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PubMed2003

[Contraceptive use among adolescents at public schools in Brazil].

OBJECTIVE: There has been a growing interest in patterns of contraceptive use among adolescents, due, in particular, to the social relevance attached to pregnancy in this age group. Therefore, the objective of the study was to investigate factors associated with the use of contraceptive methods among female and male adolescent students. METHOD: A cross-sectional study was conducted, by means of self-applied questionnaires, among 4,774 students ranging from 11 to 19 years of age. Prevalence with respect to the use of contraceptive methods during the first experience of sexual intercourse as well as the most recent one was calculated both separately, that is, for each of these events, and in conjunction as a measure of consistent use. Logistic regression was carried out for simultaneous analysis of factors associated with the use of contraceptive methods and in order to calculate adjusted measures. RESULTS: Among the 1,664 students who reported being sexually active, the factors positively associated with the consistent use of contraceptive methods among male students included a) postponing their first experience of sexual intercourse and interaction with a stable partner, b) the family as a potential supplier of contraceptive methods, and c) access to health services. On the other hand, among female students factors positively associated with the consistent use of contraceptive methods included a) recent sexual initiation, and b) having a father as their source of information regarding sexuality, contraception and STD/AIDS prevention. Pregnancy was reported by 6.4% of the boys and 18.1% of the girls, its absence was associated with the consistent use of contraceptives by them (the girls) (Odds Ratio=3.83; 2.06-7.15). CONCLUSIONS: The results confirm the complexity of determining contraceptive behavior among adolescents and therefore reinforce the need to include multi-dimensional aspects of this theme in order to ensure the efficacy of sex education programs.

Adolescent↗
PubMed2002

Family influences on adolescent sexual and contraceptive behavior.

Studies of adolescent pregnancy risk are relevant to understanding responsible adolescent sexual behavior because most investigators have focused on the key proximal determinants of pregnancy--sexual intercourse and contraceptive use--rather than analyzing pregnancy status per se. Lesser pregnancy risk is associated with teens remaining sexually abstinent, postponing onset of intercourse, and having intercourse less often or with fewer partners, as well as by using contraception at first or most recent intercourse and by using contraception consistently over time. Living with a single parent, in a lower SES family, having older sexually active siblings or pregnant/parenting teenage sisters, being a victim of sexual abuse, and residing in disorganized/dangerous neighborhoods all place teens at elevated risk of adolescent pregnancy. Parent-child closeness or connectedness, and parental supervision or regulation of children, in combination with parents values against teen intercourse (or unprotected intercourse), decrease the risk of adolescent pregnancy. Studies about parent-child sexual communication and adolescent pregnancy risk are less conclusive, largely because of methodological complexities.

Adolescent↗
PubMed1990

A survey of knowledge about AIDS and sexual behavior in sexually active men in Mae Sot, Tak, Thailand.

A survey of 15-34 year old men in Mae Sot, Tak, was conducted in December 1989 to determine their knowledge about AIDS, HIV transmission, and sexual behavior to guide future AIDS prevention programs. A total of 172 men from the municipality (urban) and 311 men from the surrounding villages (rural) were interviewed. More than 90% of both groups possessed knowledge about the existing modes of HIV transmission, however, there were some who had the mistaken belief that AIDS can be spread by mosquito bites, using public toilets, or through various forms of casual contact. These misconceptions in the community underscore the need for more education designed to counteract them. Although nearly all of them knew that condoms can prevent infection, only half of the urban and one-third of the rural sexually active men had ever used a condom during their sexual intercourse with prostitutes. However, condom use increased over time. Since a number of these men first engaged in sexual intercourse at an early age, the promotion of health education about AIDS in the schools is essential.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Sexual communication and contraceptive use in adolescent dating couples.

PURPOSE: This study had two aims: first, to examine the relationship between general sexual communication and contraceptive use in sexually active adolescent romantic couples, and second, to explore predictors of open communication from characteristics of adolescent couples and individual adolescents. METHODS: Data were drawn from 209 couples dating a minimum of four weeks who participated in the Study of Tennessee Adolescent Romantic Relationships. Seventy-three adolescent dating couples (ages 14-21 years) that engaged in sexual intercourse and completed a sexual communication questionnaire were included in current analyses. RESULTS: Nearly 30% of couples failed to use contraception at first intercourse and almost half of couples did not use contraception every time they had sex. More open communication about sex from both male and female partners was associated with increased contraceptive use. Additionally, adolescents who were more satisfied in their relationships reported more open communication about sex, and adolescent females who self-silenced reported less open communication about sex. Finally, mediation analyses revealed that boys' and girls' relationship satisfaction and girls' self-silencing indirectly predicted contraceptive use through their effects on general sexual communication. CONCLUSIONS: This is the first known study to address individual and dyadic components of sexual communication using reports from both members of established adolescent dating couples. Findings suggest that open sexual communication between intimate partners is important to sexual decision-making. The clinical implications of these findings are discussed.

