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Women's interest in vaginal microbicides.

CONTEXT: Each year, an estimated 15 million new cases of sexually transmitted diseases (STDs), including HIV, occur in the United States. Women are not only at a disadvantage because of their biological and social susceptibility, but also because of the methods that are available for prevention. METHODS: A nationally representative sample of 1,000 women aged 18-44 in the continental United States who had had sex with a man in the last 12 months were interviewed by telephone. Analyses identified levels and predictors of women's worry about STDs and interest in vaginal microbicides, as well as their preferences regarding method characteristics. Numbers of potential U.S. microbicide users were estimated. RESULTS: An estimated 21.3 million U.S. women have some potential current interest in using a microbicidal product. Depending upon product specifications and cost, as many as 6.0 million women who are worried about getting an STD would be very interested in current use of a microbicide. These women are most likely to be unmarried and not cohabiting, of low income and less education, and black or Hispanic. They also are more likely to have visited a doctor for STD symptoms or to have reduced their sexual activity because of STDs, to have a partner who had had other partners in the past year, to have no steady partner or to have ever used condoms for STD prevention. CONCLUSIONS: A significant minority of women in the United States are worried about STDs and think they would use vaginal microbicides. The development, testing and marketing of such products should be expedited.

Administration, Intravaginal↗

[I. Induced abortions and spontaneous abortions. Psychopathological aspects apropos of a preliminary sample of 411 requests for pregnancy interruption].

Since 1975 (17th January), abortion is free and legal in France. The authors analyse 411 first cases of women requiring for an abortion (seen over a period of 11 weeks). Most of them are young women, single, many begin their sexual life. Unwanted pregnancy indicates absence of contraception by ignorance, refusal or ambivalence (never used = 184 cases). 105 women used archaic and inefficient contraceptive means. Modern contraceptive means was used by 154 women but ill applied, ill tolerated and/or discarded (pill = 103 cases, I.U.D. = 14, diaphragme = 2, condoms = 35). Unwanted pregnancy and abortion signify failure of contraception. We compare psychologic and psychopathologic features of women requiring repeated induced abortion with those of women suffering of repeated spontaneous abortion and infertility. These women have frequently (same) problems of feminine identity, bad maternal imago, absence of father, unhappy, and conflictive childhood, immature sexuality and personnality. Contradiction between conscious and unconscious wishes create the two opposite situations and intrapsychic conflicts (spontaneous abortion = conscious willing of pregnancy + unconscious rejection of unbearable pregnancy; induced abortion = strong but unconscious wish of pregancy + conscious and volontary rejection of maternity). Psychotherapy should improve sexual and affective life and in both cases. The authors compare infanticide and abortion behaviors, contraceptive means, and psychological problems of doctors who are asked abortion.

Abortion Applicants↗

Advance supply of emergency contraception: a randomized trial in adolescent mothers.

OBJECTIVE: To examine whether the advanced provision of emergency contraception (AEC) to parenting youth would increase emergency contraception (EC) utilization, and whether AEC would impact the rates of unprotected sex and contraception use. DESIGN: Subjects were randomized to receive either information about EC or information and an actual supply of AEC. Subjects were interviewed at baseline, 6 and 12-month follow-up. SETTING: Urban non-medical case management office. PARTICIPANTS: 160 adolescent mothers (ages 13 to 20) who were receiving case management services. INTERVENTION: Advance supply of emergency contraception. MAIN OUTCOME MEASURES: Emergency contraception use, sexual activity, unprotected intercourse, contraceptive methods and use. RESULTS: Parenting teens who received AEC were much more likely to have used it than the control group at the 6-month interview (83% vs. 11%) and the 12-month interview (64% vs. 17%). Teens in the AEC treatment group were more likely to have unprotected sex at the 12-month follow-up interview (69% vs. 45%). There was no difference in condom use between the groups at either the 6-month, or the 12-month follow-up interviews. CONCLUSION: Advance provision of emergency contraception in parenting teens increases the likelihood of its use, and does not affect the use of condoms, or hormonal methods of birth control. Parenting teens who receive AEC may be more likely to have unprotected sex.

Adolescent↗

[Use of contraceptive methods by sexually active women in São Leopoldo, Rio Grande do Sul, Brazil].

In 2003, a population-based cross-sectional study was conducted in the urban area of São Leopoldo, Rio Grande do Sul, Brazil. The sample included 867 sexually active women from 20 to 60 years of age. The objective was to describe the use of contraceptive methods. Data were collected using a standardized questionnaire. The study analyzed the prevalence of contraceptive use and socioeconomic variables in women reporting an active sex life (84.5%), stratified by age groups. Some 627 (61.1%) women reported use of contraceptive methods. In the 20-49-year old group, 48.8% reported using oral contraceptives, 18.7% tubal ligation, 17.3% condoms, and 7.3% IUDs. In the 50-60-year old group, the most widely used method was tubal ligation (79.6%). Regarding tubal ligation, the schooling variable showed a linear trend, that is, women with less schooling showed a higher prevalence. Prevalence of oral contraception was higher in low-income women.

