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PubMed2006

Effect of postpartum counseling on postpartum contraceptive use.

OBJECTIVE: The aim of this study was to evaluate the effect of postpartum counseling on postpartum contraceptive use. METHODS: One hundred and forty-three women who delivered between 1 January 2004 and 31 September 2004 and counseled about postpartum contraception were included in the study. The participants were interviewed by telephone. Age, gravidity, parity, and mode of delivery of the participants were recorded. Their method of contraception before pregnancy, their decision on the contraceptive method after counseling and the method actually used were asked. RESULTS: Just after postpartum counseling, 47 women (32.9%) decided to use the intrauterine device (IUD), 23 (16.1%) condoms, 16 (11.2%) progestin injections, 7 (4.9%) oral contraceptives, and 7 (4.9%) coitus interruptus for contraception. Thirty-six women (25.2%) did not decide on any method of use. At the time of the telephone interview the actual method used was learned. Fifty-one women (35.7%) were using coitus interruptus, 45 women (31.5%) condoms, and 14 (9.8%) the IUD. Sixteen women (11.2%) were reported as not using any methods. CONCLUSION: In spite of postpartum counseling, a high majority of the women appeared to use traditional and less effective contraceptive methods.

Adolescent↗
PubMed1985

Contraceptive decision-making in urban, black female adolescents: its relationship to cognitive development.

Contraceptive education and accessible contraceptive methods have not reduced significantly the incidence of adolescent pregnancy. The cognitive development of adolescents makes contraceptive decision-making difficult. This study examined how cognitive development affected contraceptive decision-making among 86 urban black female adolescents attending three family planning clinics. Hierarchical multiple regression analyses revealed that the stage of cognitive development was the best predictor of contraceptive decision-making. Age and relevant sexual knowledge added to the explanation of decision-making variance. Potential nursing implications include: (1) screening of stage cognitive development prior to rendering care, (2) continuation of contraceptive education and (3) presentation of contraceptive education at appropriate cognitive levels.

Adolescent↗
PubMed1995

Relationship between use of condoms and other forms of contraception among human immunodeficiency virus-infected women. Supplement to HIV and AIDS Surveillance Project Group.

OBJECTIVE: To describe the relationship between condom use and use of other contraceptives among human immunodeficiency virus (HIV)-infected women. METHODS: We interviewed 1232 women, 18-50 years of age, who had had sex with a man in the prior 12 months and who were reported with AIDS or HIV to local health departments in 12 states and cities in the United States. These women were asked about condom use and other contraceptive use in the past year. RESULTS: Forty-seven percent of women reported using condoms as a form of contraception in the past 12 months. Thirty-four percent of the 286 women who had had a tubal ligation and 42% of the 182 women who used oral contraceptives (OC) used condoms. When we controlled for all factors associated with failing to use condoms, women who had had a tubal ligation (adjusted odds ratio [OR] 1.72, 95% confidence interval [CI] 1.28-2.33), women who used OCs (adjusted OR 1.44, CI 1.00-2.08), and women who were unaware of the HIV status of their most recent steady sex partner (adjusted OR 1.72, CI 1.28-2.31) were the least likely to use condoms. CONCLUSION: Human immunodeficiency virus-infected women who used more effective contraceptive methods were the least likely to have male sex partners who used condoms. In counseling women at high risk of transmitting HIV, health care providers should discuss reasons for using contraceptives (ie, preventing pregnancy versus preventing HIV transmission) and ensure that women understand that different forms of contraceptives may be needed to achieve those different purposes.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Psychosocial conventionality, health orientation, and contraceptive use in adolescence.

