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PubMed2004

Risk factors for childbearing during adolescence in a population-based birth cohort in southern Brazil.

OBJECTIVE: To use a case-control study to analyze risk factors associated with teenage childbearing among adolescents who were in a birth cohort study that began in 1982 in the city of Pelotas, Rio Grande do Sul, Brazil. METHODS: Adolescent mothers in Pelotas who gave birth between January 1995 and March 2001 and who had been born in 1982 were identified through the local birth information system. These subjects from the 1982 birth cohort were compared to adolescents from the same cohort who had not given birth before March 2001. Standardized interviews were used in 2001 to obtain information about socioeconomic, maternal reproductive, demographic, and lifestyle characteristics. This information was combined with data obtained in earlier phases of this 1982 birth cohort study. Unconditional logistic regression was used to analyze the risk factors associated with childbearing during adolescence. RESULTS: A total of 420 parous adolescents from the 1982 birth cohort were identified and then compared with 408 cohort adolescents who had not given birth by March 2001. Higher family income in 1982 and more parental schooling in 1982 were inversely related to childbearing among the birth cohort adolescents. Cohort girls whose mothers were under age 20 when they gave birth in 1982 had a higher risk of becoming pregnant while still an adolescent. Cohort girls who, during childhood, lived with siblings from different fathers were twice as likely to become an adolescent mother. Compared to cohort adolescents who had not failed during the first four years of school, those girls who had done so had twice the risk of giving birth during adolescence. Among the cohort girls a positive association was found between younger age at first intercourse and childbearing in adolescence. CONCLUSIONS: The results indicate that the educational level of the adolescent mothers must be considered in planning policies that attempt to disrupt successive cycles of socioeconomic deprivation. Early interventions to improve sex education and to increase the motivation of young girls to achieve higher levels of education are needed. The interventions should aim for a reduction in the risk of long-term poverty and poorer educational achievements of teenage mothers and their children.

Adolescent↗
PubMed2004

Community attitudes to the sexual behaviour of young people in an urban area with high rates of sexual ill-health.

CONTEXT: Adults in any community are a potentially important source of sexual health information for young people. Open discussion of sexual health issues is associated with low rates of sexual ill-health. Adults who disapprove of teenage sexual behaviour are poor sources of advice. The study of adult attitudes to the sexual behaviour of young people is relevant to work on improving access to sexual health services. SETTING: Adults' attitudes to the sexual behaviour of young people in an urban area with high indices of sexual ill-health were documented. DESIGN: Data were collected via questionnaires administered in popular shopping areas by local people after training. RESULTS: A total of 283 interviews were completed. Eighty-eight percent of respondents thought that the likely age of first sex among young people was under the age of consent but only 8% thought that the acceptable age of first intercourse was under 16 years. Knowledge of local services was suboptimal. Twenty percent of respondents did not know where young people could get contraception or advice on sexual health issues. Less than half (42%) suggested a general practitioner with a similar proportion suggesting a family planning clinic (FPC) or Brook clinic. When asked what services FPCs provide, only 40% mentioned contraception and 32% did not know. Despite their lack of knowledge, the majority (84%) of respondents would tell a young person where they could obtain contraception or sexual health advice. Seventy-six percent thought parents and 56% thought schools are the key sources of sexual health information for young people. CONCLUSIONS: Adults resident in this area have negative attitudes to the sexual behaviour of local young people and suboptimal knowledge of local contraceptive services. They do, however, identify themselves as potentially important sources of sexual health advice and may therefore benefit from more information and an opportunity to discuss their attitudes.

Adolescent↗
PubMed1984

The association between smoking and sexual behavior among teens in US contraceptive clinics.

A study of teenage women in 32 contraceptive clinics in the United States shows a strong negative relationship between age of first intercourse and the level of cigarette smoking; the association is strong enough to reverse the usual correlation of smoking and age during the teenage years. Preventive, timely contraceptive behavior is also negatively associated to smoking. These findings suggest that interventions could well be designed and located in settings which take this association into account.

Adolescent↗
PubMed1985

Coital and non-coital sexual behaviors of white and black adolescents.

