy will both maximize limited resources as well as provide improved reproductive outcomes.

Male Hormonal Contraception: Looking Back and Moving Forward

PubMed Central

Roth, Mara Y.; Page, Stephanie T.; Bremner, William J.

2015-01-01

Despite numerous contraceptive options available to women, approximately half of all pregnancies in the United States and worldwide are unplanned. Women and men support the development of reversible male contraception strategies, but none have been brought to market. Herein we review the physiologic basis for male hormonal contraception, the history of male hormonal contraception development, currents agents in development, as well as the potential risks and benefits of male hormonal contraception for men. PMID:26453296

Contraceptive needs of the adolescent.

PubMed

Steyn, Petrus S; Goldstuck, Norman D

2014-08-01

The provision of contraception to adolescents requires specific attention. Adolescents require contraceptive methods which are safe, effective and simple to use. While long-acting reversible contraceptive methods are preferable, they should have a choice and not be forced or mandated especially in situations where this may compromise safety. After counselling they should have the ability to choose any method of contraception. Under the appropriate circumstances, each method of contraception may have a place. This chapter will be devoted to evaluating the most current scientific rationale for the indication for use of each method of contraception in adolescents. Copyright © 2014. Published by Elsevier Ltd.

Male contraception: history and development.

PubMed

Kogan, Paul; Wald, Moshe

2014-02-01

Although the twentieth century has seen great strides in the development of female contraception, not a single new agent has been introduced as an approved method for common use for male contraception. Condoms (considered uncomfortable by some) and vasectomy (a permanent invasive procedure) are the only options provided to men, leaving an undue burden on women to bear contraceptive responsibility. Significant developments have, however, been made with regard to hormonal and nonhormonal contraception, and minor, reversible, procedural contraception. This article reviews the currently available, soon to be available, and theoretically possible methods of male contraception. Copyright © 2014 Elsevier Inc. All rights reserved.

Obesity and hormonal contraceptive efficacy.

PubMed

Robinson, Jennifer A; Burke, Anne E

2013-09-01

Obesity is a major public health concern affecting an increasing proportion of reproductive-aged women. Avoiding unintended pregnancy is of major importance, given the increased risks associated with pregnancy, but obesity may affect the efficacy of hormonal contraceptives by altering how these drugs are absorbed, distributed, metabolized or eliminated. Limited data suggest that long-acting, reversible contraceptives maintain excellent efficacy in obese women. Some studies demonstrating altered pharmacokinetic parameters and increased failure rates with combined oral contraceptives, the contraceptive patch and emergency contraceptive pills suggest decreased efficacy of these methods. It is unclear whether bariatric surgery affects hormonal contraceptive efficacy. Obese women should be offered the full range of contraceptive options, with counseling that balances the risks and benefits of each method, including the risk of unintended pregnancy.

An update on emergency contraception.

PubMed

Bosworth, Michele C; Olusola, Patti L; Low, Sarah B

2014-04-01

Emergency contraception decreases the risk of unintended pregnancy after unprotected sexual intercourse or after suspected failure of routine contraception (e.g., a condom breaking). Oral methods include combined contraceptive pills (i.e., Yuzpe method), single- or split-dose levonorgestrel, and ulipristal. The Yuzpe method and levonorgestrel are U.S. Food and Drug Administration-approved for use 72 hours postcoitus, whereas the newest method, ulipristal, is approved for up to 120 hours postcoitus. The copper intrauterine device may be used as emergency contraception up to seven days after unprotected intercourse. It is nonhormonal and has the added benefit of long-term contraception. Advanced provision of emergency contraception may be useful for all patients, and for persons using ulipristal because it is available only by prescription. Physicians should counsel patients on the use and effectiveness of emergency contraception, the methods available, and the benefits of routine and consistent contraception use.

Current contraceptive status among women aged 15-44: United States, 2011-2013.

PubMed

Daniels, Kimberly; Daugherty, Jill; Jones, Jo

2014-12-01

Nearly all women use contraception at some point in their lifetimes, although at any given time they may not be using contraception for reasons such as seeking pregnancy, being pregnant, or not being sexually active. Using data from the 2011-2013 National Survey of Family Growth (NSFG) on contraceptive use in the month of the interview, this report provides a snapshot of current contraceptive status among women aged 15-44 in the United States. In addition to describing use of any method by age, Hispanic origin and race, and educational attainment, patterns of use are described for the four most commonly used contraceptive methods: the oral contraceptive pill, female sterilization, the male condom, and long-acting reversible contraceptives, which include contraceptive implants and intrauterine devices. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

What influences women's contraceptive choice? A cross-sectional study from Turkey.

