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PubMed2003

Can women's childbearing and contraceptive intentions predict contraceptive demand? Findings from a longitudinal study in Central India.

CONTEXT: To predict the need for contraceptive services, family planning program managers often rely on levels of unmet need derived from measures of childbearing intentions. However, women's intention to use a method has not received as much attention as a measure of contraceptive demand. METHODS: A survey was conducted in 1999 in rural Madhya Pradesh, India, among a subsample of women who had participated in the 1992-1993 National Family Health Survey (NFHS). The women's childbearing and contraceptive behaviors were compared with the intentions they had stated in the NFHS, and logistic regression was performed to analyze the association between socioeconomic and demographic variables and inconsistent behavior. RESULTS: Among women who were fecund and married in 1992-1993, 29% of those who intended to have children and 61% of those who intended not to have children failed to adhere to their intentions by 1999. Furthermore, 51% of women who were not practicing contraception at the time of the NFHS but planned to do so acted against their intention by 1999, as did 29% of those who planned not to use a method. NFHS respondents who intended both not to have children and to use a method were more likely than others to have used a method by 1999 (63% vs. 25-41%). Age and history of child death were key factors associated with inconsistency between women's intentions and behavior. CONCLUSIONS: In India, use of both contraceptive and childbearing intentions predicts contraceptive demand better than use of either indicator alone, and may thus help program planners estimate future demand for contraceptive services.

Adolescent↗
PubMed1976

[Patterns of sexual behavior. A study on gynecological patients (author's transl)].

With a standard questionnaire 7356 lying-in patients at the Department of Obstetrics and Gynecology, University Erlangen-Nürnberg, were asked about their social background and their sexual habits. First of all some statistical facts concerning the frequency of distribution: 20% of all women questioned had their first cohabitation before the age of seventeen. 53% had sexual intercourse with one man, 23% with two, the remainder with more than two men. Quite a number of social characteristics influenced the sexual behavior of women. Thus it was shown that women have their first cohabitation before the age of eighteen the sooner the lower their social status is and the more partners they had. Insufficient contraceptive precautions or the neglect of any contraception were mainly met with women of lower social status. The same correlation could be found between contraceptive behavior on the one hand and the parameters education and strong religious commitment on the other hand. In rural aereas contraceptive measures were used insufficiently or less often then in urban communities.

Adolescent↗
PubMedDate not supplied

Factors affecting British teenagers' contraceptive use at first intercourse: the importance of partner communication.

CONTEXT: Despite the growing body of knowledge about teenager's sexual and contraceptive behavior in the United Kingdom, much quantitative work has failed to consider the broader social contexts in which this behavior occurs. METHODS: A 1999 survey of 963 full-time students aged 16-18 gathered information on individual, contextual and background factors. Logistic regression analyses were conducted to investigate how these factors determine use of a modern method at first sex and whether such use is discussed beforehand. RESULTS: Three factors were significantly associated with the odds of contraceptive use at first sex among young men-discussing contraception beforehand (odds ratios, 5.7-13.8), giving an intimate reason for having sex the first time (6.4) and having parents who portrayed sexuality positively during childhood and the early teenage years (1.2). For young women, five factors significantly predicted use-communication (odds ratios, 6.2-15.0), age at first sex (1.8), not having visited a service provider (5.0), feeling comfortable interacting with teenage males (1.2) and "sort of" or not expecting to have sex (0.2 and 0.4, respectively). Among young men, the factors significantly associated with the odds of having discussed contraception were the level of social deprivation, the length of the relationship and parents' openness to talking about sex; among young women, the factors were the number of intimate reasons given for having sex and the warmth and availability of parents. CONCLUSIONS: Efforts to increase young people's ability to negotiate sexual and contraceptive decision-making should be multifaceted. It is essential that parents provide a supportive climate throughout childhood and adolescence, where discussions of sexual issues are acceptable and where families feel comfortable talking openly.

Adolescent↗
PubMedDate not supplied

Adolescent males' orientation toward paternity and contraception.

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.

Adolescent↗
PubMedDate not supplied

Personal narratives of adolescent mothers-to-be: contraception, decision making, and future expectations.

Results not discussed in a previously published qualitative study (Spear, 2001) are presented in this article. Analysis of the personal narratives of eight pregnant adolescents who attended an alternative school for pregnant teens yielded the following categories: decision making, contraceptive behavior and sexual attitudes, and future expectations. The findings revealed that decisions regarding pregnancy were made with little deliberation and some participants implied that pregnancy was planned. Although knowledgeable about how to prevent pregnancy, participants did not consistently practice contraception and their sexual experiences were marked by indifference and lacked intimacy. Future expectations consistently included support from the fathers of their unborn children. Implications for nursing practice and further research are discussed.