As part of a longitudinal study of young adolescents, data were collected in 1980 on the non-coital and coital sexual experiences of male and female adolescents who ranged in age from 12 to 15 at the time of the initial contact. The follow-up data were collected two years later. Both a Guttman-scale analysis and a longitudinal analysis of these data indicate different sexual patterns between White and Black teens; Whites are more likely than Blacks to engage in a predictable series of non-coital behaviors for a period of time before their first intercourse experience. Of the sexual behaviors studied, the pre-coital experiences of Black teens were less predictable and often involved only necking. These differences in sexual norms offer a partial explanation for the different pregnancy rates between these two groups. They also suggest that sexual and contraceptive education and counseling need to be cognizant of these differences since pre-coital experience may function as both a mechanism to prolong abstinence and to promote a gradual acceptance of one's sexuality.

Adolescent↗
PubMed1990

Prior condom use and the risk of tubal pregnancy.

The relationship between prior condom use and tubal pregnancy was assessed in a population-based case-control study at Group Health Cooperative of Puget Sound during 1981-86. We interviewed 227 women with a tubal pregnancy who had no clinical indication of infertility and no history of sterilization and 674 similarly defined controls who were matched to the cases on age and county of residence. A history of condom use for more than one year was associated with a decreased risk of subsequent tubal pregnancy (RR = 0.74, 95% CI = 0.44, 1.26) adjusted for the effects of age, current use of contraceptive methods, educational level, and age at first intercourse. The effect was more pronounced when condoms had been used during five-year periods with more than one partner (RR = 0.38, 95% CI = 0.15, 1.0) than during five-year periods with one partner (RR = 0.89, 95% CI = 0.45, 1.76). Condom use for less than one year was unrelated to risk of ectopic pregnancy. Since the use of condoms offers protection against sexually transmitted diseases, one or more of which are likely to be causally related to tubal pregnancy, the observed negative association plausibly represents a protective influence of long-term condom use on the occurrence of tubal pregnancy.

Adult↗
PubMed1998

Patterns of condom use among adolescents: the impact of mother-adolescent communication.

OBJECTIVES: The association between the timing of discussions about condoms between mother and adolescent and adolescents' condom use during their first and subsequent sexual encounters was examined. METHODS: Sexually active adolescents reported whether and when they discussed condoms with their mother and answered questions about their own condom use. RESULTS: Mother-adolescent discussions about condoms that occurred prior to sexual debut were strongly associated with greater condom use during first intercourse and most recent intercourse, along with greater lifetime regular condom use. CONCLUSIONS: Discussions about condoms prior to sexual debut are important in promoting condom use among adolescents.

Adolescent↗
PubMed1992

Contributions to the history of psychology: XC. Evolutionary biology and heritable traits (with reference to oriental-white-black differences): the 1989 AAAS paper.

Genetic distance estimates calculated from DNA sequencing indicate that in years since emergence from the ancestral hominid line, Mongoloids = 41,000, Caucasoids = 110,000, and Negroids = 200,000. Data also show that this succession is matched by numerous other differences such that Mongoloids > Caucasoids > Negroids in brain size and intelligence (cranial capacity = 1448, 1408, 1334 cm3; brain weight = 1351, 1336, 1286 gm.; millions of excess neurons = 8900, 8650, 8550; IQ = 107, 100, 85); maturational delay (age to walk alone, age of first intercourse, age of death); sexual restraint (ovulation rate, intercourse frequencies, sexually transmitted diseases including AIDS); quiescent temperament (aggressiveness, anxiety, sociability); and social organization (law abidingness, marital stability, mental health). This pattern is ordered by a theory of r/K reproductive strategies in which Mongoloids are posited to be more K-selected than Caucasoids and especially more than Negroids. (K-selected reproductive strategies emphasize parental care and are to be contrasted with r-selected strategies which emphasize fecundity, the bioenergetic trade-off between which is postulated to underlie cross-species differences in brain size, speed of maturation, reproductive effort, and longevity.) It is suggested that this pattern came about because the ice ages exerted greater selection pressures on the later emerging populations to produce larger brains, longer lives, and more K-like behavior. One theoretical possibility is that evolution is progressive and that some populations are more "advanced" than others. Predictions are made concerning economic projections and the spread of AIDS.