Adolescent↗
PubMed1987

The Cape Town Teenage Clinic.

Over a 6-month period 265 white females aged under 24 years attending the Teenage Clinic of the Western Cape Region of the Family Planning Association were interviewed at their first visit; 81% were sexually active. The age of menarche and the parents' marital status were important parameters of socio-sexual behaviour. The earlier the menarche, the higher the prevalence of coitus at a younger age, and the shorter the interval between menarche and the first coitus. Young age at first coitus, in turn, was associated with a higher prevalence of multiple sexual partners and smoking, and a longer period of unprotected intercourse before attending the clinic than among those who first attempted intercourse at a later age. Of those who had first experienced coitus at under 17 years, 37% came from single-parent families, compared with 12% of those in whom coitus was delayed until over 19 years of age. The important health and educational implications are discussed.

Adolescent↗
PubMed1993

Effect of anoreceptive intercourse on anorectal function.

This study is the first published assessment of the effect of anoreceptive intercourse (ARI) on anal sphincter tone and function. Forty anoreceptive (AR) male homosexuals were compared with 18 age matched non-anoreceptive (non-AR) heterosexual males. Subjects were questioned about ARI, defaecation and faecal incontinence. Anal resting pressure, maximum voluntary squeeze pressure, anal mucosal electrosensitivity, perineal descent and rectal sensation were measured in all subjects. Fourteen of the AR subjects but only one of the non-AR subjects had symptoms of frequent anal incontinence (P < 0.05). There was a significant reduction in both maximum anal resting pressure (P < 0.01) and anal mucosal electrosensitivity (P < 0.05) and a significant difference in the anal resting pressure profile (P = 0.02) in the AR subjects compared with the non-AR subjects. There was a significant reduction in maximum squeeze pressure in AR subjects with anal incontinence compared with either AR subjects without anal incontinence (P < 0.01) or non-AR subjects (P < 0.01). There were no significant differences in stoll consistency, frequency of defaecation, perineal descent or rectal sensation between the groups. ARI is associated with reduced resting pressure in the anal canal and an increased risk of anal incontinence. The risk of incontinence is greatest amongst AR subjects with reduced maximum squeeze pressure.

Adult↗
PubMed1984

Age at beginning of coitus versus chronologic age as a basis for Papanicolaou smear screening: an analysis of 747 cases of preinvasive disease.

Disease onset in 747 routinely screened women who developed cervical intraepithelial neoplasia was analyzed. Average age at diagnosis was 30 years; the range was 16 to 71 years. In 19% diagnosis was made after age 35, and in 1% after age 60. Grouping cases by age at beginning of coitus produced significant differences (p less than 0.001) in cumulative proportions of patients with the diagnosis made at any age. In 11% of patients initiating intercourse between ages 15 and 17 diagnosis was made after age 35; the figure was 19% for the 18 to 19 age group and 36% for the 20+ group. Screening by chronologic age is effective for women initiating intercourse early. Screening by years of exposure to intercourse produced a uniform distribution regardless of age at beginning of coitus. In 75% the diagnosis was made within the first 15 years of intercourse, in 88% by year 20; and in 97% by year 30. In 70% the diagnosis was made between 6 and 20 years. Cytologic surveillance should be concentrated during the sixth through twentieth years when most cases develop.

Adolescent↗
PubMedDate not supplied

The effects of sex education on adolescent behavior.

By age 18, according to the 1982 National Survey of Family Growth, 68 percent of 15-19-year-old women have received formal instruction about pregnancy and contraceptive methods, 16 percent have had instruction about pregnancy only, and another 16 percent have received neither type of education. The age at which formal contraceptive education is first provided has been declining; among 15-year-olds, for example, 47 percent have had instruction by their 15th birthday, compared with 33 percent of 17-year-olds and 26 percent of 19-year-olds. Forty-six percent of adolescent women have had premarital intercourse. Exposure to formal sex education appears to have no consistent effect on the subsequent probability that a teenager will begin to have intercourse. Sex education does influence contraceptive knowledge and behavior, however. Sexually active teenagers who have had formal instruction report knowing how to use more methods than do adolescents who have had no instruction. The former group is also significantly more likely to have practiced contraception at some time. And among ever-users, those who have received pregnancy and contraceptive education before first coitus are significantly more likely to have used a method at first intercourse. Nearly one-third of premaritally sexually active adolescents have had at least one premarital pregnancy. The NSFG data reveal no significant relationship between exposure to sex education and the risk of premarital pregnancy among sexually active teenagers.