PURPOSE: The purpose of this paper is to determine psychosocial and behavioral factors that are associated with variation in contraceptive use among adolescents. Because regular use of contraception may be seen both as a conventional behavior and as a health-protective behavior, analyses assess the association between psychosocial conventionality and health orientation, on the one hand, and variation in contraceptive use, on the other. METHODS: Analyses are based on an urban sample of 971 white, African-American, and Hispanic male and female sexually active high school students. Study participants filled out a 38-page questionnaire that included a wide range of measures derived from Problem-Behavior Theory. RESULTS: Correlational analysis and hierarchical regression analysis indicate that more regular contraceptive use is associated with greater psychosocial conventionality and also with greater orientation toward health for both male and female adolescents. These relationships hold when the sociodemographic characteristics of race/ethnicity, socioeconomic status, grade in school, family composition, and pregnancy experience are controlled. The linkages of psychosocial conventionality and health orientation to contraceptive behavior are stronger for African-American than for white and Hispanic adolescents. CONCLUSIONS: The present findings establish a more comprehensive and more distal set of influences on regularity of contraceptive use. In its negative relationship to problem behavior and its positive linkage with health behavior, contraceptive behavior may be seen as part of a larger, organized system of behavior in this stage of development (i.e., a more conventional adolescent lifestyle).

Adolescent↗
PubMed1999

Comparison of continuation rates for hormonal contraception among adolescents.

BACKGROUND: Inadequate contraception is common among sexually active female adolescents, resulting in a high incidence of unwanted pregnancy. The authors were interested in comparing continuation rates for the different forms of hormonal contraception in this age group. METHODS: A retrospective chart review. The setting was an urban clinic in a large Midwestern city. Participants were 64% black, 34% white, and the average age was 15.5 years (+/- 1.6 SD), with implant users significantly older than oral contraceptive pill (OCP) users (P < .05). Interventions were self-selection to depo-medroxyprogesterone acetate (Depo-Provera; DMPA), levonorgestrel implants (Norplant), or oral contraceptive pills (OCPs). Previous pregnancy was significantly more prevalent in implant and DMPA users than in OCP users (P < .001). Over 4 years of follow-up, continuation rates were significantly higher for implant users than for the other hormonal groups (P < .001). At 1 year, continuation rates were as follows: 82% implants, 45% DMPA, and 12% OCPs. Combining these rates with those of the subsample who switched without interruption to another hormonal method, "continued protection" rates were much higher after 1 year: 96% implants, 83% DMPA, and 49% OCPs. Calculations of contraceptive "restarts," i.e., hormonal method use in those who discontinued and then restarted after a gap of time, also increased to the prevalence of contraceptive protection. CONCLUSION: Continuation rates for levonorgestrel implants were significantly higher than those for DMPA and OCPs, the latter group having the lowest continuation rates. Factoring in switches and restarts to other hormonal methods further boosted the prevalence rates of contraceptive use in the adolescent population.

Adolescent↗
PubMed2006

Prospective study of hormonal contraception and women's risk of HIV infection in South Africa.

BACKGROUND: Many women using hormonal contraceptives are also at risk of sexually transmitted HIV infection, but data are mixed on whether hormonal contraception increases women's risk of HIV. We investigated associations between HIV incidence and use of combined oral contraceptives (COC), norethindrone enanthate (NET-EN) or depot medroxyprogesterone acetate (DMPA) in a cohort of South African women. METHODS: Participants were 4200 HIV-negative women aged 35-49 years enrolled into a cervical cancer screening trial. At enrollment, women were tested for sexually transmitted infections and reported on their sexual behaviour and contraceptive use. During the 24 months of follow-up, women reported on their sexual behaviours and contraceptive use and underwent repeat HIV testing. RESULTS: During the 5010 person-years of follow-up, 111 incident HIV infections were observed (HIV incidence, 2.2 infections/100 person-years). At enrollment, 21% of women reported using hormonal contraception, primarily DMPA (14% of all women) or NET-EN (5%). After adjusting for sexual risk behaviours and sexually transmitted infections, the incidence of HIV was similar among women using COC, NET-EN or DMPA compared with women not using any hormonal method [incidence rate ratios and 95% confidence intervals, 0.65, 0.16-2.66; 0.79, 0.31-2.02 and 0.96, 0.58-1.59, respectively]. There was also no association between increased duration of DMPA use and HIV incidence (P-value for trend, 0.51). CONCLUSIONS: These findings contribute to the evidence from general population cohorts of women that hormonal contraceptive use is not associated with increased risk of HIV acquisition. Nonetheless, family planning services are an important venue for HIV prevention activities.