Asian People↗
PubMed1988

Human seminal plasma allergy in India.

Human seminal plasma allergy (HSPA) in women has been documented in the West. We describe here the first case of HSPA reported in India. An 18-year-old married woman presented with a 2-year history of episodic wheezing dyspnea. She had always had local postcoital symptoms since her first intercourse. Systemic symptoms developed subsequently. Despite more than 2 years of unprotected coitus, the patient had not conceived. The intradermal tests with seminal plasma antigen prepared from her husband's semen and from a healthy volunteer were markedly positive in the patient. Similar tests on her husband were negative. HSPA, especially the local forms, may be difficult to identify in our social conditions.

Antigens↗
PubMed1993

Characteristics of young female smokers in a Swedish primary health care area.

OBJECTIVE: To analyse the correlation between smoking, socioeconomic characteristics, and sexual and contraceptive patterns in young women. DESIGN: Cross-sectional population study, smokers compared with non-smokers. SETTING: Nättraby-Hasslö, a rural area in southern Sweden. PARTICIPANTS: All women between 15-34 years of age (n = 541). RESULTS: 26% smoked daily. Smokers on average had less schooling, lower 9th grade results, less satisfaction in school, and more unskilled professions than non-smokers. Apart from a higher parental divorce rate among smokers, no correlation between parental factors and smoking was found. Smokers on average reported an earlier sexual debut, more unprotected first intercourse, more life-time sexual partners, and more legal abortions. CONCLUSION: Smoking is associated with sexual habits, which may reflect a higher tendency to take personal risks among smokers.

Adolescent↗
PubMed2005

Prevalence and risk factors for vaginal candidiasis among women seeking primary care for genital infections in Dar es Salaam, Tanzania.

OBJECTIVE: To determine the prevalence and risk factors for vaginal candidiasis (VC) among women seeking primary care for genital infections. DESIGN: Cross-sectional study. SETTING: Ilala Municipal Hospital in Dar es Salaam, Tanzania. SUBJECTS: Four hundred and sixty four women presenting with complaints of genital infections. RESULTS: Of the 464 women examined, 177 (38.1%) had abnormal vaginal discharge, 68(14.7%) had genital ulcers, 272 (58.6%) had genital pruritus, 18 (3.9%) had genital warts and 58 (12.5%) had chancre. The prevalencies of VC, bacterial vaginosis, HIV, T vaginalis, N. gonorrhoeae and syphilis were 45%, 48.4%, 22%, 93%, 1.5% and 4.3%, respectively. The occurrence of VC was positively associated with HIV, (OR = 1.81, 95% CI (1.0-2.67), bacterial vaginosis; (OR = 2.6, 95% CI (1.7-3.9), genital pruritus; (OR = 1.8 1, 95% CI (1.2-2.7) genital discharge; (OR = 1.867, 95% (1.28-2.73) and negatively with T. vaginalis (OR = 0.27, 95% CI (0.12 - 0.6), occupation (OR = 0.65, 95% CI (0.35-0.86)) and with education (OR = 0.43, 95% CI (0.11-0.73). There were increased but non-significant odds for VC in patients with syphilis (OR = 1.6 95% CI (0.6-4.3) and venereal warts (OR = 2.5 95% CI (0.92-6.8) VC was not associated with N. gonorrhoeae, genital ulcers, age at first intercourse, number of sexual partners, marital status or antibiotic usage. CONCLUSION: The high prevalence of vaginal candidiasis among women with genital infections should be taken into account when updating policies concerning syndromic management of sexually transmitted diseases. More gender specific approach to syndromic management of sexually transmitted infections in females should be considered.

Adult↗
PubMedDate not supplied

Effects of a replication of a multicomponent model for preventing adolescent pregnancy in three Kansas communities.

