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PubMedDate not supplied

The use of traditional methods of contraception among Turkish couples.

About half the users of contraceptives in Turkey employ traditional methods of family planning, particularly withdrawal. This report presents data from a 1988 national survey to examine Turkish couples' use of and opinions about these methods. Use of traditional methods is widespread across all geographic, demographic, and socioeconomic groups. The principal reasons reported for not using methods generally considered to be highly reliable were fear of health problems and side effects and the opposition of husbands to such methods. Most couples who practice withdrawal also feel that it is as effective as modern methods. These findings imply that a major focus of family planning efforts should be the education of women, of their partners, and of health-care and family planning providers concerning the benefits, risks, and failure rates of both traditional and modern contraceptive methods.

Adolescent↗
PubMedDate not supplied

A direct mailing to teenage males about condom use: its impact on knowledge, attitudes and sexual behavior.

In August 1987, a letter, informational pamphlet and order coupon for free mail-order condoms were sent to an experimental group of teenage males 16-17 years of age. An experimental design was used to measure the impact of the mailing on teenagers' knowledge, attitudes and behavior. Approximately five weeks after the mailing, 985 members of this group and 1,033 members of the control group (who received no mailing) were interviewed by telephone. About seven months after the mailing, members of the experimental group who claimed they had ordered the free condoms were reinterviewed by phone. The results of the initial interviews revealed that about three-fourths of the teenagers in the experimental group had received the materials, and about two-thirds had read them. Moreover, males in the experimental group, particularly those who reported having received and read the pamphlet, were slightly but statistically significantly more knowledgeable about sexually transmitted diseases (STDs), pregnancy and contraceptives. On the other hand, there were no differences between males in the experimental and control groups in attitudes toward STDs or birth control, nor were there differences in actual sexual activity or in the use of birth control. However, the experimental group was significantly more likely to have ordered condoms by mail, presumably as a result of having received the free mail-order condom offer. Many of those who ordered condoms had previously had sex and had used condoms. However, a sizeable portion of those who ordered condoms did so prior to first intercourse, suggesting a possibly important early intervention.

Adolescent↗
PubMed1994

Contraceptive use and attitudes in Great Britain.

In order to update current knowledge on contraceptive use and attitudes in Great Britain (i.e. England, Scotland and Wales), a survey was conducted among 1753 randomly selected British women aged 15-45. Replies were received from 967 women (55.2%). Seventy-three percent (73%) of fertile, sexually active women who wished to avoid pregnancy were using reliable methods of contraception, viz. oral contraceptives (OCs), intrauterine devices (IUDs) or sterilization. However, it was found that adolescents and women over 40 who wished to avoid pregnancy were, nevertheless, especially likely not to be using any contraceptive method at all. The women surveyed were concerned about weight gain, cardiovascular and cancer risks associated with OC use, and infection and infertility risks associated with IUD use. Sixty percent (60%) perceived sterilization as a major and risky surgical operation. It was concluded that contraceptive practice in Britain had not improved greatly in recent years. The latest scientific findings regarding the true advantages and disadvantages of OCs, IUDs and sterilization, therefore, need to be brought to the attention of the lay public more effectively. Special efforts need to be directed towards providing adolescents and women over 40 with proper information. Physicians and the mass media could play a considerable role in this respect.

Adolescent↗
PubMed1997

Social factors predicting postpartum choice of Norplant among African-American and non-Hispanic white adolescents.