Adolescent↗
PubMed2001

"Primary" versus "secondary" vulvar vestibulitis: one disease, two variants.

OBJECTIVE: Our aim was to determine whether women with primary vestibulitis-since the first episode of sexual intercourse-differ in disease characteristics and outcome of operative treatment from women with secondary vestibulitis. STUDY DESIGN: A total of 111 patients with severe vulvar vestibulitis underwent perineoplasty from 1991 to 1995. Thirty-nine (35%) of them had primary vestibulitis (ie, dyspareunia from the first attempt at sexual intercourse). They were compared with 72 (65%) who had secondary vestibulitis with regard to demographic, social, and medical variables, the presence of human papillomavirus deoxyribonucleic acid, physical and histopathologic findings in the vestibule, and surgical outcome. RESULTS: Women with primary vestibulitis were 5 years younger than those who had secondary vestibulitis (22.9 +/- 2.9 years vs 27.7 +/- 8.6 years, respectively; P <.0001) and differed in their marital status (unmarried, 84% vs 56%, respectively; P <.008), parity (nulliparous, 97% vs 67%, respectively; P <.0002), and involvement of the whole vestibule (74% vs 93%, respectively; P <.006). The 2 groups were similar in all other variables, including use of oral contraception, smoking, presence of human papillomavirus, dysuria, success of perineoplasty (average, 83%), and histopathologic findings. CONCLUSIONS: Women with primary vestibulitis were younger than women with secondary vestibulitis. Most other differences were dependent on the different ages of the 2 groups. Primary and secondary vestibulitis may therefore be two presentations of the same disease.

Adolescent↗
PubMed2002

Sexual behaviour in a low-income high school setting in Stockholm.

Teenage abortions and sexually transmitted infections (STIs) are increasing in Sweden, and risky adolescent sexual behaviour is an issue of major concern. The aim of the present cross-sectional questionnaire-based study was to investigate adolescent sexual experience in a low-income high school setting in Stockholm. Among 340 students, 258 participated, response rate=75.9%, mean age=17 years. Homo- or bisexual preference was reported by 11.6% (29/250). Experience of oral sex was reported by 66.3% (163/246), vaginal intercourse by 55.5% (141/254), and anal sex by 10.0% (25/250), with no gender-specific differences. Five or more coital partners were reported by 29.8% (34/114). Condom use at first and most recent intercourse was reported by 61.7% (87/141) and 42.6% (60/141), respectively, and condom breakage by 39.5% (34/86). Truancy, smoking, alcohol and drug use were factors associated with coital experience. Sexual abuse was reported by 2.2% (3/134) of the boys and 13.0% (16/123) of the girls.

Adolescent↗
PubMed2005

Early puberty and adolescent pregnancy: the influence of alcohol use.

OBJECTIVE: Early pubertal timing predicts deleterious outcomes for young girls, including substance use, risky sexual behavior, and pregnancy. In turn, adolescent pregnancy predicts long-term negative consequences such as reduced educational attainment and income-earning potential. Despite evidence of the direct links between early puberty and negative outcomes, this study is the first to examine the role that alcohol plays in the timing of sexual intercourse and pregnancy among early-maturing females. DESIGN: Participants were 666 females, aged 18 to 22 years, from 4 major ethnic groups in Arizona (non-Hispanic white, black, Latino, and Native American). All women included in the sample had experienced a pregnancy in their teens or early 20s. Participants completed a self-administered questionnaire that inquired about their timing of menarche, sexual initiation, first alcohol use, and age at first pregnancy. A mediating model predicting age at pregnancy was tested by using path modeling. RESULTS: Early puberty was found to be associated with earlier age of alcohol use and sexual initiation, which in turn predicted early pregnancy. Age at first sexual intercourse and age at first substance use significantly mediated the relation between age at menarche and age at first pregnancy. The results did not vary by ethnic group. CONCLUSIONS: Girls who mature early are more likely to engage in early substance use and sexual intercourse, which in turn puts them at greater risk for adolescent pregnancy. It is important that health care providers are sensitive to the risks associated with early maturation among young girls and provide preventive screening, education, and counseling related to alcohol use and sexual initiation for this group.