CONTEXT: A significant amount of attention has been devoted to the complex issue of teenage pregnancy and to programs for reducing pregnancy among adolescents. Careful evaluations of such programs are needed to ascertain what strategies will be most effective at reducing teenage pregnancy. METHODS: A pretest-posttest comparison group design was used to analyze the effects of a comprehensive multicomponent school and community intervention on estimated pregnancy rates and birthrates among young people in three Kansas communities: Geary County, Franklin County and selected neighborhoods of Wichita. RESULTS: There were high levels of program activity in all three communities during the intervention period, including teacher training and sexuality education for students. Survey respondents rated highly such project interventions as the extension of school-linked clinic hours to accommodate student schedules and support groups established in middle schools. Between 1994 and 1997, the proportions of adolescents reporting that they had ever had sex decreased significantly among all ninth and 10th graders in Geary County, from 51% to 38% among females and from 63% to 43% among males. In Franklin County, more males in grades 11 and 12 reported using condoms in 1996 (55%) than had done so in 1994 (39%). Age at first intercourse remained relatively stable in Franklin and Geary counties during the intervention period. The estimated pregnancy rate among adolescents aged 14-17 decreased between 1994 and 1997 in Geary Country, while it increased in comparison areas. The estimated pregnancy rates among 14-17-year-olds decreased in both Franklin County and its comparison communities. The birthrate declined both in one target area of Wichita and in its comparison area from 1991-1993 to 1994-1996. Over the same time period, the birthrate increased in a second target area of Wichita, while it decreased in the comparison community. CONCLUSIONS: This evaluation of a comprehensive multicomponent program for adolescent pregnancy prevention contributes to our understanding of this model and its replicability in diverse communities. Ongoing program evaluation is important for developing initiatives and for refining strategies so they respond to local conditions.

Adolescent↗
PubMed1999

Changes in the sexual lifestyles of young people in Somerset, 1990-1996.

OBJECTIVES: The immediate objective was to up-date knowledge of the socio-sexual lifestyles and AIDS awareness of young people (16-24 years of age) in Somerset, and to compare these 1996 survey findings to the Somerset Survey findings from 1990. The ultimate objective was to provide information to assist the continuing development of HIV risk-reduction and sexual health promotion strategies for young people. DESIGN: An identical schedule-structured survey strategy to that employed in 1990 was undertaken in May to July 1996 among 498 young people throughout Somerset. A quota sampling strategy was undertaken in 50 electoral wards, randomly selected in proportion to population size. The interviews, undertaken in respondents' homes, involved a combined personal interview and self-completion booklet. RESULTS: Between 1990 and 1996 broad shifts in sexual lifestyles were identified, involving earlier ages of first intercourse, slight increases in numbers of sexual partners and more 'casual-recreational' sexual attitudes. These changes were accompanied by a substantial increase in condom use. CONCLUSIONS: The trend among youth in Somerset is towards more open sexual lifestyles, but with the positive public health implications of higher levels of 'safer sex' practice.

Acquired Immunodeficiency Syndrome↗
PubMed1999

Epidemiology of preinvasive lesions.

OBJECTIVE: Review of epidemiological data on pre-invasive cervical lesions. MATERIAL AND METHODS: Literature review and analysis of data from our Department. RESULTS: Prevalence of data on preinvasive cervical lesions varies widely and depends on factors such as differences among countries or regions and among ethnic groups, and especially, differences in the type of population studied. Most important risk factors are: number of sexual partners, smoking, contraceptive use, HPV, age at first intercourse, and screening. CONCLUSIONS: In order to reduce risk, pap smears should be performed regularly, safe sex practices should be recommended, and the use of tobacco products should be avoided.

Adult↗
PubMed1999

Sexual lifestyle of women attending inner-city general practices for cervical smears.

Despite high prevalences of sexually transmitted infections, little is known about the sexual lifestyles of women attending inner-city general practices. Responses from a 1996 questionnaire showed that age at first intercourse and numbers of sexual partners were similar to the national survey five years earlier. However, only 49% of women reporting > or = 2 sexual partners in the past year said their partner had used a condom at the last sexual intercourse.

