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The relationship between female adolescents' oral contraceptive adherence and autonomy.

This exploratory study examines the relation between female adolescents' emotional autonomy and oral contraceptive adherence. The participants were 51 single female adolescents (16, 17, and 18 years old) who had never been pregnant. At the 3-month follow-up, 39 of the subjects (77%) completed the study. Subjects completed the Emotional Autonomy Scale (Steinberg & Silverberg, 1986) initially and at the 3-month follow-up. Oral contraceptive adherence was assessed at the 3-month follow-up. Subjects had relatively high oral contraceptive adherence and autonomy. Oral contraceptive adherence was not associated with autonomy (r = .22, p = .21). Autonomy may be more influential on adolescents' seeking oral contraceptives rather than to adhering to their use.

Adolescent↗

Analysis of compliance with oral contraception in Spain.

OBJECTIVE: The study was designed to analyze factors related to compliance in oral hormonal contraception in Spain. METHOD: A review study and a multicenter analysis of experience of compliance by 300 doctors, by means of a questionnaire and discussion about the determinants of contraceptive use. RESULTS: Compliance is a major problem in Spain, being influenced mainly by side-effects, the general perception of the method and personal factors. The different factors involved in non-compliance in Spain were analyzed, with regard to the perspective of the professionals. CONCLUSIONS: Strategies to improve compliance in Spain aim mainly at improving the general perception of the method and the accessibility of family planning centers. Factors associated with compliance are still not well known in our country. Better knowledge of the determinants of non-compliance in Spain is needed. For this purpose, another research group was formed to conduct a national study among women.

Contraception Behavior↗

Emergency contraception: a qualitative study of young women's experiences.

Emergency contraception has the potential to greatly reduce the number of unintended pregnancies. Experiences in the use of emergency contraception have rarely been reported in the literature. Thirteen young women (a subset of a larger study cohort), were individually interviewed in a variety of settings about their personal experiences in relation to the use of emergency contraception. A thematic analysis of the transcribed data was undertaken. Barriers and facilitators to its use are explicated using excerpts from individual interviews with participants. Some young women had positive experiences, however many experiences were negative and reflected difficulties with access and availability of emergency contraception, as well as poor provider attitudes. Positive experiences generally occurred where services were responsive to the needs of young people or when a provider was well known to the young woman. Their experiences underscore the need to understand the situational stress and sometimes difficult arrangements needed to obtain this method of contraception. To optimise young women's experiences of emergency contraceptive use, a number of strategies need to be implemented. These include improvement of information about emergency contraception for young women and their partners; for health professionals; and for the broader community. Of critical importance is the need to include strategies to improve access to emergency contraception. A number of recommendations to achieve this within current health care delivery sectors in Australia, as well as suggestion forfuture access are provided.

Adolescent↗

Environmental fertility research at the turn of the century.

Research into environmental causes of impaired human fertility is still immature. Knowledge on the strengths and limitations of several research options, the main sources of bias, the occurrence of infertility and subfecundity in several countries, the patterns of contraceptive behavior, and the distribution of sperm counts at the population level has advanced, but the much-debated questions about temporal and regional trends in fertility and semen quality remain unsettled. Refined biological markers of male fecundity and markers feasible for large-scale studies of female fecundity are needed. The effects of several life-style factors have been characterized successfully, but the detrimental effects of environmental exposures have not. Most studies are either inconclusive or fail to demonstrate any important risks. If comprehensive knowledge on biological mechanisms is a criterion of maturity, epidemiologic and toxicologic fertility research is young. The new millennium will be challenged to determine the role played by the environment in developed countries, wrong exposure time windows, too crude or inappropriate measures of fertility, and overlooked critical exposures.

Epidemiologic Methods↗

Reasons for contraceptive nonuse at first sex and unintended pregnancy.

OBJECTIVE: To examine reasons for contraceptive nonuse at first sex and subsequent unintended pregnancy among women attending family planning and prenatal clinics. METHODS: Data come from the Determinants of Unintended Pregnancy Risk in New Orleans study. Reasons for nonuse by age, partner's age, and pregnancy status are compared. RESULTS: Concern about parents' finding out about sexual activity was a common reason for nonuse at first sex and first unintended pregnancy. Problems accessing and discontinuation of contraception were reasons given at second or higher-order unintended pregnancy. CONCLUSIONS: Reasons for nonuse vary by event and age at event. Providers should consider various reasons when counseling patients on contraceptive options.

