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PubMed2000

Risk factors for pelvic inflammatory disease in inner-city adolescents.

OBJECTIVE: To determine risk factors associated with pelvic inflammatory disease (PID) among inner-city adolescents. STUDY DESIGN: A case-control study was performed from 1994 to 1997 in an inner-city hospital. METHODS: Seventy-one adolescent girls diagnosed with PID and 52 sexually active adolescents girls without PID participated in a confidential face-to-face interview using a questionnaire about risk behaviors. Established criteria were used for the diagnosis of PID. Data were analyzed using t tests, chi-square tests, and stepwise logistic regression. RESULTS: Persons with PID were significantly more likely to show younger age at first intercourse, older sex partners, involvement with a child protection agency, prior suicide attempt(s), consumption of alcohol before last sex, and a current Chlamydia trachomatis infection. There were no significant differences between the two groups regarding number of lifetime sex partners, condom use, rape, syphilis, prior PID, hepatitis B, hepatitis C, or HIV infection. CONCLUSIONS: Not previously noted in the literature are the association of PID with older sex partners, prior involvement in a child protection agency, and a prior suicide attempt. Confirming prior studies are the association of PID with earlier age at first sex, alcohol use, and C trachomatis infection.

Adolescent↗
PubMed2000

Risk factors for pre-cancerous lesions of the cervix.

Studies on risk factors for pre-cancerous lesions of the uterine cervix have shown strong association with sexual practice. Women with multiple sexual partners and intercourse at early age are at high risk. A role of male partners in further enhancing the risk has been identified. All these support the hypothesis relating to a sexually transmissible aetiological agent. An extensive review of the literature on the risk factors for pre-cancerous lesions of cervix has been carried out. The risk factors were grouped into genital, sexual, chemical, dietary and life factors. Human papilloma virus (HPV) is the major infectious aetiological agent associated with the development of pre-cancerous lesions of cervix. Other co-factors such as multiple sexual partners of the male as well as the female and early age of first intercourse are also involved at the critical aetiological step of progression from low-grade to high-grade lesions. The role of other infectious agents in terms of supportive or interactive effects is not clear. No independent effect for herpes simplex virus 2 on risk is observed. Other risk factors include cigarette smoking, oral contraceptive usage, certain nutritional deficiencies and poor personal hygiene. However, it is not clear whether these factors operate independently from HPV. There is no consistency in the independent effect of these factors on the development of low- to high-grade lesions of cervix. There is a similarity in the patterns of risk between pre-cancerous lesions of the cervix and cervical cancer. Monogamy, late commencement of sexual activity, personal hygiene and use of barrier contraceptive methods help towards primary prevention. In the long-term, primary prevention of cervical neoplasia through HPV immunization of population may be a possibility.

Coitus↗
PubMedDate not supplied

The sexual and reproductive behavior of American women, 1982-1988.

Comparison of 1988 data from the National Survey of Family Growth with 1982 data reveals that the proportion of U.S. women who have had sexual intercourse rose slightly, from 86 percent to 89 percent. Among teenagers, the proportion sexually active rose from 47 percent to 53 percent; most of the change is attributable to increases occurring among white and nonpoor teenagers, thus narrowing racial and income differences. Among women aged 15-44 in 1988 who have ever had intercourse, 67 percent reported that they had had two or more sexual partners in their lifetime. The proportion was highest among women aged 20-34 (about 70 percent), but 58 percent of sexually active teenage women reported having had two or more sexual partners. About 67 percent of women of reproductive age in 1988 were exposed to the risk of unintended pregnancy, up from 63 percent in 1982. Among these women, 35 percent rely on contraceptive sterilization to prevent pregnancy and 55 percent use reversible methods, while 10 percent use no method. Poor women are much more likely than nonpoor women to be using no method of contraception (15 vs. eight percent); among poor teenagers, this proportion reaches 25 percent. The level of contraceptive use at first intercourse among teenage women improved substantially between 1982 and 1988, however, rising from 48 percent to 65 percent. During 1984-1988, almost four in 10 births and almost six in 10 pregnancies among American women were unintended; most of these were mistimed, but 12 percent of births were unwanted ever.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2001

Viewpoints of Korean senior high school students on school-based sex education.