Adult↗
PubMed1993

Contraceptive problems in the developed world.

In most developed countries contraception is available and relatively cheap. In Britain 50% of women use reversible contraception and over the age of 35 more than 50% of women (or their partners) have been sterilised. Nevertheless large numbers of unplanned pregnancies still occur in all countries. Annual abortion rates (per 1000 women aged 15-44) are 5.6 in the Netherlands, 13 in Britain and 28 in the USA. In Britain about 50% of all conceptions are unplanned. Ambivalent attitudes to sex mean that there is inadequate public discussion about contraception. The media publicise adverse effects of oral contraceptives more than their benefits. Advertising of condoms is restricted, and the marketing of oral contraceptives to doctors emphasizes their side-effects. Contraception should be made more accessible to potential users, particularly the young, who are at greatest risk of unwanted pregnancy. Opinion among teenagers and their parents is in favour of more sex education at school. Efforts should be directed towards providing young people with better education on sex and contraception.

Adolescent↗
PubMed1984

Effect of various oral contraceptive combinations on dysmenorrhea.

The influence of different oral contraceptives on the prevalence and severity of dysmenorrhea was investigated in a representative sample of 19-year-old women from an urban Swedish population. The prevalence and severity of dysmenorrhea were significantly (p less than 0.01) reduced amongst users of progestogen-dominated oral contraceptives compared to a control group of women who used neither oral contraceptives nor an intrauterine device. However, there was no significant difference in the prevalence and severity of dysmenorrhea between users of oral contraceptives with low progestogen activity and the same control group. Thus, the relative progestogen activity of the oral contraceptive used appears to be of importance for the effective treatment of dysmenorrhea. Possible reasons for the superior therapeutic efficacy of progestogen-dominated oral contraceptives are discussed. Further studies are, however, necessary to evaluate the importance of the progestogen activity of oral contraceptives in the treatment of dysmenorrhea.

Absenteeism↗
PubMedDate not supplied

Contraceptive use and consistency in U.S. teenagers' most recent sexual relationships.

CONTEXT: Most U.S. teenage pregnancies are unintended, partly because of inconsistent or no use of contraceptives. Understanding the factors associated with contraceptive use in teenagers' most recent relationships can help identify strategies to prevent unintended pregnancy. METHODS: Data on 1,468 participants in Waves 1 and 2 of the National Longitudinal Study of Adolescent Health who had had two or more sexual relationships were analyzed to assess factors associated with contraceptive use patterns in teenagers' most recent sexual relationship. Odds ratios were generated through logistic regression. RESULTS: Many relationship and partner characteristics were significant for females but nonsignificant for males. For example, females' odds of ever, rather than never, having used contraception in their most recent relationship increased with the duration of the relationship (odds ratio, 1.1); their odds were reduced if they had not known their partner before dating him (0.2). The odds of consistent use (vs. inconsistent or no use) were higher for females in a "liked" relationship than for those in a romantic relationship (2.6), and for females using a hormonal method instead of condoms (4.5). Females' odds of consistent use decreased if the relationship involved physical violence (0.5). Among teenagers in romantic or "liked" relationships, the odds of ever-use and of consistent use were elevated among females who had discussed contraception with the partner before their first sex together (2.9 and 2.1, respectively), and the odds increased among males as the number of presexual couple-like activities increased (1.2 for each). CONCLUSIONS: Teenagers must use contraception consistently over time and across relationships despite pressure not to. Therefore, they must learn to negotiate sexual and contraceptive decisions in each relationship.

