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Sociodemographic and sexual health profile of users of emergency hormonal contraception: data from a British probability sample survey.

OBJECTIVE: This study aimed to identify factors associated with the use of emergency hormonal contraception (EHC). METHODS: Data from a probability sample survey of 12,110 men and women aged 16-44 living in Britain were used for this study; 5916 women were selected as potential users of EHC, defined as women reporting at least one male partner in the year prior to the survey. RESULTS: Of the 5916 women, 2.3% reported EHC use in the previous year. EHC use was more common among younger, single women, those with more than one sexual partner in the past year and those using condoms for contraception. It was significantly associated with experience of abortion (odds ratio adjusted for age, marital status and number of male partners: 2.40) but not with sexually transmitted infection (STI) diagnosis. CONCLUSIONS: The use of EHC identifies a group of women at increased risk of unplanned pregnancy and condom use but not STI acquisition. Provision of information on more reliable contraceptive methods is needed to reduce the risk of unplanned pregnancy recurrence.

Adolescent↗

A survey of female prostitutes at risk of HIV infection and other sexually transmissible diseases.

OBJECTIVE: To determine risk factors for the transmission of human immunodeficiency virus (HIV), including injecting drug use (IDU), sexual behaviour and other sexually transmissible diseases (STDs), in female prostitutes who attended the Sydney Sexual Health (previously STD) Centre. DESIGN: We surveyed by questionnaire 231 (47%) of 491 female prostitutes who visited the Centre over a 19 month period from 1986 to 1988. All were tested for HIV antibody. MAIN OUTCOME: All the women were seronegative for HIV but a number of major risk factors for infection were identified. RESULTS: Seventeen of 26 (65%) current injecting drug users had shared needles in the previous 6 months. Nineteen per cent of those surveyed had bisexual non-paying partners and 21% had partners who injected drugs. Sixty nine per cent always used condoms for vaginal intercourse with paying clients, but they were rarely used with non-paying partners. Condom use was also rare for anal intercourse with clients and/or partners by those (18%) who practised it. Seventeen per cent used condoms alone for contraception and 48% relied on oral contraceptives. We found a reduction in gonorrhoea, herpes and trichomoniasis when compared with a 1985 study conducted at the same Centre. However, there was an increase in reported abnormal cervical cytology. CONCLUSION: In spite of behaviour change by some, there are still many women working as prostitutes in Sydney who remain seriously at risk of HIV infection. We recommend more widespread use of barrier methods of contraception, intensified efforts to prevent the sharing of intravenous needles, closer monitoring of the health of prostitutes, and scientific study of their paying and non-paying sexual partners.

Adolescent↗

Birth control and its determinants.

"The article presents the results of the three family [sample] surveys [in Poland]: 'Newlyweds Survey 1985', 'Family Survey 1987'...and 'Determinants and Consequences of Divorces'.... The subject of this article is: the methods of birth control which were used during married life, their moral evaluation and opinions about abortion.... This article indicates the influence of an unhappy marriage and of different phases of family life on the attitudes and opinions about birth control."

Abortion, Induced↗

The importance of discreet use of the diaphragm to Zimbabwean women and their partners.

We conducted a 6-month acceptability study of diaphragms as a potential HIV/STI prevention method among Zimbabwean women. We examined partner involvement in diaphragm use, and importance of discreet use (use without partner awareness). Of the 181 women who completed the study, 45% said discreet use was "very or extremely important" and in multivariate logistic regression, women were more likely to value discretion if their partners: had other partners; drank alcohol; or were believed to prefer condoms to diaphragms. Qualitative data confirmed these findings. Both women and their partners reported that diaphragms can be used discreetly and saw this as advantageous, for both sexual pleasure and female control. However, many were concerned that use without partner approval could lead to marital problems. Discreet use should be considered in development of barrier methods and in diaphragm promotion, if proven effective against HIV/STI.

Adolescent↗

Learning in social networks and contraceptive choice.

A puzzling observation in the diffusion of modern fertility control is the persistent diversity in contraceptive practices across communities or social strata. I propose a model of "learning in social networks" to explain this diversity with the random dynamics of word-of-mouth communication. Women are uncertain about the merits of modern contraception and estimate the different qualities of available method based on imprecise information from network partners. Their contraceptive choices are determined by this estimate and by private knowledge about one's personal characteristics. This process of social learning leads to path-dependent adoption of fertility control within, and diversity in contraceptive practices across villages or social strata.

Bayes Theorem↗

Unapproved use of high-dose combined pills in Japan: a community study on prevalence and health characteristics of the users.