The percentage of sexually experienced young persons in South Korea has increased and the age of first intercourse has lowered significantly. However, these marked changes in the sexual behavior of young people have been taking place when schools in the country still generally lack a realistic sex education program. Given this situation, the aim of this study is to gather student opinions on current school-based sex education in Korea. A self-administered questionnaire survey was conducted in Seoul, Incheon, and Kyunggi Province to assess the status and needs of high school sexuality education. Survey data was obtained from 1,160 senior high school students. In this study 68.8% of boys and 94.4% of girls had some school-based sex or sexuality education. The mean hours of sex education instruction of boys and girls were 2.29 and 3.39 hours respectively. There are several reasons for not being satisfied with sex education in schools. Lack of information was the first reason in all categories. About seventy-four percent of respondents felt that the sex education taught in schools did not cover the information that they want. The second reason was that there was no trained sex education teacher. Lack of materials, interactive teaching method, and time were the other reasons given. They advocated starting sex education in elementary school and covering all topics by the age-appropriate level. More than half supported that sex education should be made compulsory in schools.

Adolescent↗
PubMed1994

Risk factors for invasive cervical cancer in Kenyan women.

BACKGROUND: Few epidemiological investigations of invasive cervical cancer have been conducted in Sub-Saharan African populations. METHODS: Using information collected as part of the hospital-based World Health Organization (WHO) Collaborative Study of Neoplasia and Steroid Contraceptives, we examined potential risk factors for invasive cervical cancer among Kenyan women. In all 112 women with histologically confirmed invasive cervical cancer diagnosed at the Kenyatta National Hospital, Nairobi, Kenya, between June 1981 and September 1988 and 749 control subjects were included in the present analyses. All women were interviewed regarding their medical and reproductive history, methods of birth control, and history of sexual relationships and sexually transmitted infections. Multiple logistic regression procedures were used to derive maximum likelihood estimates of adjusted odds ratios (OR) and 95% confidence intervals (CI). RESULTS: After adjusting for age, several factors were found to be associated with invasive cervical cancer. These include multiple sexual partners, early age at first sexual intercourse (OR = 1.9 and 2.6 for women reporting first intercourse at age 16-17 years and < 15 years, respectively, compared to women with first intercourse > or = 18 years), history of abnormal vaginal discharge (OR = 13.8, 95% CI: 8.3-23.0), and history of gonorrhoeal infection (OR = 3.2, 95% CI: 1.6-6.2). Low educational attainment and multiparity were also associated with the risk of invasive cervical cancer. Although the Papanicolaou smear has been extensively used as a screening method for cervical cancer in many countries, only three cases and four controls reported ever having a Papanicolaou smear (2.6% cases and 0.5% of controls). CONCLUSIONS: As has been observed in other parts of the world, cervical neoplasia in Kenya appears to be a late consequence of venereally transmitted carcinogenic agents.

Adolescent↗
PubMed1998

Sexual behavior and contraceptive knowledge and use among adolescents in developing countries.

This article offers an overview of sexual behavior and contraceptive knowledge and use among adolescent women across a large number of developing countries. The results demonstrate that almost universally in sub-Saharan Africa and in the majority of countries in other regions, the gap between age at first sexual intercourse and age at first marriage has increased across age cohorts. The predominant pattern is one in which both age at marriage and age at first intercourse have risen, but the increase in age at marriage is greater, resulting in a widening gap. In most countries in sub-Saharan Africa, current contraceptive use is higher among sexually active, unmarried teens than it is among married teens, whereas in Latin America and the Caribbean, current-use levels are higher among married teens. The results also show that adolescents are unlikely to use a contraceptive the first time they have sex and are more likely than older women to experience a contraceptive failure.

Adolescent↗
PubMedDate not supplied

Age differences between sexual partners in the United States.