PubMed

Kahramanoglu, Ilker; Baktiroglu, Merve; Turan, Hasan; Kahramanoglu, Ozge; Verit, Fatma Ferda; Yucel, Oguz

2017-01-01

In our study, we tried to investigate the determinants of women's choices about contraception with the aim of discovering whether or not there is a difference in their preferences before and after consultation with a gynaecologist. A total of 1058 women were enrolled. They were given detailed information regarding contraception and contraceptive methods. Subsequently, a survey which was made of 21 questions was administered. Contraceptive counselling significantly changed the contraceptive choice of women. However, influences from social media and friends, their partners and religious belief affected their contraceptive choices. Significant differences in contraceptive choice were observed when women were categorized according to their marital status, education level, household income, age, and number of children. Although contraceptive counselling influenced Turkish women's choices, there were still other determinants like social media and input from outside sources such as clerics and husbands, which should be overcome.

Factors Associated with Contraceptive Use among Women of Reproductive Age in Rural Districts of Burkina Faso.

PubMed

Wulifan, Joseph K; Mazalale, Jacob; Jahn, Albrecht; Hien, Hervé; Ilboudo, Patrick Christian; Meda, Nicolas; Robyn, Paul Jacob; Hamadou, Saidou; Haidara, Ousmane; De Allegri, Manuela

2017-01-01

Given the current low contraceptive use and corresponding high levels of unwanted pregnancies leading to induced abortions and poor maternal health outcomes among rural populations, a detailed understanding of the factors that limit contraceptive use is essential. Our study investigated household and health facility factors that influence contraceptive use decisions among rural women in rural Burkina Faso. We collected data on fertile non-pregnant women in 24 rural districts in 2014. Of 8,657 women, 1,098 used a modern contraceptive. Women having a living son, a child younger than one year, and household wealth were more likely to use modern contraceptives. Women in polygamous marriages and women living at least 5 kilometers from a health facility were less likely to use contraception. We conclude that modern contraceptive use remains weak, hence, programs aiming to encourage contraceptive use must address barriers at both the health facility and the household level.

Determinants of contraceptive use among Nigerian couples: evidence from the 2013 Demographic and Health Survey.

PubMed

Blackstone, Sarah R; Iwelunmor, Juliet

2017-01-01

Nigeria remains a focus for increasing contraceptive use, as it is one of the most populous countries in Sub-Saharan Africa. The objective of the current study was to investigate determinants of contraceptive use in Nigeria couples. Using the 2013 Nigeria Demographic and Health Survey, we estimated the likelihood of contraceptive use based on concordance with male partner desire for family size, male and female fertility preferences, female decision making power, and male partner attitudes toward contraceptive use. Male partner perception that decisions regarding health should be made jointly or primarily by women was positively associated with use. Women were less likely to use contraceptives in couples in which male partners had greater earning power. Finally, men who viewed contraceptives as an enabler for promiscuity had female partners less likely to use contraceptives. These findings highlight the importance of male partners in women's contraceptive decision making.

Informing the introduction of contraceptive implants in the Pacific: a mixed methods study of contraceptive beliefs and behaviours in Tonga.

PubMed

Winn-Dix, Edward A; Nathan, Sally A; Rawstorne, Patrick

2016-04-01

To explore the knowledge and attitudes underlying contraceptive use and non-use among Tongan adults and investigate the potential acceptability of contraceptive implants. A mixed methods study was conducted that used two focus groups and a short self-completed survey (n=109). Participants were recruited from a Tongan non-governmental sexual and reproductive health clinic. Contraceptive method discontinuation was high among the study group, with reasons for discontinuation often relating to misconceptions circulating in the community about the side effects of contraceptives. A high proportion (38%) reported using 'natural' contraceptive methods. A total of 47% of survey participants reported having heard of implants and 37% indicated they would be willing to try them. Current Tongan contraceptive uptake and continuation is hampered by misconceptions about side effects of methods and their risks, particularly among long-acting and reversible methods. Contraceptive implants may be acceptable to Tongans given their arm placement, reversibility and long-lasting effect. Efforts to improve contraceptive continuation in Tonga should focus on improving counselling on potential side effects for all methods. The introduction of contraceptive implants as an additional long-acting reversible method should be considered. © 2015 Public Health Association of Australia.

Perception and practice of contraception among male soldiers in Sobi barracks, Ilorin, Nigeria.