Adolescent↗
PubMed2001

A large observational clinical evaluation of a desogestrel-containing combiphasic oral contraceptive in Germany.

OBJECTIVE: The aim of this observational study was to assess the influence of a new combiphasic oral contraceptive on cycle control, tolerability and acne in a large cohort of women who wanted to switch from their previous oral contraceptive. METHODS: A total of 2,280 women were enrolled in this clinical evaluation at 232 centers in Germany. All women switched from their previous pill to a combiphasic oral contraceptive containing ethinylestradiol and desogestrel (combiphasic EE/DSG; comprising 25 microg desogestrel and 40 microg ethinylestradiol for 7 days followed by 125 microg desogestrel and 30 microg ethinylestradiol for 15 days and then a 6-day pill-free interval) for three cycles. RESULTS: Most women (53%) had previously used a monophasic oral contraceptive containing 20 or 30-35 microg ethinylestradiol. The most frequent reasons for switching were bleeding irregularities (41% of women), other menstrual disorders (27%) and migraine/headache (10%). After switching to combiphasic EE/DSG, cycle control improved significantly: the incidences of spotting and breakthrough bleeding decreased from 33% and 23% of women, respectively, before the start of the study, to 7% and 3% of women at the end of the study period. At the end of the study, acne was no longer present in 37% of the 592 women who had acne at the start of the study, and subjective complaints such as headaches were less frequent than before. Most women were satisfied or very satisfied with the combiphasic oral contraceptive and 89% wished to continue using it. CONCLUSIONS: The results of this observational clinical evaluation indicate that in everyday use, for women who wish to switch from another oral contraceptive, combiphasic EE/DSG is an effective and well-tolerated oral contraceptive, which improves cycle control and has a beneficial effect on acne.

Acne Vulgaris↗
PubMed1981

[Chen Muhua holds meeting on contraceptives].

On February 19, Chen Muhua, vice premier of the State Council and head of the family planning leading group, held a discussion with responsible comrades of the State Council's Family Planning Office, the State Pharmaceutical Administration, the Ministry of Chemical Industry, the State Planning Commission, the Ministry of Finance and other departments concerned with the production and supply of contraceptive drugs and devices. Vice Premier Chen Muhua pointed out: Contraceptive drugs and devices are the material guarantees for the practice of family planning. Doing a good job in the production and supply of contraceptives is a political task. It is hoped that from now on all departments concerned will pay still greater attention to it. Vice Premier Chen Muhua put forward 4 points: 1. To control population, the stress should be placed on contraception. This is the basic way. 2. It is necessary to popularize in an all-round way methods of using contraceptive drugs and devices. 3. Supply channels should be kept open for the convenience of the masses and to guarantee supplies. 4. It is necessary to strengthen scientific research. The quality and packing of presently available drugs and devices should be improved. At the same time, it is necessary to develop new contraceptive drugs and devices welcomed by the masses. Special efforts should be made in research in the field of Chinese herbal medicine. At the meeting the State Council Family Planning Office and the State Pharmaceutical Administration were instructed to conduct a joint investigation on present production arrangements and supply channels of contraceptive drugs and devices and to adopt effective measures to solve existing problems.

Asia↗
PubMed1992

Reproductive knowledge, and contraceptive awareness and practice among secondary school pupils in Bagamoyo and Dar-es-Salaam, Tanzania.