CONTEXT: Researchers have examined the age of partners of young women at first intercourse and of young women who have given birth, but little is known about the age of partners of young women in current sexual relationships or young women who have had an abortion. METHODS: Data from the 1995 National Survey of Family Growth (NSFG) were used to examine age differences between women and their current partner and women's use of contraceptives at last intercourse, by marital status and by the age difference between women and their partner. Data from the NSFG and the 1994-1995 Alan Guttmacher Institute Abortion Patient Survey, with supplemental information from other sources, were used to estimate 1994 pregnancy rates for women by their age and marital status, according to the age difference between the women and their partner. RESULTS: Among all sexually active women aged 15-44, 10% had a partner who was three or more years younger, 52% a partner who was within two years of their age, 20% a partner who was 3-5 years older, and 18% a partner who was six or more years older. In contrast, 64% of sexually active women aged 15-17 had a partner within two years of their age, 29% a partner who was 3-5 years older, and 7% a partner who was six or more years older. Among women younger than 18, the pregnancy rate among those with a partner who was six or more years older was 3.7 times as high as the rate among those whose partner was no more than two years older. Among women younger than 18 who became pregnant, those with a partner who was six or more years older were less likely to have an unintended pregnancy (70%) or to terminate an unintended pregnancy (21%) than were those whose partner was no more than two years older (82% and 49%, respectively). Among women younger than 18 who were at risk of unintended pregnancy, 66% of those who had a partner who was six or more years older had practiced contraception at last sex, compared with 78% of those with a partner within two years of their own age. Young women who were Catholic and those who had first had sex with their partner within a relatively committed relationship were less likely to be involved with a man who was six or more years older than were young women who were Protestants and those who first had sex with their partner when they were dating, friends or had just met. Young women who had ever been forced to have sex were twice as likely as those who had not to have a partner who was 3-5 years older. CONCLUSION: Although the proportion of 15-17-year-old women who have a much older partner is small, these adolescents are of concern because of their low rate of contraceptive use and their relatively high rates of pregnancy and birth. Research is needed to determine why some young women have relationships with an older man, and how their partner's characteristics affect their reproductive behavior.

Abortion, Induced↗
PubMed2001

Dating violence against adolescent girls and associated substance use, unhealthy weight control, sexual risk behavior, pregnancy, and suicidality.

CONTEXT: Intimate partner violence against women is a major public health concern. Research among adults has shown that younger age is a consistent risk factor for experiencing and perpetrating intimate partner violence. However, no representative epidemiologic studies of lifetime prevalence of dating violence among adolescents have been conducted. OBJECTIVE: To assess lifetime prevalence of physical and sexual violence from dating partners among adolescent girls and associations of these forms of violence with specific health risks. DESIGN, SETTING, AND PARTICIPANTS: Female 9th through 12th-grade students who participated in the 1997 and 1999 Massachusetts Youth Risk Behavior Surveys (n = 1977 and 2186, respectively). MAIN OUTCOME MEASURES: Lifetime prevalence rates of physical and sexual dating violence and whether such violence is independently associated with substance use, unhealthy weight control, sexual risk behavior, pregnancy, and suicidality. RESULTS: Approximately 1 in 5 female students (20.2% in 1997 and 18.0% in 1999) reported being physically and/or sexually abused by a dating partner. After controlling for the effects of potentially confounding demographics and risk behaviors, data from both surveys indicate that physical and sexual dating violence against adolescent girls is associated with increased risk of substance use (eg, cocaine use for 1997, odds ratio [OR], 4.7; 95% confidence interval [CI], 2.3-9.6; for 1999, OR, 3.4; 95% CI, 1.7-6.7), unhealthy weight control behaviors (eg, use of laxatives and/or vomiting [for 1997, OR, 3.2; 95% CI, 1.8-5.5; for 1999, OR, 3.7; 95% CI, 2.2-6.5]), sexual risk behaviors (eg, first intercourse before age 15 years [for 1997, OR, 8.2; 95% CI, 5.1-13.4; for 1999, OR, 2.4; 95% CI, 1.4-4.2]), pregnancy (for 1997, OR, 6.3; 95% CI, 3.4-11.7; for 1999, OR, 3.9; 95% CI, 1.9-7.8), and suicidality (eg, attempted suicide [for 1997, OR, 7.6; 95% CI, 4.7-12.3; for 1999, OR, 8.6; 95% CI, 5.2-14.4]). CONCLUSION: Dating violence is extremely prevalent among this population, and adolescent girls who report a history of experiencing dating violence are more likely to exhibit other serious health risk behaviors.

Adolescent↗
PubMed1977

Rarity of cancer of the cervix in the Malaysian Orang Asli despite the presence of known risk factors.

Cancer of the cervix is exceedingly uncommon in the Malaysian Orang Asli (aborigine), despite the presence of factors associated with an increased risk of developing this malignancy. In only three patients was the diagnosis of carcinoma of the cervix established, out of a total of nearly 18,000 female inpatients, admitted to the Gombak Orang Asli Hospital over a 13-year period. Over this same period, 81 female patients were diagnosed as having cancer. Interviews with female Orang Asli patients show the presence of alleged risk factors for cervical cancer, including early age of first intercourse, multiparity and non-circumcision of husbands. The low incidence of cancer of the cervix in this aborigine community may be due to the strict moral code of the Orang Asli, limiting extramarital sexual activity and associated venereal infection.