PURPOSE: This study was designed to determine the factors associated with Norplant choice for postpartum teens. METHODS: A total of 151 teenagers, ages 12-20 years, who delivered at the Medical Center of Delaware from July to December 1992, were offered insertion of Norplant within 48 h postpartum. A structured interview was conducted in the postpartum period after nondirective counseling sessions including a physical demonstration using anatomical models of various contraceptive methods. Student's t-tests, chi-square, and multivariate analyses were used. RESULTS: Eighty-six teenagers were African-American (mean age = 17.3 +/- 1.9 years) and 65 non-Hispanic white (NHW) (mean age = 18.3 +/- 1.5 years). The NHW teenagers were older (p < 0.001); the African-American teenagers were more likely to have Medicaid (49% vs. 14%; p < 0.001) and to have one or more friends who use Norplant (62% vs. 34%; p < 0.001). In multivariate analyses, NHW teenagers were more likely to choose Norplant if they had discussed their choice with a parent or guardian [adjusted odds ratio (AOR) = 14.6, 95% confidence interval (CI), 2.12-100.57]; had Medicaid funding (AOR = 12.1; 95% (CI), 10.6-91.34); and had any friends who used Norplant (AOR = 6.3; 95% (CI), 1.38-28.40). However, for African-American teenagers, the strongest predictor for choice of Norplant was number of prior children delivered. After two deliveries, there was a better than four-fold likelihood (AOR = 4.8; 95% (CI), 1.47-15.94) that African-American teenagers would choose Norplant. For the African-American teenagers, parental discussion, Medicaid status, and friends' use of Norplant were not as important as family size, but far greater percentages of the African-American teenagers had access to Medicaid funding and peers who used Norplant. CONCLUSIONS: NHW and African-American teenagers choose Norplant for different reasons. Lack of funding may have been a barrier to choosing Norplant. Discussions with parents and friends have a positive influence on choosing Norplant for NHW teenagers. African-American teenagers were more likely than NHW to have Medicaid coverage, and more frequently choose Norplant if the current birth was their third child.

Adolescent↗
PubMedDate not supplied

Characteristics of women who stop using contraceptives.

A relatively new multivariate life-table technique has permitted the effect of socioeconomic characteristics on first-year contraceptive failure rates to be determined to a greater degree of precision than was possible in the past. This technique is employed in this article to determine the one-year rates of contraceptive discontinuation among currently married U.S. women, using data from the 1973 and 1976 National Surveys of Family Growth (NSFG). The results indicate that poor women, black women and younger women are all relatively more likely to stop using contraceptives for reasons other than method-switching or the desire to become pregnant, as are women who have not completed high school, Catholic women and those who have never had a birth. Of all methods, the IUD is associated with the lowest rate of discontinuation. Pill users over age 30 are more likely to stop using their method than are comparable women using the IUD, diaphragm or condom. Women relying on spermicides are generally most likely to cease using a method. Finally, the subgroups of women who are most likely to stop using a particular method also are generally the groups that are most likely to experience contraceptive failures, while those that are least likely to discontinue use are also least likely to fail. Two exceptions are women who rely on rhythm and those who use the pill. The former experience relatively high rates of failure but are relatively less likely to stop using the method, and the latter have relatively high rates of discontinuation despite a low rate of failure.

Adolescent↗
PubMed1993

Contraception choice and sexually transmitted disease.

Sexually active couples need to be concerned with the risk of sexually transmitted diseases (STDs) and how their choice of contraception influences that risk. Condoms provide the best documented protection against such pathogens as: gonorrhea, herpes simplex virus (HSV), hepatitis B, HIV, and chlamydia. Female dependent barrier methods also provide protection against most STDs and also possibly HIV. Most hormonal non-barrier contraceptives, although providing excellent protection against unwanted pregnancies, provide little protection against STDs. Oral contraceptive pills (OCP) may increase the risk of infection with human papillomavirus (HPV) and cervical infections of chlamydia. Individuals at high risk for both an unwanted pregnancy and an STD should be counseled to use both a hormonal and barrier contraceptive. Recently, nonoxynol-9 (N-9) and OCP use have been associated with an increase in HIV infection in African women at high risk for HIV. This association has not been found in other studies and currently does not outweigh the proven benefits of these contraceptive methods.

Choice Behavior↗
PubMed1976

The changing African family project: a report with special reference to the Nigerian segment.

The Changing African Family Project was begun in 1973 as a cooperative venture of the Sociology Department of the University of Ibadan and the Demography Department of the Australian National University, with research institutes and individual researchers in 11 representative countries of Africa, to investigate the preconditions for fertility decline. This paper reports initial initial findings from the large Nigerian segment of the project, which was used as a laboratory, and presents technical information about the surveys, as well as findings on economic supports for high fertility, factors affecting fertility, the role of sexual abstinence in determining fertility levels, the increase in contraception and its relation to family size limitation, and the incidence and nature of achieved small families. Information is also provided on the projects in Cameroon, the Congo (Brazzaville), Ghana, and the Sudan.

Adolescent↗
PubMed1987

Epidemiology of contraception with steroids in Western Europe.