PubMed

Hussain, N A; Akande, T M; Osagbemi, G K; Olasupo, S T; Salawu, K Y; Adebayo, E T

2013-06-01

There is a popular belief among the general population that Nigerian soldiers tend to have large families but this has not been substantiated with evidence-based research. The Nigerian military health authority implements female-targetted contraception strategies, with less focus on their husbands; who are the dominant fertility determinants. To determine the perception and practice of contraception among male soldiers of Sobi Cantonment, Ilorin, Nigeria, with a view to instituting male-targeted contraceptive/family planning strategies. A cross-sectional survey of 334 male soldiers using multistage sampling technique and pre-tested interviewer administered questionnaires. The respondents' approval of contraception (73.6%) and willingness to discuss it with their spouses/partners (71.6%) were high. Fear of wives/partner's sexual promiscuity (55.7%), cultural and religious beliefs (43.2%), fear of the side effects of contraceptives (29.5%) and the desire for more children (21.6%) were reported reasons for the non-approval of contraception. The prevalence of contraceptive use among the respondents was low (12.3%). There was a significant relationship between the respondents' educational level and contraceptive use (p< 0.05). The study revealed a high approval and willingness to discuss contraception with their spouses/partners but low contraceptive use.

Association between college health services and contraceptive use among female students at five colleges in Wuhan, China: a cross-sectional study.

PubMed

Long, Lu; Chen, Zhenhua; Shi, Yun; Wei, Sheng; Nie, Shaofa; Liu, Yi

2016-09-05

College students have a high incidence of unplanned pregnancies in China, which has highly raised public attention. As such, numerous reproductive health services are provided to college students. This study examined whether health services in college lead to contraceptive use among female college students in heterosexual relationships. A self-administered questionnaire survey with cross-sectional design was administered among female students in four colleges in Wuhan, China to identify health service factors associated with contraceptive use in the past 6 months. The analysis revealed that younger female students had lower odds of contraception use, whereas students who reported availability of health-related web sites were more likely to use contraceptives. Female students who reported that contraceptives and birth control counselling were accessible from college health services had greater odds of contraceptive usage. Finally, provision of contraceptives and birth control counselling from school were associated with greater odds of contraceptive use. Contraceptive-related health services play an important role in reducing unintended pregnancies by directly addressing the contraceptive needs of female students. Programs that provide targeted services may help to reduce high rates of unexpected pregnancies among female students in China.

Perceptions of female teenagers in the Tshwane District on the use of contraceptives in South Africa.

PubMed

Tabane, Ntswaleng S; Peu, Mmapheko D

2015-10-22

Perceptions of female teenagers in the Tshwane District contribute to the nonuseand or discontinued use of contraceptives as evidenced by increased levels of unplanned pregnancies. The objective of this study was to explore and describe the perceptions of female teenagers in the Tshwane District on the use of contraceptives. A qualitative, explorative, descriptive approach was followed in this study. The population comprised of pregnant female teenagers who were purposively selected. Data were collected using unstructured individual interviews on a face-to-face encounter in a natural setting. Data were analysed using the discourse method of data analysis. The following perceptions on the use of contraceptives emerged: Perceptions on the use of contraceptives, emotions, contraceptive effects, social pressure and education on contraceptives. Teenagers' perceptions were predominantly negative with unfounded fears. Though the teenagers were aware of the importance of the use of contraceptives, motivation to pursue contraception was lacking. Teenagers verbalised to be uncommitted as well. Various perceptions of female teenagers in the Tshwane District on the use of contraceptives were explored and described. It was noted that all the teenagers interviewed had great remorse and feelings of guilt regarding their behaviour of not using contraceptives.Their need for re-education was cited and seen as motivational enough to encourage the use of contraceptives at primary health care settings. Therefore, the study recommended that health education programmes should be restructured to effectively influence the female teenagers'perceptions positively and to promote the use of contraceptives.

Association of Hormonal Contraceptive Use With Reduced Levels of Depressive Symptoms: A National Study of Sexually Active Women in the United States

PubMed Central

Keyes, Katherine M.; Cheslack-Postava, Keely; Westhoff, Carolyn; Heim, Christine M.; Haloossim, Michelle; Walsh, Kate; Koenen, Karestan