Adult↗

A study on the knowledge and practice of contraception among men in the United Arab Emirates.

OBJECTIVE: To determine the knowledge and practice of contraception among United Arab Emirates (UAE) men. DESIGN: Cross-sectional survey. PARTICIPANTS: Four hundred UAE monogamously married men with children. METHOD: The participants were randomly selected from the community and interviewed about knowledge and practice of contraception using a structured questionnaire. RESULTS: A total of 348 men (87%) gave consent to participate in the study. Two hundred and ninety-four participants (84.5%) were aware of the availability of male contraceptive methods but only 94 (27%) were currently using these methods; 39 (41.5%) used condoms, 30 (31.9%) practised coitus interruptus, 24 (25.5%) practised the rhythm method and only one (1.1%) had been sterilised. Male contraception was accepted by 116 (33.3%) subjects of the total study population. The reasons for the objections were: religious 133 (57.3%), cultural barriers 47 (20.3%), personal beliefs 29 (12.5%), medical disorders 18 (7.8%) and economical factors five (2.2%). Of 54 users of condoms and coitus interruptus, 16 (29.6%) reported to have experienced adverse effects that included testicular pain in six (37.5%), decreased libido in six (37.5%) and diminished orgasm in four (25%). There were significant associations between using male contraception and levels of education of the partners (male p < 0.007, female p < 0.01), low family size (p = 0.0001) and family income (p < 0.05). Fifty-seven subjects (19.4%) thought that a 'male contraceptive pill' is available and 44 (15.0%) believed that a monthly injection is available for men. CONCLUSIONS: The level of awareness of contraception among men attending primary care in UAE is moderate. Two-thirds of the study subjects objected to the use of contraception by their wives and less than 20% practise contraception themselves. This is partly due to sociocultural traditions, religious beliefs and poor knowledge.

Adult↗

[Choice of contraception in relation to sexual activity among younger women in Nuuk/Godthåb (Grönland) and in Nykøbing Falster (Danmark). A population-based cross-sectional study among 1,247 women].

Contraceptive habits in relation to sexual activity were investigated in a population-based cross-sectional investigation. A total of 661 women from Nykøbing Falster and 586 women from Nuuk/Godthåb in Greenland participated. The women, who were in the age group 20-39 years, were selected at random from the census and all underwent a personal interview. Both in Godthåb and in Nykøbing Falster a "non-barrier" method of contraception was the commonest method employed, regardless of the number of sexual partners. In Godthåb, the majority had thus employed IUDs and in Nykøbing Falster, oral contraception was the method most employed. In Godthåb, 9-22% had employed condoms on one or other occasion and the prevalence of this was found to increase with the number of sexual contacts. In Nykøbing Falster 57-63% had employed condoms but no significant variation was observed between various categories of numbers of partners in this area. From the point of view of prevention of sexually transmitted disease, it is striking that among women with greater than or equal to 20 sexual partners, approximately 79% and approximately 40% in Godthåb and Nykøbing Falster, respectively, had never employed condoms or diaphragms. In future, it will be important to investigate the patterns of sexual behaviour in various cultures and their development during the course of time in order to advise a population on the basis of the norms found in the culture concerned.

Adult↗

Religion and adolescent sexuality.

The health professional can be helpful to the adolescent, the adolescent's family, and the community through participating in and initiating local sex education programs. Religious settings provide a great potential for sexuality education within a value framework. A helpful curriculum will include the meaning of sexuality; developing a positive concept of sexuality, and a healthy sexual identity; present the issues of adolescent sexuality, including the various health issues; and an understanding of quality relationships within the family and among peers. If health professions and the community religious institutions can joint together, they can reach the goals of most programs in human sexuality, namely, "learning to appreciate our sexuality as a positive potential for self-expression, fulfillment and intimacy; respect for the personhood and well-being of others; and responsible decision-making."

Abortion, Induced↗

[Statistical analysis on andrological patients. I. Frequencies].

According a collective of 1619 andrological patients of the year 1975 some statistical data were given: age distribution, frequencies, frequency of sexual intercourse, anticonception and relation to age, coitus frequency and relation to age, impotence and relation to age, previous andrological treatment.

Adolescent↗

Behavioral tests in monkey infants exposed embryonically to an oral contraceptive.

The behavior of rhesus monkey infants exposed to high levels (20 to 100 X the human therapeutic dosage) of an estrogen-progesterone contraceptive (Norlestrin) during embryogenesis was compared to that of untreated controls. No serious deficiencies in regulation of activity, motor maturity, manual dexterity or discrimination learning were recorded in the 3 to 5 month old infants. In addition, age appropriate sex-differentiated behavior was observed in social groups of treated infants at 5 and 11 months of age. On the basis of this information it seems unlikely that accidental use of birth control pills during early pregnancy will seriously affect behavioral competence of offspring during infancy.

Animals↗