Adolescent↗
PubMed2000

Trends in fertility and contraception in the last quarter of the 20th century.

The late 1960s and early 1970s saw major changes in access to birth control. This article reviews trends in fertility and contraception between 1976 when the Family Formation Survey was undertaken and 1998, the latest year for which data are available. There has been an increase in mean age at childbirth over the period. Some of this increase is possibly a result of childbearing in second and subsequent relationships when the women will be older on average. This also has had an impact on their patterns of contraception use. Teenage pregnancy is high on the Government's agenda. Teenage pregnancy continues at constant levels. As the estimated age of first intercourse decreases, there is a continued need for sufficient, accessible and appropriate family planning services.

Abortion, Legal↗
PubMed2000

[Psychosexual development and sex life of women with congenital adrenogenital syndrome].

OBJECTIVE: The aim of the study was to examine the psychosexual development and sexual life of 13 adult women with congenital adrenogenital syndrome. DESIGN: A clinical study. SETTING: Psychiatric clinic, Gynecological clinic and Sexological institute, Medical Faculty of the Charles University in Prague. METHODS: The examination was carried out using a structured interview and three tests: MF (Masculinity and feminity), SFW (Sexual function of women) and SAI (Inventory of sexual arousibility). RESULTS AND CONCLUSION: It was ascertained that only about one third of the patients were coitally active and that the first intercourse was delayed. The results of the questionnaire SFW were in 66% subnormal and an adequate sexual arousability was found only in 40% of examined persons (the test SAI).

Adolescent↗
PubMed2000

The relationship between barriers to birth control use and actual birth control use among Mexican-American adolescents.

This study examined the relationship between barriers to using birth control and actual use of birth control among a national sample of Mexican-American adolescents. Participants were either over age 15 or sexually active (regardless of age). They responded to survey items on birth control use. Chi-square analysis and t tests were used to investigate whether barriers to using birth control were related to actual use during first intercourse and most recent sexual intercourse. It was found that nonusers had significantly higher barrier scores compared with users of birth control. The results indicate that attitudes toward birth control are associated with actual birth control use among Mexican-American adolescents. Additionally, males and females may have distinct barriers to using birth control. It was concluded that a better understanding of the sexual attitudes and beliefs associated with birth control is needed in order to improve programs seeking to increase the use of birth control among this rapidly expanding, high-risk population.

Adolescent↗
PubMed2001

[Recent progress in epidemiologic research of uterine cancer].

Although the mortality and incidence of cervical cancer have been decreasing, those of uterine-body, or endometrial, cancer have been increasing. The proportion of endometrial cancer was reported to have become 33.6% of primary uterine cancers in 1995. Infection with certain types of human papilloma virus (HPV) is considered to be etiologically important for the occurrence of cervical cancer. Because HPV is sexually transmitted, some risk factors for cervical cancer are associated with certain kinds of sexual behavior such as a young age at first intercourse, multiple partners, and infrequent use of barrier-type contraceptives such as condoms. Frequent conceptions and deliveries and histories of sexually transmitted diseases like infection with herpes simplex virus type 2 or chlamydia also have been suggested to be associated with the risk of cervical cancer. Smoking habits and infrequent intake of vegetables and fruits may be related to the increased risk of cervical cancer by supporting persistent infection of HPV through impaired immunological function. Although host factors such as a variant of a tumor suppressor gene like p53 have been assessed in terms of the risk of cervical cancer, these are not yet clearly elucidated. Estrogen stimulation of the endometrium unopposed by progesterone stimulation, namely, unopposed estrogen stimulation, is thought to be involved in the etiology of endometrial cancer. Frequent intake of animal fat, obesity or being overweight, infertility, and histories of diabetes mellitus, hypertension, and polycystic ovary syndrome have been reported to be risk factors for endometrial cancer, and they are thought to increase unopposed estrogen stimulation. Estrogen replacement therapy for postmenopausal symptoms, tamoxifen therapy for breast cancer, and taking sequential-type oral contraceptives have been shown to be exogenous risk factors for endometrial cancer in that they increase unopposed estrogen stimulation to endometrium.

Adult↗