A study of contraceptive practice, essential knowledge and communication concerning contraception as well as the related perceptions was conducted among women aged 15-44 in Italy, France, Great Britain, Spain and the Federal Republic of Germany in the years 1984 and 1985. The pattern of contraceptive use and its differential varied strongly between countries. Knowledge, information and communications were observed to be different to a similar degree. Motives for changing contraceptive methods were largely inspired by concern for health and, to a lesser degree, reliability. Perceptions of contraceptive methods were found to be reasonably well in concurrence with reality, with the important exception of the perceptions of the health hazards of the pill which were largely overestimated, giving oral contraception and injustified bad image where effects on health are concerned.

Adolescent↗
PubMed1981

Response of unmarried adolescents to contraceptive advice and service in Nigeria.

The responses of a group of all unmarried, sexually active teenagers in a developing country to offers of contraceptive service were assessed in a prospective, 30-month study at a teaching hospital family planning center. Teenagers of this group constituted 7.2% of the clinic population. The default rate was very high (43.0%) and was most noticeable among users of oral contraceptives. The intrauterine device seemed more acceptable, as were injections of norethisterone enanthate. Possible reasons for this pattern of response are given, and the authors suggest giving new consideration to making the intrauterine device more suitable for and acceptable to teenagers of developing countries. The place of norethisterone enanthate in teenage contraception is also discussed.

Adolescent↗
PubMed1989

Adolescent contraception: nonhormonal methods.

A comparison of the advantages, disadvantages, and costs of each method is presented in Table 1. Barrier methods of contraception offer adolescents protection against both pregnancy and STDs, but innovative approaches are needed to enhance availability and acceptability. Condom use in conjunction with a vaginal spermicide would provide optimal protection. The "female condom" may prove to be an effective alternative. Diaphragms and cervical caps can be prescribed for well-educated, highly motivated adolescents comfortable with insertion and removal. The vaginal contraceptive sponge provides many of the advantages of the diaphragm and cap without the need for an examination and fitting and also may be used as a backup method with the condom. Vaginal spermicides used alone are significantly less effective than in combination with a mechanical barrier. The IUD is not considered appropriate for most adolescents due to its association with an increased risk of pelvic infection. Periodic abstinence requires accurate identification of the fertile period, extensive education, and partner cooperation. Sterilization is rarely considered an option in adolescents. Alternate forms of sexual expression are available to adolescents who choose to abstain from intercourse.

Adolescent↗
PubMed1996

Contraceptive methods: do Hispanic adolescents and their family planning care providers think about contraceptive methods the same way?

This article describes how a family planning clinic-based program to prevent repeat pregnancy among Hispanic adolescents in Los Angeles used qualitative research to understand client contraceptive behavior. Background information on Hispanic adolescent reproductive patterns and an overview of paths to motherhood among teen clients are provided to contextualize the results. Participants sorted contraceptive methods on perceived similarities and ranked them on effectiveness, safety, and use-preference. Multidimensional scaling was used to identify and compare conceptual models. Both providers and teens grouped methods by effectiveness and mode of action, but acceptability and ease of method use were also important for teens. Providers found participation a worthwhile educational experience that facilitated self-reflection about their own biases and better understanding of their clients' needs. This method could be applied in many clinical settings where education and counseling are important in treatment and where patients and providers are likely to have different conceptual models regarding therapy.

Adolescent↗
PubMed1985

Factors associated with married women's selection of tubal sterilization and vasectomy.

Multivariate analyses of data from 248 married women scheduled for tubal sterilization and 165 wives of men scheduled for vasectomy indicated that male and female sterilization methods were selected for different reasons and under different circumstances. More specifically, the woman who underwent tubal sterilization was more likely to have perceived that she had greater influence than her husband over the sterilization decision, to have had cesarean section or vaginal delivery in association with sterilization, to have chosen tubal ligation because her spouse refused to undergo the alternative procedure or because it was convenient to combine it with delivery or other surgery, and to have had a spouse who was unwilling to be sterilized because of possible side effects associated with vasectomy. The woman whose husband underwent vasectomy was more likely to have been very fearful of surgery in general or especially fearful of reproductive surgery, to have known many men who already had had a vasectomy, to have perceived that her husband was more strongly motivated than herself to terminate childbearing, to have had a spouse who participated in birth control, and to have chosen vasectomy because it was easier or less expensive or because her physician advised against tubal sterilization.

Adult↗