Implications of the sexual revolution.
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Family Planning Services↗
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Letters to loved ones: please don't bring HIV home.
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Correspondence as Topic↗
Training profoundly retarded adults to communicate using handguiding.
Four multiply disabled, profoundly retarded young adults received two series of instructional activities designed to teach them to use handguiding to communicate basic needs and intents. All had failed in previous attempts to learn to communicate using augmentative devices and strategies. Caregivers and staff served as partners in communication. Three of the four subjects were successful in learning some basic communication skills using the strategy of having a partner and handguiding as a technique.
Adult↗
Sex therapy for erectile dysfunction: characteristics of couples, treatment outcome, and prognostic factors.
Outcome and prognostic factors were studied in 36 couples who entered sex therapy because of the male partners' erectile dysfunction. Treatment was completed by two thirds. Noncompletion was associated with lower socioeconomic status, the female partner having a history of psychiatric treatment, pretreatment poorer motivation of the male partner, poor communication in the general relationship, and less sexual pleasure experienced by the female. A positive treatment outcome occurred in 69.4%, and was associated with better pretreatment communication and general sexual adjustment, especially the female partner's interest and enjoyment of sex, absence of a positive psychiatric history in the female partner, and a couple's early engagement in homework assignments. Results highlight important aspects of the initial assessment, indicate couples for whom the initial phase of treatment should be prolonged and modified or an alternative approach considered, and have implications for assignment of couples to treatment groups in evaluative studies of therapy.
Adult↗
Contraceptive decision making in a sample of Jordanian Muslim women: delineating salient beliefs.
In this article, the authors identify attitudes, normative beliefs, and behavioral control beliefs of Muslim Jordanian women with regard to avoiding unplanned pregnancy and using specific contraceptive methods. Based on Ajzen and Fishbein's theory of planned behavior, open-ended questions were used in audio-taped face-to-face interviews with 25 married 19-44-year-old Jordanian Muslim women. A majority of respondents interviewed were currently using an intrauterine device (IUD) for contraception. Few women were using oral contraceptives, condoms, or the rhythm method and none of them reported using foam or a diaphragm. Content analyses of narrative transcriptions suggest the individual's concerns for family and individual well-being, as well as husbands' and families' opinions, may influence women's contraceptive behavior in this population.
Adult↗
Teaching partner-focused questions to individuals who use augmentative and alternative communication to enhance their communicative competence.
A single-subject, multiple-probe experimental design was used to investigate the effect of instruction on the acquisition, generalization, and long-term maintenance of partner-focused questions (i.e., questions about communication partners and their experiences) by individuals who use augmentative and alternative communication (AAC). Six participants who had severe speech impairments and used AAC participated in the study; they ranged in age from 10 to 44 years, had a variety of disabilities, and used a range of AAC systems. Instruction used a least-to-most prompting hierarchy in real-world interactions and during simulations. All of the participants successfully learned to ask partner-focused questions spontaneously in social interactions; they required an average of approximately 6 hours of instruction (range: 3-11 hours). The participants generalized the use of partner-focused questions to new situations in the natural environment and maintained use of partner-focused questions at least 2 months postinstruction; one participant required some "booster" instructional sessions 4 weeks postinstruction to maintain her long-term use of partner-focused questions. The participants all reported high levels of satisfaction with the outcomes of the instructional program, as did their facilitators. Members of the general public, blind to the goals of the study, judged the majority of the participants to be more competent communicators after instruction.
Adolescent↗
The effect of husband counseling on NORPLANT contraceptive acceptability in Bangladesh.
A pilot study of the effect of husband counseling on NORPLANT contraceptive acceptability was conducted at four family planning clinics in Bangladesh. The study objectives were to compare discontinuation rates and user satisfaction among acceptors whose husbands received counseling about the method versus those who did not. Of a total 617 subjects enrolled in the study which began in 1988, about two-thirds (408) of the husbands were counseled at admission or at the one-month follow-up visit while the remainder of the husbands (209) were not counseled. Follow-up visits were scheduled at one and six months after NORPLANT implants insertion, and every six months thereafter until the close of the study in 1991. Some evidence was found that counseling husbands of NORPLANT implants acceptors may reduce discontinuation rates. At the end of 36 months, a difference of 10 percentage points in total discontinuation rates was observed between the husband-counseled group (32 per 100 women) and the husband-not-counseled group (42 per 100 women). The husband counseling had the most impact at clinics with higher discontinuation rates. Based on Cox's proportional hazards regression model results, the hazard for discontinuation among the acceptors in the husband-not-counseled group. Satisfaction with NORPLANT implants did not differ between the two groups. Although these results are not striking, they do suggest a potential positive effect of husband counseling on NORPLANT contraceptive accept-ability. In future studies, the counseling of husbands should be more intensive and standardized.
