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Biomedical subjects

J Trussell

Publications and source records attributed to J Trussell.

At least 109 records · Page 6Linked to original sources
PubMedDate not supplied

Condom slippage and breakage rates.

A prospective study using two brands of condoms found that of 405 condoms used for intercourse, 7.9% either broke during intercourse or withdrawal or slipped off during intercourse; none of these events were related to condom brand, past condom use or use of additional lubricant. Of the remaining condoms, 7.2% slipped off during withdrawal; slippage was not related to condom brand or past use of condoms, but it was significantly higher when additional lubricant was used.

Adolescent↗
PubMedDate not supplied

Contraceptive failure in the United States: an update.

This report provides an update of the authors' previous estimates of first-year probabilities of contraceptive failure for all methods of contraception. Estimates are provided of failure during typical use (which includes both incorrect and inconsistent use) and during perfect use (correct use at every act of intercourse). The difference between these two probabilities provides a measure of how forgiving of imperfect use each method is. These revisions are prompted by recent studies that provide the first estimates of failure during perfect use for periodic abstinence and the cervical cap, by more complete evaluations of implants, and by the appearance of the Copper T 380A and disappearance of other IUDs from the US market. Also provided is a more complete explanation of how the previous estimate of the probability of becoming pregnant while relying solely on chance should be interpreted, and this estimate is revised slightly downward.

Clinical Trials as Topic↗
PubMedDate not supplied

Contraceptive failure of the ovulation method of periodic abstinence.

Previously published estimates of probabilities of method and user failure for all contraceptive methods suffer from a serious methodological error and are biased downward, with the extent of bias unknown. Data from a World Health Organization clinical trial of the ovulation method of periodic abstinence were used to provide the first correctly calculated measures of method and user efficacy and to determine the characteristics that distinguish women who consciously take risks from those who do not. Probabilities of pregnancy during the first year are 3.1 percent during perfect use (method failure) and 86.4 percent during imperfect use (user failure). Thus, if used perfectly, the ovulation method is very effective. However, it is extremely unforgiving of imperfect use. Because perfect compliance is difficult for many couples who desire intercourse when it is forbidden by ovulation method rules, and because the risk of pregnancy during imperfect use is so great, the ovulation method cannot be considered an ideal contraceptive method for the typical couple, who are likely to be less compliant than couples who volunteer for a clinical trial. The probability of an accidental pregnancy is greatest when any of the three most serious rules--no intercourse during mucus days, within three days after the day of peak fecundity or during times of stress--are broken. Those who have a poor attitude toward the rules are more likely to take risks, including serious risks. Those who get away with taking a risk (i.e., do not get pregnant) are very likely to take risks again. Because breaking the most serious rules entails a 28 percent risk of pregnancy per cycle, those likely to take risks should be counseled about the probable consequences.

Adult↗
PubMedDate not supplied

Teenage pregnancy in the United States.

One out of every 10 women aged 15-19 becomes pregnant each year in the United States. Of these pregnancies, five out of every six are unintended--92 percent of those conceived premaritally, and half of those conceived in marriage. The teenage pregnancy rate is high because only a minority (one in three) of sexually active young women always use contraceptives, and only one in two of these women rely on the most effective methods. The two most common reasons given by adolescents for not using contraceptives are believing that the risk of pregnancy is small, and failing to anticipate intercourse. Experience in other developed countries clearly shows that the incidence of adolescent pregnancy can be reduced if effective contraceptives are made widely available. Although high quality sex education programs that include information about contraception, reproductive biology and responsible sexual behavior can enhance the effectiveness of contraceptive delivery systems, they are not a substitute for the actual provision of services and supplies. However, there is formidable political opposition to the provision of such services by a vocal minority who believe that the crux of the problem is premarital sexual activity, and that lowering the cost of such behavior by reducing the risk of pregnancy will both legitimize adolescent sex and increase its prevalence. Consequently, there is a political impasse that guarantees a continuing large number of adolescent pregnancies. Further, even if contraceptives and sex education were readily available to all adolescents, there would still be a pool of teenagers who would see little benefit in postponing parenthood. This pool would be composed overwhelmingly of the poor and of blacks and Hispanics. Increasing the demand for pregnancy prevention among young women and men in this hard-core, high-risk group will be extremely hard to achieve without a fundamental restructuring of society.

Adolescent↗
PubMedDate not supplied

Contraceptive failure in the United States: a critical review of the literature.

The overall goal of this paper is to provide for the first time a comprehensive critical review of the literature on contraceptive failure in developed countries, primarily the United States. The first two sections of our paper lay the groundwork for a critical assessment of the extensive body of studies on this subject, by systematically exploring the concepts and measurement of contraceptive efficacy and the methodological pitfalls that snare many investigators and compromise their results. The next two sections focus on results in the literature. First we provide a method-by-method critique of the available studies and then we summarize our conclusions in a single table that provides efficacy information necessary for women and couples to make an informed choice of a method of contraception. We close with a set of substantive observations and also a set of methodological recommendations intended to improve the quality and comparability of findings from future research.

Adolescent↗
PubMedDate not supplied

The potential impact of changes in fertility on infant, child, and maternal mortality.

In this paper we explore the relation between changes in reproductive behavior, such as those that might result from an effective family planning program in developing countries, and changes in child and maternal mortality. Specifically, we use the results from recent multivariate studies to estimate the changes in mortality that might result from altering maternal age, birth order, and birth spacing distributions of live births. Our results indicate that if childbearing were confined to the "prime" reproductive ages of 20-34, then infant and child mortality rates would fall by about 5 percent. Limiting childbearing to ages 20-39 may also reduce the maternal mortality ratio by 11 percent. The elimination of fourth and higher order births would reduce the maternal mortality ratio by about 4 percent. Universal adoption of an "ideal" spacing pattern in which all births subsequent to the first are spaced at least two years apart may reduce infant mortality by about 10 percent and child mortality by about 21 percent.

Birth Intervals↗
PubMedDate not supplied

Reproductive mortality.

Explore the source record for details and available documents.

Contraceptives, Oral↗
PubMedDate not supplied

The impact of restricting Medicaid financing for abortion.

If all states observed the Hyde Amendment restrictions, many thousands of Medicaid-eligible women who would have obtained abortions under the 1977 funding policy would not receive them--in addition to the 133,000 who could not get Medicaid-funded abortions in the year preceding the restrictions.

Abortion Applicants↗
PubMedDate not supplied

Contraceptive practice and trends in coital frequency.

Coital frequency among white, continuously married couples increased by 19 percent between 1965 and 1970, but by only five percent between 1970 and 1975. All of the increase in the latter five-year period is connected with a greater concentration of women in pregnancy-exposure and contraceptive-use categories associated with higher coital frequency. Over the five years, individual women who switched to more effective methods did not, on the average, experience as much of a decline in coital frequency as those who changed to less effective methods and those who did not change methods. (Some decline would be expected to be associated with the five-year increase in age.)

Adolescent↗