Adaptation, Psychological↗
PubMed2003

Reproductive health counseling at pregnancy testing: a pilot study.

OBJECTIVES: To pilot brief reproductive health counseling for women obtaining pregnancy testing in a managed-care setting who did not desire pregnancy. METHODS: Women received counseling, access to contraception and a booster call at 2 weeks. Changes in contraceptive behavior were evaluated. RESULTS: Of 85 women who completed counseling, 58 (68%) completed follow-up. Participants reported that counseling was useful at baseline (94%) and follow-up (83%). The staff found the intervention important (100%) and implementation feasible (100%). Forty-one percent of participants improved their use of contraception (from no use or from less effective use to more effective use). Twenty-nine percent continued highly effective use and 9% recessed from highly effective use. Of 22 participants with risk of sexually transmitted disease, 3 (14%) began using condoms consistently, while 1 (5%) continued using condoms consistently. CONCLUSIONS: Counseling at pregnancy testing was well accepted by the staff and participants. Observed behavioral changes suggest that this intervention may be effective in increasing effective use of contraception.

Adolescent↗
PubMed1989

Factors influencing selected heterosexual male college students' condom use.

This study assessed selected heterosexual male college students' use of condoms, their reasons for using condoms, and their attitudes toward sexuality and condoms. Three hundred five male subjects completed a questionnaire that assessed class standing, marital status, reasons for using condoms, number of recent sexual partners, intention to use condoms, and attitudes toward sexuality and condoms. Although no relationship between attitudes toward sexuality and attitudes toward condoms was noted, a negative correlation (-.42) was found between attitude toward condoms and intention to use condoms within the next month if the subject were to have intercourse during that time. Recommendations for increasing condom use are presented.

Attitude to Health↗
PubMed1988

Contraceptive use in a sample of young Danish females.

During the period April 1984-February 1985, 4 test samples of totally 380 young Danish women aged 16-20 years old were invited to interview about contraception and sexual behaviour. The response rate was 75.3%. There were 208 (74.0%) who had had sexual debut. Median age was estimated to 16.8 years. At first intercourse 168 (80.8%) used contraception, 36.5% used condom and 36.1% oral contraception (OC). Among teenage-girls with sexual debut before 15 years old 32.5% were unprotected against pregnancy. At the time of the interview 64.4% did use contraception. The most frequently used contraceptive device was OC (46.6%). Teenage-girls changed the contraceptive method from condom to OC after sexual debut. A small proportion of sexually active girls (8%) did not use contraception neither at first intercourse nor at the moment.

Adolescent↗
PubMed1985

Development of a decision aid for women choosing a method of birth control.

The choice of a contraceptive method is complex and difficult. This study identifies issues for concern for women in selecting a birth control method, examines the accuracy of a self-administered questionnaire based upon these outcomes in predicting actual use, and in a preliminary fashion evaluates the usefulness of such an instrument as a decision aid. A questionnaire was designed to assess women's perceptions of the likelihood of each issue of concern for four birth control methods--oral contraceptives, intrauterine device (IUD), diaphragm, and foam or condoms--as well as the relative value of each issue. It was then tested among a convenience sample of 106 women. A weighted score was constructed by combining likelihood and value estimates for each contraceptive method. The method with the highest score was compared with actual contraceptive use and the intention to use such methods in the future. Positive predictive values were highest for pill use (83 percent) and lowest for IUD use (40 percent). While 65 percent of the sample were satisfied with their current method, 60 percent also found the questionnaire helpful. This attitude was most prevalent among younger, unmarried women. A decision aid for contraceptive decision making appears to be reasonably predictive of actual contraceptive use and helpful in thinking about the choice of a birth control method.

Adolescent↗
PubMedDate not supplied

AIDS beliefs in young women: are they related to AIDS risk-reduction behavior?

Little is known about the relationship between AIDS beliefs and AIDS risk-reduction behavior, especially in young heterosexual adults. This study explores young women's beliefs and behavior regarding AIDS. The results of this exploratory study indicate that college women generally see AIDS as serious, do not see themselves as susceptible, and are uncertain if AIDS beliefs influence their contraceptive behavior. Higher susceptibility scores are consistently correlated with AIDS risk-reduction behavior, and women who believe that AIDS affects their contraceptive use are more likely to use condoms. Implications for practice and strategies to increase susceptibility in women at risk are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed2002

Unintended pregnancy in a commercially insured population.