Adolescent↗

[Not using contraception among women requesting abortion].

The aim of this survey was to examine the number of abortion applicants not using contraception at the time of conception, to shed light on the reasons for this, and to acquire information about the knowledge of postcoital anticonception in this patient group. The registered data is collected from precoded medical records at the University Hospital of Trondheim comprising 2,074 women applying for abortion in the period 1.1. 1995-15.7. 1997. The 291 applying for abortion 15.1-15.7. 1997, and who had not used contraception were given a questionnaire. 160 (55%) answered the questionnaire. During the period of 2.5 years 57.4% had not used contraception at the time of conception. The tendency of non-use has increased significantly during the last 2.5 years. Concern about sideeffects was the most common reason for not using contraceptives (36%). One third trusted the rhythm method and coitus interruptus. The postcoital pill was known by 93%; of the 61 women who had considered using it, 67% thought of it too late. To prevent unwanted pregnancies, it is important to focus on the positive health effects of oral contraception. Information efforts should especially be aimed at young and single women, who represent the majority of the non-users. The cost is no great impediment to the use of contraception. Availability of emergency contraception should be improved.

Abortion Applicants↗

Knowledge of emergency contraception amongst female patients attending a department of genitourinary medicine.

The aim of the study was to assess the knowledge of emergency contraception amongst new female patients attending an inner-city department of genitourinary medicine. Information was also sought about use of regular contraception and demography. Three hundred and ninety nine questionnaires were suitable for analysis. Half of the sample answered that the latest a woman could take emergency contraception after unprotected sex was three days. None of the sample knew that emergency contraception could be obtained up to five days. Twenty nine per cent of the sample reported sex without contraception during the menstrual cycle preceding attendance. Women who had ever used regular contraception in the past were statistically less likely to have reported unprotected sex in the menstrual cycle preceding attendance (p=0.0000068). Professional women were statistically less likely to have reported unprotected sex in the menstrual cycle preceding the clinic visit. Fourteen per cent of the sample had genital warts at this first clinic visit, 10 per cent had Chlamydia trachomatis, seven per cent had herpes simplex infection, six per cent had gonococcal infection and five per cent had trichomonal infection. Women who reported unprotected sex during the preceding menstrual cycle were not statistically more likely to have a sexually transmitted infection at this first clinic visit. A large number of women attending departments of genitourinary medicine are at risk of both pregnancy and also sexually transmitted infection. Staff working in all areas of sexual health need to have a good knowledge of both contraception and sexually transmitted infections in order to educate the clients on both aspects of unprotected sex.

Adolescent↗

Issue of emergency hormonal contraception through a casualty department in a community hospital.

The results of this survey show that sexually active women seeking emergency hormonal contraception are finding that a casualty department in a community hospital offers convenience, confidentiality and accessibility above all else. There is a growing tendency for those registered with the local practice to prefer to come to the hospital for post-coital contraception, even though casualty nurses are not family planning qualified. This applies especially to the under twenties. More needs to be done in persuading patients that ongoing contraception should be addressed. To this end, if casualty departments are the preferred outlets in the rural communities, then nurses need further training. All providers of emergency contraception in rural areas need to be aware that offering such a service by well trained RGNs working to a protocol could reduce the incidence of unintended conceptions amongst teenagers. At the same time, every effort has to be made to increase awareness of the availability of emergency hormonal contraception by advertising the sources of contraceptive advice, which could soon include pharmacists.

Adolescent↗

Perception and practice of emergency contraception by post-secondary school students in southwest Nigeria.

A survey of 1500 students in post-secondary institutions in southwest Nigeria showed that the concept of emergency contraception (EC) was well known. Respectively, 32.4%, 20.4% and 19.8% knew that combined pills, progesterone only pills and intrauterine contraceptive device (IUCD) were usable for EC, while 56.7% mentioned the use of traditional methods. Only 11.8% had ever used either pills or IUCD and 10.7% had used a traditional method. Few students (11.5% and 2.3% respectively) knew the correct timing of EC pills and IUCD. The respondents reported varying circumstances under which EC was indicated but the majority cited condom breakage and sexual assault. The popular media represent the commonest source of information while hospitals/clinics were the commonest sources of procurement. About 37% of the respondents planned to use EC in future while 58% would not and 4.7% were uncertain. Reasons for these responses were explored.

Adolescent↗