Reproductive knowledge, and contraceptive awareness and practice were assessed among secondary school pupils in Bagamoyo and Dar-es-Salaam, Tanzania. Four classes from four government secondary schools were randomly selected within strata of year of schooling, and students were interviewed using a structured questionnaire. All 490 pupils in selected classes participated in the study. Of 481 respondents with complete data, 315 (65.5 pc) were males and 166 (34.5 pc) were females; 256 (53.2 pc) were from Dar-es-Salaam while 225 (46.8 pc) were from Bagamoyo. Two hundred and ninety three (60.9 pc) respondents reported they were sexually active. However, only 77 (17.0 pc) pupils knew the "safe period" within the menstrual cycle and 329 (68.4 pc) pupils were able to spontaneously mention at least one method of contraception. Less contraceptive awareness was noted among respondents below 18 years of age particularly among females in both study areas. Only 45 (15.4 pc) pupils had ever used a contraceptive method. Despite a reasonable level of awareness and a positive attitude towards contraception, only a small proportion of sexually active pupils had ever used contraceptives. More research is required to identify the barriers to contraceptive use in the presence of knowledge.

Adolescent↗
PubMedDate not supplied

[Contraceptive practices among adolescents and youths of the metropolitan area of Mexico City].

The purpose of this article is to provide a brief description of the information that the adolescent and youth population of Mexico City has concerning the knowledge and use of contraceptive methods, as well as the reasons why they do not adopt some contraceptive method during their sexual relations. The data obtained from the Survey on Adolescent and Youth Reproductive Behavior in the Metropolitan Area of Mexico City serves as a basis for pointing out several behavior patterns of the male and female population from 10 to 25 years of age. Of those interviewed, 32.7 per cent had had at least one sexual contact; the average age at which sexual relations had begun was 16 years for males and 17 for females. A total of 33.8 per cent of those who had had sexual contact stated that they had used some form of contraception, the principal methods used during first sexual intercourse being rhythm (36.9%); withdrawal (23.6%), and condoms (12.3%). The reasons for not using any contraceptive method were as follows: lack of knowledge regarding the methods, how to use them or where to obtain them (39.4%), and unplanned sexual intercourse (28.9%). During the last sexual contact they had, 70.5 per cent had used a contraceptive. The methods most frequently used were hormonal contraceptives and IUD (40.9%); rhythm (23.8%), and withdrawal and condoms. The reasons why no contraceptive was used in the last sexual contact were: neither partner thought that pregnancy would occur (27.1%) and the sexual contact was unplanned.

Adolescent↗
PubMed2006

Contraceptive use by Maori youth in New Zealand: associated risk and protective factors.

AIMS: To identify risk and protective factors associated with consistent contraception use by sexually active Maori youth. METHODS: Secondary analysis was undertaken utilising Youth2000, an anonymous nationally representative secondary school health and wellbeing survey, undertaken in 2001. We describe the self-reported sexual health and contraceptive use behaviours of Maori students. A multiple logistic regression model was utilised to identify risk and protective factors associated with consistent contraception use by sexually active Maori students. RESULTS: Half of the Maori students have had sexual intercourse (54% males; 48% females) and a third are currently sexually active (33% males; 34% females). Most Maori youth who have ever had sex use condoms for contraception (82%) and most sexually active Maori youth reported consistent use of contraception (71% males; 70% females). Maori youth who use contraception consistently are more likely to report getting enough time with a parent (OR 1.50; 95% CI 1.05-2.14; p=0.03) and less likely to report weekly marijuana use (OR 0.53; 95% CI 0.37-0.76; p=0.0006). CONCLUSIONS: Consistent use of condoms is a common self-reported contraceptive practice by many young Maori. However this behaviour is not universal, and in view of the significant sexual and reproductive health disparities that exist for Maori youth, sexual and reproductive health programs should examine a broader strategy of promoting protective factors such as strengthening youth-parent relationships and reducing risk factors, such as minimising substance misuse. Together with existing efforts in education, whanau (family), and community based programs, these strategies may support healthier sexual health outcomes for Maori youth.

Adolescent↗
PubMedDate not supplied

Husband's approval of contraceptive use in metropolitan Indonesia: program implications.