OBJECTIVES: While much attention has been focused on unintended pregnancy in disadvantaged populations, few studies have focused on women in lower risk groups. This study, conducted in a national managed care organization, reports the prevalence of unintended pregnancy resulting in live births and examines associated factors METHODS: Women ages 18-49 who delivered a live infant during a 6-month interval were eligible for the study. Telephone surveys were conducted after delivery. We report the rate of unintended pregnancy resulting in a live birth, and describe its association with sociodemographic and pregnancy-related factors, partner's intention status, and contraceptive use. RESULTS: Of 1173 births, 29% were unintended. Women who reported that the partner did not want the pregnancy were 7.4 times more likely than women whose partner wanted the pregnancy to regard the pregnancy as unintended. Only 40% of the women with an unintended birth used birth control and 64% of those used less effective methods such as condoms and diaphragms. CONCLUSIONS: In a population where the majority of women were married, educated, and with incomes over $40,000, almost 1/3 of the births resulted from unintended pregnancies. Future research is needed to help us better understand contradictions in pregnancy intention and contraceptive behavior. Comprehensive efforts are needed to promote consistent and correct use of contraception by women at risk for unintended pregnancy, and to involve male partners in family planning.

Adolescent↗
PubMedDate not supplied

Women's contraceptive attitudes and use in 1992.

Women aged 15-44 rate the pill, the condom, vasectomy and female sterilization most highly, according to 1992 data from an annual survey by Ortho Pharmaceutical Corporation of contraceptive attitudes and method use. The 6,955 survey respondents underrepresent women who are black or who have household annual incomes greater than $50,000, but they are similar to all American women in age, marital status and region of the country. About 74-84% of women giving an opinion view these methods favorably and 64% rate the hormonal implant favorably. The proportion of unmarried women who had had intercourse increased from 76% in 1987 to 86% in 1992. As a result, proportions of women at risk of unintended pregnancy rose from 72% to 77%. Contraceptive use also rose, from 92% to 94%. The most commonly used method is the pill (39%), followed by the condom (25%), female sterilization (19%) and vasectomy (12%). Married women exposed to the risk of unintended pregnancy are more likely to use sterilization (48%), while unmarried women are more likely to use the pill (52%) and the condom (33%). Pill use has increased since 1987, especially among married women, and condom use has increased among all women. Among unmarried women at risk of unintended pregnancy, condom use rose from 18% in 1987 to 33% in 1992. Among condom users, 40% of unmarried users and 13% of married users also use another method.

Adolescent↗
PubMed1991

Adolescents' perceptions of risk for HIV infection: implications for future research.

Few studies have investigated adolescents' perceptions of their risk for HIV infection. Findings from two studies of adolescents in Massachusetts indicate that there are differences in the knowledge, beliefs, behaviors, and perceptions of risk among adolescents and suggest the need for understanding the differences among adolescents from different racial or ethnic backgrounds. In both studies, white students were the most knowledgeable about casual, sexual, and drug use transmission of HIV followed by black, Hispanic, and Asian students. In both studies more black adolescents than other racial or ethnic groups were sexually active, and black and Hispanic adolescents began having sexual intercourse at an earlier age than white or Asian adolescents. Asian and Hispanic adolescents were most worried about getting AIDS. Although more Hispanics than other groups reported changing their behavior because of AIDS, fewer of them who had changed their sexual or contraceptive behavior were using effective methods. Despite clear differences in the perceived risk of getting AIDS among these adolescents, the underlying reasons remain to be explicated, using, among other data collection methods, ethnographic techniques to probe adolescents' risk perceptions, their understandings of sickness, and their explanatory models of AIDS. Life events affect risk taking behaviors and also shape perceptions of risk. To understand what it is that adolescents consider 'risky' requires seeing their life options as they do in the larger context of their aspirations and worries about how 'to fit in'.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Premature discontinuation of contraception in Australia.

Life-history data from a nationally representative survey of Australian women were used to examine discontinuation of contraceptive methods because of accidental pregnancy, side effects or dissatisfaction. The pill was the most successfully used method, with a first-year discontinuation rate of 10% for all three reasons. Side effects dominated the reasons for the premature discontinuation of both the pill and the IUD, while the reasons for discontinuing the condom stemmed equally from pregnancy and dissatisfaction with the method. Discontinuation of the diaphragm resulted largely from accidental pregnancy. Hazards models were used to identify the correlates of discontinuation of each method. Predictors of premature discontinuation reflect the availability of methods, physiological reactions to them and the social characteristics of their users. Discontinuation of the pill because of side effects or dissatisfaction was more likely among poorly educated women, non-Protestants and recent users, and less likely among teenagers. Discontinuation of the IUD was related entirely to physiological factors: Nulliparous women and users of unmedicated devices were at a greater risk than other women of accidental pregnancy, and nulliparous women were at greater risk of discontinuation associated with side effects. Nulliparous women were also more likely to discontinue the condom because of pregnancy, as were non-Protestants and the Australian-born.

Adolescent↗