Adolescent↗
Effects of female sterilization: one year follow-up in a prospective controlled study of psychological and psychiatric outcome.
A prospective controlled study of the psychological effects of elective interval and postpartum tubal sterilization was carried out on a selected sample of women. Subjects were interviewed pre-operatively (n = 138) and one year post-operatively (n = 116; 83%), using standardized instruments and procedures, including the Present State Examination. No differences within or between sterilization and control groups were found over the follow-up year in the prevalence of psychiatric morbidity, which was no higher than would be expected in a general population sample. Beneficial effects of sterilization were reported on a number of psychosexual variables. Adverse effects such as regret or deterioration in marital relationship were rare, but were more likely to occur in postpartum subjects, among whom abdominal pain was also reported more commonly at one year follow-up than pre-operatively. The relevance of "normal" postnatal events and of the role of pre-operative counselling are considered in relation to these findings. Less favourable outcome at one year follow-up was commonly associated with higher PSE scores pre-operatively.
Abdomen↗
Risk of HIV transmission in sexual behaviors of college students.
The purpose of this study was to investigate the sexual behaviors of college students and assess the extent to which they were engaging in behaviors that have a risk for contracting AIDS. A total of 132 single sexually active students and 58 married students responded to a survey on their sexual behaviors and attitudes. Risk behaviors such as engaging in unprotected sex, having multiple sex partners, practicing anal sex, alcohol use, and infidelity and deceptive communication with partner were examined. Compared with earlier surveys on the same population, there was an increase in concern about contracting AIDS and a significant increase in the percentage of students who took the AIDS antibody test. Although none indicated they would lie to partners about a seropositive AIDS test, a few would not tell their partner unless specifically asked. A small percentage of subjects would have extradyadic relations without informing their steady partners and a small number of respondents indicated they might continue to engage in sexual relations with a seropositive partner or a new partner who recently had a seronegative AIDS test. The risks most predominant in this sample were the practice of unprotected sex, having multiple sex partners, and the consumption of alcohol in conjunction with sexual activity. With the exception of unprotected intercourse, the majority of respondents were engaging in behaviors that pose a minimal risk for contracting AIDS.
Adolescent↗
Rural women are using contraceptives.
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Adolescent↗
The after-care of abortion patients.
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Abortion, Induced↗
Socioeconomic status and use of family planning among Ghanaian government workers.
The low utilization of family planning methods in Ghana, and by inference in much of Africa, is explained by reference to traditional sociocultural values held by males. A LISREL model is tested using data collected from educated males working in the Ghanaian government. Among the findings are that lack of couple communication, segregated conjugal role relationships, and male-dominated decision-making are all significant predictors of non-use of family planning methods (pronatalist attitude is not). Possession of knowledge of family planning among Ghanaian males alone is unlikely to initiate use of family planning methods. Additional sociodemographic and modernization findings are reported.
Adult↗
The causes of unmet need for contraception and the social content of services.
Since the 1960s, survey data have indicated that substantial proportions of women who have wanted to stop or delay childbearing have not practiced contraception. This discrepancy is referred to as the "unmet need" for contraception. The traditional interpretation, that these women lack access to contraceptive supplies and services, has led in turn to an emphasis on expanding family planning programs. This study analyzes survey data and related anthropological studies on the causes of unmet need and concludes that the conventional explanation is inadequate. Although for many environments geographic access to services remains a problem, the principal reasons for nonuse are lack of knowledge, fear of side effects, and social and familial disapproval. This finding underscores the need for expanded investment in services that not only provide contraceptives, but also attend to closely related health and social needs of prospective clients. Programs are likely to be most successful when they reach beyond the conventional boundaries of service provision to influence and alter the cultural and familial factors that limit voluntary contraceptive use.
Contraception Behavior↗
An investigation of the role of fathers in immunization uptake.