Adolescent↗
PubMed2006

Carcinoma of the cervix and tobacco smoking: collaborative reanalysis of individual data on 13,541 women with carcinoma of the cervix and 23,017 women without carcinoma of the cervix from 23 epidemiological studies.

Tobacco smoking has been classified as a cause of cervical cancer, but the effect of different patterns of smoking on risk is unclear. The International Collaboration of Epidemiological Studies of Cervical Cancer has brought together and combined individual data on 13,541 women with and 23,017 women without cervical carcinoma, from 23 epidemiological studies. Relative risks (RRs) and 95% confidence intervals (CIs) of carcinoma of the cervix in relation to tobacco smoking were calculated with stratification by study, age, sexual partners, age at first intercourse, oral contraceptive use and parity. Current smokers had a significantly increased risk of squamous cell carcinoma of the cervix compared to never smokers (RR = 1.60 (95% CI: 1.48-1.73), p<0.001). There was increased risk for past smokers also, though to a lesser extent (RR = 1.12 (1.01-1.25)), and there was no clear trend with time since stopping smoking (p-trend = 0.6). There was no association between smoking and adenocarcinoma of the cervix (RR = 0.89 (0.74-1.06) and 0.89 (0.72-1.10) for current and past smokers respectively), and the differences between the RRs for smoking and squamous cell and adenocarcinoma were statistically significant (current smoking p<0.001 and past smoking p = 0.01). In current smokers, the RR of squamous cell carcinoma increased with increasing number of cigarettes smoked per day and also with younger age at starting smoking (p<0.001 for each trend), but not with duration of smoking (p-trend = 0.3). Eight of the studies had tested women for cervical HPV-DNA, and in analyses restricted to women who tested positive, there was a significantly increased risk in current compared to never smokers for squamous cell carcinoma (RR = 1.95 (1.43-2.65)), but not for adenocarcinoma (RR = 1.06 (0.14-7.96)). In summary, smokers are at an increased risk of squamous cell but not of adenocarcinoma of the cervix. The risk of squamous cell carcinoma increases in current smokers with the number of cigarettes smoked per day and with younger age at starting smoking.

Adult↗
PubMed1984

Prospective study on the relationship between cervical neoplasia and herpes simplex type-2 virus. I. Epidemiological characteristics.

To determine the risk associated with previous herpes simplex type-2 (HSV-2) infection and possibly other virus infections, a prospective study of cervical neoplasia in more than 10,000 women was performed in the 1975-1983 period. The subjects were selected at random from an alphabetical listing of eligible women living in one district of Prague. At enrollment colposcopy and cervical cytology were performed, a blood sample was taken and data regarding education, socio-economic status, personal habits and sexual and reproduction-associated attributes were obtained from each woman. A total of 10,683 women were enrolled; a complete set of data was obtained in 10,389 women. Women with normal or non-significant findings were invited for further colposcopical and cytological investigations after 2 years and 4 years, the other women were followed at 3- to 6-monthly intervals. In women with highly significant findings, histological investigation was performed. The total of 150 cases of moderate to severe dysplasia (i.e. cervical intraepithelial neoplasia, grade II, CIN II), 83 cases of carcinoma in situ (CIN III) and 21 cases of invasive carcinoma (INCA) were detected. More than 60% of the patients were ill at enrollment, the other cases developed in subjects with originally slightly suspicious (27 CIN II, 17 CIN III, 3 INCA) or negative findings (30 CIN II, 12 CIN III, 3 INCA). Analysis of the data indicated significantly positive correlation of one or more of these clinical conditions with a number of sexual and reproduction-related attributes of which early age at first intercourse was most consistent. Among the other attributes, the smoking habit was associated with the highest risk of developing the disease. A negative correlation of cervical neoplasia with several attributes was demonstrated; of these diathermoelectrocoagulation of the ectopic epithelium and transformation zone of cervix was the most important single protective factor. On the basis of these findings, control subjects were selected for serological studies.

Adult↗
PubMed1984

Prospective study on the relationship between cervical neoplasia and herpes simplex type-2 virus. II. Herpes simplex type-2 antibody presence in sera taken at enrollment.