BACKGROUND: Because of the ban on oral contraceptive use in Japan, only high-dose combined pills (HDCP), permitted as treatment for menstrual disorders, can be used as a contraceptive. We determined the prevalence of the use of such preparations in a community in Japan and assessed the health characteristics of the users. METHODS: A total of 18,435 female residents age 35 years and over in a city of Gifu Prefecture, Japan, responded in 1992 to a health questionnaire that included questions on the use of HDCP, lifestyle, and dietary habits. The response rate was 92%. RESULTS: The rates of current and past HDCP use were 1.3 and 7.1%, respectively, among women ages 35-49 years, and 2.2% of the women had used HDCP for longer than any other method of contraception. Current HDCP users were more likely to be smokers. They had lower intakes of carotene, fiber, and vitamins C and E and a lower polyunsaturated/saturated fat ratio than never-users. CONCLUSIONS: The prevalence of HDCP use was 1.3% among Japanese women ages 35-49 years. Potential risk factors for cardiovascular diseases, such as smoking and a diet with lower intakes of antioxidants, were prevalent among current HDCP users.

Adult↗

Young women's attitudes toward injectable and implantable contraceptives.

STUDY OBJECTIVE: To assess the potential acceptability of implantable and injectable contraceptive characteristics by young women of diverse ethnic and educational backgrounds. DESIGN: A cross-sectional self-administered survey. SETTINGS: The waiting room of three clinical sites: an elite women's college health service, a coeducational state university health service, and an inner city hospital-based adolescent clinic. PARTICIPANTS: 328 young women awaiting medical care in one of three clinical sites, aged 13 to 21 years (85% 18-21 years); ethnic distribution differed significantly by site. The majority (83%) were sexually active, and of those who were sexually experienced, 25% had been pregnant. OUTCOME MEASURES: A 47-item questionnaire examining attitudes toward characteristics of injectable and implantable contraceptive methods, menstrual, sexual, and gynecologic history. RESULTS: Sixty-two percent of the sample agreed that they would get an injectable method. There was little variation in agreement to get an injectable method by sexual or pregnancy history. Fewer subjects (24%) agreed that they would like to get subdermal implants and agreement to get an implantable method of contraception did not vary by sexual history; however, ever-pregnant young women (33%) were significantly more likely to agree to implants than never-pregnant subjects (21%; chi2, 4.109; p = 0.04). Seventy-four percent of subjects said they would stop using a contraceptive that caused irregular menses, whereas 65% would stop using a method that caused amenorrhea. CONCLUSIONS: An injectable contraceptive method has universal appeal across ethnic, educational, and age categories, whereas implants are less appealing. Irregular bleeding and amenorrhea are poorly perceived side effects of long-acting contraceptives.

Adolescent↗

Acceptability of an injectable male contraceptive regimen of norethisterone enanthate and testosterone undecanoate for men.

BACKGROUND: We assessed attitudes towards and acceptability of male hormonal contraception among volunteers participating in a clinical trial of a prototype regimen, consisting of progestin and testosterone injections. METHODS: After completing screening, eligible men were randomly assigned to the no-treatment group (n = 40) or to receive injections of norethisterone enanthate and testosterone undecanoate or placebo at different intervals (n = 50) according to a blocked randomization list. They underwent self-administered questionnaires. RESULTS: The average age of the participants was approximately 28 years; most were involved in a stable relationship and had no children. Ninety-two percentage of the respondents thought that men and women should share responsibility for contraception and 75% said they would try a hormonal contraceptive if available. At the end of the treatment phase, 66% of the participants said that they would use such a method, and most rated its acceptability very highly; none reported it to be unacceptable. The injections themselves were indicated as the biggest disadvantage. No significant changes in sexual function or mood states were detected among the men who underwent hormone injections. CONCLUSIONS: The contraceptive tested in this study was well accepted by the participants over the course of 1 year.

Adult↗

[Life style, Chlamydia trachomatis infection, bacterial vaginosis and their impact on the frequency of cervical lesions].

OBJECTIVES: Sexually transmitted infectious factors attained unquestionable importance in the initiation of the cervical intraepithelial neoplasia. The aim of this study was to evaluate the incidence and impact of Bacterial vaginosis, Chlamydia trachomatis infection in accordance to a life style on clinically and cytologically evaluated cervical lesions. DESIGN/METHODS: Seventy-two young women without any symptoms were included to the study. Women underwent pelvic examination when cervical smears for cytology and Ch.tr. were taken and BV tests were performed. Presence of Chlamydia was estimated by direct immunofluorescent method. Subjects included to the study provided information concerning life style, and gynecological complaints. RESULTS: In both BV(+) or Ch.tr.(+) women, abnormal PapTest results were more frequently observed. All those three factors correlated with declared over 5 lifetime sexual partners. Ch.tr. infection correlated with BC pills using, cigarette smoking and presence of the cervical lesions evaluated as glandular ectopy. Abnormal PapTest result was obtained in 12 subjects. Two, the most abnormal cases were described as LSIL and confirmed by direct biopsy as CIN 1, also with coexistence of C. trachomatis infection and positive for BV. CONCLUSIONS: Ch.tr. infection seems to affect more frequently sexually active, smoking, young women using BC pills, with presence of cervical lesion described as clinically unsuspected glandular ectopy, although with occasionally cytological abnormal findings.

Adult↗