BACKGROUND: Mothers, but not fathers, are the usual focus of strategies to maximize immunization coverage in low income countries. METHODS: A study of the immunization determinants of children aged 12-18 months was conducted in 1991 in the Eastern Region of Ghana using structured interviews of a population sample of 294 mothers and 170 (67%) of the children's fathers. RESULTS: Fathers were more likely than mothers to perceive that the fathers had participated in the decision to send children for immunizations. Where both parents reported that the father had participated in the decision, and he could speak English, the child was more likely to have completed the immunization schedule by 12 months (OR = 5.7, 95% confidence interval [CI]: 1.5-21.7), independently of other factors. Neither the father's participation, nor his ability to speak English, was independently associated with the child's immunization status. CONCLUSIONS: The results of the study suggest that, where fathers have a higher level of education, programmes which are designed to involve them in decisions about their children's use of preventive health services have the potential to increase timely immunization coverage levels.
Child, Preschool↗
Women's position and family planning in Egypt.
In this report, data from the 1988 Egypt Demographic and Health Survey are used to address some of the most frequently raised questions about the relationship between gender inequality and reproductive behavior. The findings from binomial and multinomial logit models show that while the relationship between women's position and fertility control in Egypt is complex, some clear, broad patterns exist that have important theoretical and policy implications. First, although women's status in Egypt is clearly multidimensional, the reproductive aspect of women's position has a strong connection with the nonreproductive dimensions. Second, the case of the continued use of education and employment as proxies of women's position, especially in relationship to fertility control, is considerably discredited by the results. Finally, the findings indicate that Egyptian culture supports gender equality in the form of interaction and negotiation rather than women's autonomy.
Adolescent↗
Men's unmet need for family planning: implications for African fertility transitions.
This article introduces the concept of men's unmet need for family planning and explains its programmatic relevance. Using data from Demographic and Health Surveys (DHS) of Ghana (1988, 1993) and Kenya (1989, 1993), married men are found to have high levels of unmet need for family planning that are comparable to, although slightly lower than, those for women. The importance of men's unmet need is demonstrated when the analysis is restricted to marital pairs in the DHS samples; trends in the joint unmet need of husbands and wives are shown to be closely associated with the nature of the fertility transitions occurring in Ghana and Kenya. Because of wide discrepancies found between husbands' and wives' unmet need statuses, family planning programs that foster spousal communication are likely to facilitate the transition to lower fertility.
Adolescent↗
Family planning in the Jewish population of Israel: correlates of withdrawal use.
This report describes trends and differentials in contraceptive practices among Israeli Jews. Data from two fertility surveys show a heavy reliance on the IUD, little use of sterilization, and declining, but still significant use of withdrawal. The factors associated with the practice of withdrawal are explored. Evidence is found in support of Santow's hypotheses that the degree of sex-role differentiation within marriage and the belief that men hold the authority in reproductive decisionmaking are both positively related to the practice of withdrawal. Fear of oral contraceptives, a dislike of sterilization, and a reliance on the IUD only at greater parities imply a continuing role for withdrawal, especially among Israeli Jewish couples in which wives are less educated and have more traditional sex roles than the wives in other couples.
Adult↗
Initiation of prenatal care by adolescents. Associations with social support, stress, and Hispanic ethnicity.
The purpose of this study was to determine the social factors associated with initiation of prenatal care by adolescents. Eighty-one postpartum adolescents aged 17 years and under were interviewed within 24 hours of delivery about background factors, living situation, experiences, and behaviors during pregnancy. Of the adolescents, 58 were of Hispanic (Mexican) origin; the remainder were non-Hispanic whites. The first prenatal visit occurred at a mean of 4.04 months' gestation for Hispanics and 4.39 months' gestation for the non-Hispanics, one month after the pregnancy test. Differences between the ethnic groups were not significant. Controlling for ethnicity, both age and social support from the partner and his family were associated with initiation of care (P less than .01). In a separate analysis, age and partner-family support were unaffected by the introduction of stress and parental support (P less than .01). These findings highlight the importance of the partner and his family as a source of support to pregnant adolescents. To whom and when the adolescent communicates about the pregnancy may be the key linking social support to initiation of prenatal care. Providers who work with sexually active adolescents should emphasize the importance of early communication with partners and with family members if a pregnancy is suspected.
Adolescent↗