2013-01-01

An estimated 80% of sexually active young women in the United States use hormonal contraceptives during their reproductive years. Associations between hormonal contraceptive use and mood disturbances remain understudied, despite the hypothesis that estrogen and progesterone play a role in mood problems. In this study, we used data from 6,654 sexually active nonpregnant women across 4 waves of the National Longitudinal Study of Adolescent Health (1994–2008), focusing on women aged 25–34 years. Women were asked about hormonal contraceptive use in the context of a current sexual partnership; thus, contraceptive users were compared with other sexually active women who were using either nonhormonal contraception or no contraception. Depressive symptoms were assessed with the Center for Epidemiologic Studies Depression Scale. At ages 25–34 years, hormonal contraceptive users had lower mean levels of concurrent depressive symptoms (β = −1.04, 95% confidence interval: −1.73, −0.35) and were less likely to report a past-year suicide attempt (odds ratio = 0.37, 95% confidence interval: 0.14, 0.95) than women using low-efficacy contraception or no contraception, in models adjusted for propensity scores for hormonal contraceptive use. Longitudinal analyses indicated that associations between hormonal contraception and depressive symptoms were stable. Hormonal contraception may reduce levels of depressive symptoms among young women. Systematic investigation of exogenous hormones as a potential preventive factor in psychiatric epidemiology is warranted. PMID:24043440

A Statistical Assessment of Information, Knowledge and Attitudes of Medical Students Regarding Contraception Use.

PubMed

Simionescu, Anca A; Horobet, Alexandra; Belascu, Lucian

2017-12-01

To evaluate how contraception use is linked to information, knowledge and attitudes towards family planning and contraception of medical students. This is a voluntary cross-sectional study using an anonymous questionnaire applied to 62 medical students. The questionnaire had the following main structure: characteristics of the studied population, information on contraception, knowledge about contraception methods, attitudes regarding family planning and contraception, and contraception use. Statistical analysis was performed using STATISTICA 8.0 software and statistical significance of the data was verified using the t-statistic test. The survey had a 95% response rate. Seventy seven percent of the studied population consisted of females aged between 20-40 years, with 85.50% of them being 20-25 years old. The overwhelming majority of respondents believed it was important to be informed on the subject and considered themselves to be well informed on contraception. The internet and courses are the main sources of information. Of all respondents, 75.41% had routine discussions with their partners regarding contraception, 53.23% talked about it with family members and 46.77% with their physician; 90.16% had at least one gynecological examination and 47.54% got themselves tested for sexually transmitted diseases. The condom and the contraceptive pill were the main contraceptive methods for the respondents. Romanian medical students share similar features to their peers in European developed countries. We used a statistical analysis to demonstrate that information, knowledge and attitudes on contraception are closely linked to contraceptive choice.

Contraceptive prevalence and preference in a cohort of south–east Nigerian women

PubMed Central

Egede, John Okafor; Onoh, Robinson Chukwudi; Umeora, Odidika Ugochukwu Joannes; Iyoke, Chukwuemeka Anthony; Dimejesi, Ikechukwu Benedict Okechukwu; Lawani, Lucky Osaheni

2015-01-01

Background Rates of fertility, population growth, and maternal deaths in Nigeria are among the highest in the world, with an estimated 4% of all births being unwanted and 7% mistimed. These are caused mainly by nonuse, inappropriate choice, and difficulty in accessing contraceptive commodities. The purpose of this study was to determine the prevalence and factors influencing the choice and sources of contraceptive options among market women in Ebonyi State, Nigeria. Methods This was a questionnaire-based, cross-sectional, descriptive study involving 330 market women of reproductive age in Abakaliki, Ebonyi State, Nigeria. A survey was carried out to identify their knowledge, use, and sources of contraception and the factors that influence their contraceptive practices. Results Knowledge of contraception was high (275 [83.3%]), and 229 (69.4%) of the study population approved of contraceptive use. However, only 93 (28.3%) of the respondents were currently using any form of contraception. Fifty-four women (16.3%) were using modern methods. The commonly used forms of modern contraception were the barrier method (male condoms, 27 [8.2%]), the oral contraceptive pill (10 [3.0%]), injectables (8 [2.5%]), and the intrauterine contraceptive device (7 [2.0%]). The most common source of contraceptive products was patent medicine dealers (58 [51%]). The main barriers to use of contraception were desire for more children (86 [26.1%]), religious prohibition (62 [18.8%]), spousal disapproval (32 [9.7%]), and the perceived side effects of modern contraceptives (25 [7.6%]). There was a significant association for approval of contraception when the model was adjusted for religion (odds ratio [OR] 0.39, 95% confidence interval [CI] 0.18–0.84; P=0.02); educational status (OR 2.84, 95% CI 0.96–8.40; P=0.04); parity (OR 1.78, 95% CI 1.09–2.85; P=0.03); and social class (OR 2.54, 95% CI 1.26–5.11; P=0.01). Conclusion There is good knowledge about contraception among Nigerian women, but use of these products is low. The main barriers to use of contraception are the desire for more children, religious prohibition, and spousal disapproval. PMID:26045662