Sera obtained at enrollment in the study from patients suffering from moderate to sever dysplasia (cervical intraepithelial neoplasia grade II), carcinoma in situ (cervical intraepithelial neoplasia grade III) and invasive carcinoma, or developing any of these conditions in the course of the prospective study, and from control subjects, were examined for herpes simplex type-2 (HSV-2) antibody presence. The controls were matched with the patients by age, age at first intercourse, number of sexual partners, smoking habits and history of diathermoelectrocoagulation of the ectopic epithelium and transformation zone of cervix. Only those subjects were selected as controls who remained free of pathological colposcopical and cytological findings throughout the observation period, i.e. for at least 4 years after their serum sample was obtained. The microneutralization test (MNT) and type-2-specific solid-phase radioimmunoassay (SPRIA) were used as serological tests. No difference in the prevalence of HSV-2 antibody between the patients and controls was revealed by either test. Various combinations of the results from the two tests also failed to show any difference between patients and controls. Moreover, no significant differences were observed in the prevalence of HSV-2 antibody between patients suffering from the various pathological conditions and those diagnosed at enrollment and later in the course of the study. These results do not provide any support for the hypothesis of the involvement of HSV-2 in cervical neoplasia.

Animals↗
PubMed1985

Case control study of cervical cancer in Herrera Province, Republic of Panama.

A previous survey found the average annual age-adjusted incidence of cervical cancer in Herrera Province, Panama, to be 79/100,000, exceeding any other reported world rate. In an effort to clarify the reasons for this excessive occurrence, a case-control study was conducted among patients diagnosed between 1974-1980. Sixty-six percent of cervical cancer patients from Herrera Province were alive and were contacted by the study team; of these 91% were successfully interviewed and provided serum specimens. The total study encompassed 156/169 surviving patients and 309 age-neighborhood matched controls. Sexual promiscuity was uncommon, but it exerted a major effect, with those reporting 4 or more life-time sex partners being at a 4-fold excess risk compared to those reporting only one partner. First intercourse at a young age was common (21% began sexual activity prior to age 16) but it failed to alter risk once number of partners was taken into account. Oral contraceptive use was associated with a 2-fold excess risk and this was not substantially affected by controlling for sexual parameters. Thirty-three percent of the study subjects had anti-herpes-simplex type-2 antibody as measured by both neutralization and radioimmunoassays. Although results of the neutralization test were not predictive of risk, women with a radioimmunoassay indicative of HSV-2 infection were at a 40% excess risk for cervical cancer after adjustment for sexual characteristics.

Adult↗
PubMed1987

Case-control study of human papillomaviruses and cervical cancer in Latin America.

Human papillomavirus (HPV) types 16 and 18 have been implicated as risk factors for cervical dysplasia and neoplasia. However, most studies have been observational, uncontrolled and conducted in populations at low risk for invasive cancer. We report a pilot case-control study of incident invasive cervical cancer in Panama, Costa Rica and Bogota, Colombia. Between July and September 1985 we enrolled 46 consecutive newly diagnosed invasive cervical cancer cases and 51 age-matched control women. Subjects were interviewed and samples collected for HPV DNA assays. HPV infection was defined by a filter in situ DNA hybridization technique under non-stringent and stringent conditions against HPV-6/11, 16 and 18 DNA probes. More cases (91%) than controls (63%) had HPV DNA detected (non-stringent) and more cases than controls had HPV-16 or 18 DNA (67% vs. 43%, p = 0.02). Age at first intercourse was the most significant risk factor for HPV 16/18 infection in all subjects. Smoking was significantly associated with cervical cancer (52% of cases vs. 27% controls) but was not associated with HPV infection.

Adult↗
PubMed2002

A population-based study of squamous cell vaginal cancer: HPV and cofactors.