Adolescent↗
PubMed1995

Quality of condom use as reported by female clients of a family planning clinic.

OBJECTIVES: This study analyzed the prevalence and determinants of the quality of condom use after a woman's first visit to a family planning clinic. METHODS: This report presents data from 360 female family planning clients who reported using condoms as their primary method of contraception for at least 1 sexually active month during the study's follow-up period after their first clinic visit. RESULTS: Only 1% always engaged in all five use behaviors studied: using a condom for each sexual intercourse, putting the condom on before first entry, withdrawal after intercourse while there is still an erection, holding on to the condom's rim during withdrawal, and using foam. Multiple linear regression indicated that more effective condom use was reported by women who had not had an induced abortion, were not using condoms just because they were starting oral contraceptive pill regimens, had more knowledge about birth control in general, had received a nursing intervention, and had more communication with their partner. CONCLUSIONS: Increasing attention needs to be devoted to understanding determinants of the specific actions that differentiate between more and less effective contraceptive use.

Adolescent↗
PubMed2005

Seasonality and immediate antecedents of sexual intercourse in adolescents.

OBJECTIVE: To assess immediate antecedents of and seasonal variations in sexual intercourse among a focused population of medically indigent adolescent females in Houston, Texas. STUDY DESIGN: From June 2001 to March 2002 we solicited a convenience sample of adolescent females during their visit to a school-based clinic. The survey consisted of 34 multiple choice questions targeting immediate antecedents of sexual behavior. Demographic characteristics and survey responses were compared with t tests and ANOVA. The chi2 goodness of fit test and test of homogeneity were used to assess seasonality. RESULTS: One hundred thirty-three teenagers completed our survey. Both African American and Hispanic teens were significantly more likely to report that their sexual debut occurred in June (p < 0.01 and = 0.02, respectively). More than 50% of those surveyed reported having sex either in their homes or in the homes of their partners. Doing "nothing" was the most common antecedent activity for sexual intercourse. There were no statistically significant differences in location or antecedent activity for first or most recent sexual intercourse between teens with and without prior pregnancy. CONCLUSION: Both the timing and location of sexual intercourse among the teens in this study suggest that unsupervised time may be a factor contributing to sexual activity in teens.

Adolescent↗
PubMed2000

Are adolescents being screened for sexually transmitted diseases? A study of low income African American adolescents in San Francisco.

OBJECTIVES: To determine the proportion of sexually experienced African American adolescents who report having been screened for sexually transmitted diseased (STDs), and to determine the proportion who report having been screened for STDs among those adolescents who have had a preventive primary healthcare visit in the past 2 years. METHODS: A telephone survey of a population based sample of African American 12-17 year old adolescents residing in a low income San Francisco neighbourhood with a high prevalence of STDs. RESULTS: Of the 302 adolescents surveyed, 118 (39%) reported a history of sexual intercourse. Of these, 26% of the males and 59% of the females had been screened for an STD in the previous 12 months. 31% of the males and 63% of the females had been screened for an STD in the previous 24 months. Of the 93 participants who had had a preventive primary care visit since their first episode of sexual intercourse, 26% of the males and 60% of the females had been screened for an STD in the previous 24 months. CONCLUSIONS: Sexually experienced African American adolescents in San Francisco are being screened for STDs at rates well below that recommended by current clinical guidelines. A low rate of screening was found even in those adolescents who had been seen for a preventive primary care visit since they first had sex. This suggests that the preventive primary care visit is not being used to its full potential as an opportunity to screen and treat adolescents for STDs. Capitalizing on this opportunity to screen may increase the number of STDs diagnosed and, thus, decrease rates of STDs in this population.

Adolescent↗
PubMed2000

Are adolescents being screened for sexually transmitted diseases?