Husband's approval of contraceptive use plays a decisive role in Indonesia. Despite this, no previous study of contraceptive use in Indonesia has evaluated the importance of husband's approval. Such evaluation is especially important in metropolitan areas where family planning programs have encountered more difficulty than those elsewhere in recruiting contraceptive users. Using data from the first Indonesia Contraceptive Prevalence Survey for metropolitan cities, husband's approval and other determinants of contraceptive use among fecund women were evaluated. The levels of contraceptive use varied among cities, ranging from 34.2 percent in Ujung Pandang to 56.5 percent in Semarang. For all cities, however, husband's approval was the most important determinant, followed by number of living children and wife's education. Among women who desire to have no more children, 17.4 percent and 27.8 percent of contraceptive nonuse in Medan and Jakarta, respectively, was attributable to husband's disapproval. Because most of the family planning programs in Indonesia are designed to serve primarily women, the finding of husband's approval as the most important determinant has important program implications.

Adolescent↗
PubMedDate not supplied

Contraceptive continuation among adolescents attending family planning clinics.

An attempt to find a reliable way to measure contraceptive continuation among teenagers was made in a study of 445 adolescents under age 18 who made an initial visit to one of nine federally funded family planning clinics in the Philadelphia area in 1980 and 1981. The participants were interviewed at their initial visit and at six and 15 months to collect information on background characteristics, pregnancy history and contraceptive use. A cross-check of the information on contraceptive use reported during the study showed that 38 percent of the respondents who reported that they had been continuous users during the 15 months supplied information at other points indicating that they had not always used contraceptives during that period. In an attempt to examine the effects of adolescent reporting errors on measures of contraceptive use, the investigators constructed three alternative measures of contraceptive continuation. The simplest measure assessed current use at 15 months. A second measure accepted only reports of continuous use at 15 months and ignored inconsistent data. The third measure corrected for inconsistent data. Applying these measures to the study population produced proportions of contraceptive continuation ranging from a low of 43 percent when the most stringent measure was used to a high of 82 percent for the current-use category. Whatever the measure used, much of the discontinuation appears to have occurred in the first three months after the initial visit to a family planning clinic.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

[Contraception in the premenopause].

Reproduction continues in the perimenopause. To prevent unintended pregnancies, the use of a highly effective reversible contraceptive is necessary. The most effective methods of contraception are hormonal contraceptive methods and the intrauterine device (IUD). Barrier contraceptives can have a high-use effective rate in motivated users, too. Hormonal contraception has both risks and benefits, but can be used safely for healthy women without risk factors during the time of perimenopause. To prevent the metabolic side effects of synthetic estrogen-ethinyl-estradiol in the contraceptive pill in perimenopause, the use of natural estrogen (estradiol) in combination with a progestagen for contraception is effective, too. A major problem of IUDs has been the increased incidence of bleeding or dysmenorrhea. For these women, Progestin-releasing IUDs are recommended because of their ability to reduce the amount of uterine bleeding associated with menstruation.

Adult↗
PubMed1989

Long-term oral contraceptive use does not affect trabecular bone density.

To determine whether long-term exposure to exogenous estrogen in oral contraceptives influences trabecular bone mass in premenopausal women, we studied 25 closely matched, healthy, premenopausal women, who were recruited from an active obstetrics and gynecology practice. Eleven women had never used oral contraceptives, and 14 women had used oral contraceptives for a minimum of 67 months. All oral contraceptive users had used preparations that provided a minimum of 50 micrograms mestranol per day. Trabecular bone density was determined by quantitative single-energy computerized tomography of the L1-3 lumbar vertebral bodies. Trabecular bone density was similar for both the control group and the oral contraceptive users, 160.6 +/- 6.9 versus 161.2 +/- 7.4 mg/ml, respectively. The power to detect a 15% difference in bone density between these two samples was 0.87. We concluded that long-term, premenopausal oral contraceptive use has no effect on vertebral bone density.

Absorptiometry, Photon↗