BACKGROUND: Little is known about the etiology of in situ or invasive squamous cell cancer of the vagina. It is thought that some vaginal cancers may have the same etiology as cervical cancer. It is also not known whether in situ and invasive vaginal cancer share the same etiologic factors. We conducted a study to evaluate risk factors for in situ and invasive vaginal cancer and their potential relationship to prior exposure to human papillomaviruses (HPV). METHODS: A population-based case-control study included 156 women with squamous cell in situ or invasive vaginal cancer diagnosed between January 1981 and June 1998 and 2041 control women identified through random-digit dialing in western Washington state. Cases and controls were interviewed in person and provided blood samples; archival tumor tissue was retrieved for cases. Blood samples were tested for antibodies to HPV, and tumor tissue was tested for HPV DNA. RESULTS: Women with vaginal cancer were more likely to have five or more lifetime sexual partners (OR = 3.1, 95% CI 1.9 to 4.9), to have an early age at first intercourse (<17 years OR = 2.0, 95% CI 1.2 to 3.5), and to be current smokers at diagnosis (OR = 2.1, 95% CI 1.4 to 3.1) than control women. Approximately 30% of all cases had been treated for a prior anogenital tumor, most often of the cervix. Prior hysterectomy was a risk factor only among women who had no history of prior anogenital cancer (OR = 3.9 95% CI 2.5 to 6.1). Antibodies to HPV16 L1 were strongly related to risk of vaginal cancer (OR = 4.3, 95% CI 3.0 to 6.2). We detected HPV DNA in tumor blocks from over 80% of the patients with in situ and 60% of the patients with invasive cancers. CONCLUSIONS: In situ and invasive vaginal neoplasia have many of the same risk factors as cervical cancer, including a strong relationship to HPV infection. Women who have been treated for a prior anogenital cancer, particularly of the cervix, have a high relative risk, although low absolute risk, of being diagnosed with vaginal cancer.

Adolescent↗
PubMed1994

Characteristics of women nonsmokers exposed to passive smoke.

BACKGROUND: Studies that have investigated the association between exposure to passive smoke and increased risk for disease have had inconclusive results and have raised questions about whether women exposed to passive smoke differ from those not exposed. METHODS: The study population included 120 women nonsmokers who reported that they had been exposed to passive smoke in the 24 hr prior to the interview and 213 women who reported no exposure. Women were queried about demographic, lifestyle, sexual, and reproductive factors. RESULTS: Exposed women were younger, less educated, and slightly heavier than nonexposed women. They were more likely to be divorced or separated (OR = 3.3, 95% CI = 1.4-7.6, P = 0.005), to have had first intercourse at or before age 16 (OR = 1.4, 95% CI = 1.0-1.9, P = 0.04), and to have had three or more live births (OR = 2.9, 95% CI = 1.2-6.8, P = 0.02). Women exposed to passive smoke were more likely to have consumed two or more cups of coffee (OR = 2.0, 95% CI = 1.1-3.8, P = 0.03), two or more glasses of beer (OR = 3.7, 95% CI = 1.1-12.5, P = 0.03), or to have smoked marijuana in the past 24 hr (OR = 14.7, 95% CI = 1.8-122.3, P = 0.01) than women who were not exposed. There were no differences noted between exposed and nonexposed women in history of gynecologic diseases or number of cervical microorganisms. CONCLUSION: Women exposed to passive smoke differed from those not exposed on several factors that should be considered in future studies that seek to investigate smoking-related disease risk.

Adolescent↗
PubMed1994

Contraceptive use among women smokers and nonsmokers in the San Francisco Bay area.

BACKGROUND: Women smokers were previously reported to be more sexually active but less likely to use contraception than nonsmokers. Differences in contraceptive choices between the two groups were investigated. METHODS: Sexually active women, 287 who smoked cigarettes and 263 who did not smoke, were queried about current contraceptive use and demographic, sexual, and reproductive factors. RESULTS: Sexually active smokers were less likely than nonsmokers to use contraceptives, especially oral contraceptives. The deficit of contraceptive use among smokers was most pronounced in women under age 30, black women, single women, women with some college education, nulliparous women, women who reported early age at first intercourse, and women who reported four or more lifetime sexual partners. In contrast, smokers were more than twice as likely as nonsmokers to use sterilization (P = 0.002). Among women over age 30, prevalence of contraceptive use was similar between the two groups. Oral contraceptives were used by fewer smokers than nonsmokers who were under age 24 (P = 0.01), had a high school education or less (P = 0.01), and/or had never been pregnant (P = 0.03). CONCLUSIONS: Young, sexually active women who smoked cigarettes were less likely than nonsmokers to have used contraceptives, especially oral contraceptives, while women smokers over age 30 were more likely than nonsmokers to have used sterilization.

Adolescent↗
PubMed1988

Sexual behavior and risk for pelvic inflammatory disease.

Sexual behavior characteristics of 35 patients with pelvic inflammatory disease (PID) and 44 healthy controls was studied prospectively. Patients with PID had sex more often than did controls (P less than 0.001). The mean number of sexual partners or age at first intercourse did not differ significantly between cases and controls. PID patients more often had oral sex than controls (P less than 0.05). These results suggest that sexual behavior characteristics may be important risk factors for PID, and should be prospectively studied in larger populations.

Adult↗