OBJECTIVES: To determine the proportion of sexually experienced African American adolescents who report having been screened for sexually transmitted diseases and to determine the proportion who report having been screened for these diseases among adolescents who have had a preventive primary health care visit in the past 2 years. METHODS: A telephone survey of a population-based sample of African American adolescents aged 12 to 17 years residing in a low-income neighborhood in San Francisco with a high prevalence of sexually transmitted diseases. RESULTS: Of the 302 adolescents surveyed, 118 (39.1%) reported a history of sexual intercourse. Of these, 17 (26. 2%) of 65 males and 31 (58.5%) of 53 females had been screened for a sexually transmitted disease in the previous 12 months. Twenty (30. 8%) of the males and 32 (60.4%) of the females had been screened for a sexually transmitted disease in the previous 24 months. Of the 93 participants who had a preventive primary care visit since their first episode of sexual intercourse, 14 (26.4%) of the 53 males and 24 (60.0%) of the 40 females had been screened for a sexually transmitted disease in the previous 24 months. CONCLUSIONS: Sexually experienced African American adolescents in San Francisco are being screened for sexually transmitted diseases at rates well below those recommended by current clinical guidelines. A low rate of screening was found even in adolescents who had been seen for a preventive primary care visit since they had first had sex. This suggests that the preventive primary care visit is not being used to its full potential as an opportunity to screen and treat adolescents for sexually transmitted diseases. Capitalizing on this opportunity to screen may increase the number of cases of sexually transmitted diseases diagnosed and, thus, decrease rates of these diseases in this population.

Adolescent↗
PubMed2006

[Penile fracture with associated urethral rupture].

OBJECTIVE: We report two cases of penile fracture; one case with associated rupture of the corpus spongiosum and complete urethral section, and the other presenting a second cavernous fracture three years after a first episode. METHODS: The first patient, 32-years-old, suffered the fracture of the right corpus cavernosum during intercourse three years after a first fracture requiring surgical repair. This time he also underwent surgery immediately to find and repair the lesion, with good functional outcome. The second patient, 29-years-old, suffered a transverse fracture at the bases of both corpora cavernosa associated with complete section of the urethra. He underwent emergency surgery to repair all lesions with good esthetic and functional results. RESULTS: Traumatic lesions of the penis with fracture of the corpora cavernosa are rare and the association with urethral rupture is exceptional, as well as it is the possibility of second fracture years ofter a first episode. CONCLUSIONS: Penile fracture is a rare reason for consultation in the emergency setting, which should be repaired immediately with evacuation of the hematoma, closure of the albuginea's lesion and repair of the urethral lesions when they appear. Results are better, avoiding mid and long-term complications.

Adult↗
PubMed2006

Long-term cosmetic and sexual outcome of hypospadias surgery: norm related study in adolescence.

PURPOSE: Even if performed early in life, hypospadias surgery may have a significant impact on self-esteem and sexual behavior in adolescence. We evaluated the long-term cosmetic and sexual outcomes of hypospadias surgery performed in childhood. MATERIALS AND METHODS: A detailed questionnaire was mailed to 33 patients with hypospadias who were 18 to 26 years old and had undergone the first operation at age 6 years or younger. It was also mailed to 50 age matched controls. RESULTS: A total of 22 patients (66.7%) and 38 controls (76.0%) returned the questionnaire. Mean age in the hypospadias and control groups was 20.6 and 21.0 years, respectively. Eight of the 22 patients had mild hypospadias and 11 had severe hypospadias. Severity was unknown in 3 patients. Age at the first and final operations was 31 to 75 (mean 46) and 35 to 81 months (mean 53). The number of operation was 1 in 10 patients, 2 in 10 and 3 in 2. The rate of dissatisfaction with penile appearance was slightly higher in the hypospadias group than in the control group (40.9% vs 34.2%). The single reason for dissatisfaction in the hypospadias group was inadequate penile size, whereas in the control group penile size, phimosis and curvature were the major reasons for dissatisfaction (69.2%, 46.2% and 23.1%, respectively). Experience with masturbation (100% and 97.4%) and sexual intercourse (52.4% and 55.3%), and mean age at first masturbation (13.4 and 13.0 years) and first sexual intercourse (16.6 and 17.3 years) were similar in the hypospadias and control groups, respectively. CONCLUSIONS: Although patients with hypospadias had a slightly higher rate of dissatisfaction with penile size, their sexual behavior was not different from that in control subjects.

Adolescent↗
PubMed1997

Acute urinary retention secondary to urethral inflammation from a vaginal contraceptive suppository in a 17-year-old boy.

We report the case of a 17-year-old boy who developed acute urinary retention following unprotected intercourse. His partner employed for the first time a nonoxynol-9-based commercial vaginal contraceptive insert. During intercourse the patient felt severe burning pain in the urethra. He was subsequently unable to void. Flexible cystourethroscopy revealed gross mucosal erythema and inflammation in the distal urethra and navicular fossa. We discuss the clinical management and review relevant literature.

Acute Disease↗