Comparative study on the acceptance and use of contraceptive methods in a rural population in Kelantan.
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Ambulatory Care Facilities↗
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Past and present contraceptive behavior of new Soviet immigrant women in Israel.
This exploratory research investigated past and current use of contraceptives among a purposive sample of 117 new immigrant women from the Commonwealth of Independent States (former Soviet Union). The findings confirm the widespread use of induced abortion (IA) as a method of birth control before immigration. Fifty-eight percent of the sample had had at least one IA, and the average was 2.7 IA. The most commonly used types of contraception before immigration were the pill, safe days, withdrawal, and the IUD. Currently used types of contraception were the IUD, safe days, withdrawal, and condoms; however only 45% of the sample were currently using any type of contraception. Of particular interest were the relatively high reported use of the pill before immigration and low current use, and the former low level of condom use and its increase in popularity in Israel. Despite the availability of more effective methods of birth control, safe days and withdrawal remain commonly used. The high cost of the pill was mentioned as a deterrent to its current use. Despite the high prior level of IA, the majority of women in this sample (84%) preferred today to use other birth control methods, and would like the opportunity to receive professional advice. These findings support the need for educational efforts directed toward new immigrant women from CIS.
Abortion, Induced↗
[Contraceptive practices in France].
Between 20 and 44 years of age, in France, two women out of three use contraception; 41% use oral contraception, and 16% the IUD; 5% use condoms, and sterilization remains uncommon. Since 1988, when some information was made about the AIDS epidemics, condoms have become widely used, as a temporary method, especially by young people and people not living as a couple; 59% of women and 83% of men aged 20-24 ever used condom, and half of the women who had their first sexual intercourse during the two last years used condoms.
Adult↗
Truck crew and risk of contraction of STDS, including HIV: encouraging the use of condoms by the method of applying theories.
Studies from India conclude that the long distance truck crew are at a high risk of contracting and transmitting STDs and HIV on account of their high risk sexual behaviours. These studies indicate the necessity of changing the behaviour of the truck crew in favour of safer sexual practices. This article addresses this important issue of developing an intervention to decrease the risk of contraction of STDs, including HIV, by encouraging the use of condoms by the method of applying psycho-social theories, which aim at changing behaviours of the target group.
Condoms↗
Frequency of intercourse and contraceptive choice.
The effects of frequency of intercourse on perceptions of two of the most widely used contraceptive methods, the pill and condom, were assessed in 128 female college students currently involved in a sexual relationship. Intercourse frequency was found to be strongly associated with knowledge of both methods. People experiencing more frequent sexual intercourse were more favourably disposed towards the pill and less towards the condom than people experiencing intercourse less frequently. Implications of these results are discussed.
Adult↗
The etiology of pelvic inflammatory disease.
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Adnexa Uteri↗
Venereal disease prevention.
Outlining his interest and work in the prevention of VD, especially gonorrhea and syphilis, the author addresses the questions of prophylaxis and contraceptives, together with their technological advances, and ties these two concepts into the complex fabric of human behavior, history of available therapy in both world wars as well as the economic, social, moral and national concepts of what constitutes proper emphasis: prevention or cure. Thus, the absence of therapeutic modalities spurred the United States Armed Services to utilize Credé's solution for urethral irrigation and locally applied calomel ointment for prophylactic purposes in World War I but abandoned this mode when cheap penicillin therapy became available after World War II. Similarly, the utilization of combined prophylactic and contraceptive methods for women has to await the overcoming of societal and parental resistance. Particularly where teenagers are concerned the importance of combined modalities is stressed.
Adolescent↗
Combined use of condoms with other contraceptive methods among inner-city Baltimore women.
Data from a street survey conducted among 717 women aged 17-35 in two inner-city Baltimore communities in 1991-1992 indicate that 17% of the entire sample, 38% of women using the pill and 11% of users of methods other than the pill used a condom in addition to another method the last time they had intercourse. Although adolescents reported the highest rate of combined condom and pill use (22% of 17-19-year-olds), condom use was significantly associated with pill use among adult women (odds ratio of 1.57) but not among adolescents (odds ratio of 1.03). Condom use was negatively associated with use of methods such as the diaphragm, the IUD, the implant and the sponge (odds ratio of 0.21) among both adolescents and adults. Logistic regression analyses show that positive attitudes toward safer sex, ever having refused sex without a condom and believing in condom efficacy all significantly predicted use of the condom with another method. Having ever been tested for HIV was negatively related to combined use, while behavioral risk factors showed no association.
Acquired Immunodeficiency Syndrome↗
Characteristics of males at a public health department contraceptive service.
To effectively confront teenage pregnancy, the characteristics, attitudes, and behaviors of males, along with females, need to be better understood. This pilot study examined young males who visited the family planning clinic of a public health department to obtain free condoms. Questionnaires were distributed over a 4-week period. Nearly 30% of males reported having sex 11+ times a month. However, an equal proportion reported having sex three or fewer times in the same interval. Most males reported using condoms during sex, although one quarter reported use as "seldom." The health department was a major source of condoms and was positively evaluated because condoms were free and there were "no questions asked." Only one third of the males reported using another method of contraception. Results suggest a major role of the health department in condom availability and the potential need for contraceptive services for males.
Contraceptive Devices, Male↗
Identification of a high molecular weight trans-membrane protein in mouse L cells.
We have developed a new method for identifying proteins which span the plasma membrane ("trans-membrane" proteins) of mammalian cells grown in tissue culture. The method involves labeling proteins exposed on the cell surface with 125I by the lactoperoxidase technique and then preparing sealed, "inside-out" membrane vesicles (phagosomes) from the labeled cells using the polystyrene latex bead procedure. These inside-out vesicles are then treated briefly with trypsin and analyzed by SDS-polyacrylamide gel electrophoresis for the presence of 125I-labeled protein species which were degraded by proteolytic attack. Such proteins must be exposed on both the outer and inner membrane surfaces and, therefore, they must pass through the lipid barrier. This method is a general one in the sense that it is suitable for use with a wide variety of cell types, and here we show how it has been employed to prove that a particular high molecular weight polypeptide, called band 1, spans the plasma membrane of mouse L cells. Further studies of the band 1 polypeptide have demonstrated that it is preferentially exposed on the L cell surface during G1 phase of the cell cycle. Progression of cells from G1 to S is accompanied by a marked decrease in the availability of band 1 to iodination and it remains unavailable until cells re-enter G1. It is suggested that the band 1 polypeptide may be functionally involved in the regulation of cell proliferation.
Cell Membrane↗
Characteristics and attitudes of early contraceptive implant acceptors in Texas.
In 1991, shortly after Norplant became available in the United States, 678 women who had received the implant from 17 providers in Texas were surveyed. Forty-five percent of these women were under 21 years old. The majority (56%) had tried the implant because they were dissatisfied with their previous contraceptive method. Forty-four percent of the sample indicated that the implant was one of the first contraceptive methods they had used and that they had only recently decided to prevent unplanned pregnancy. The average number of children per woman was 1.2, and one-third of the sample had had at least one abortion. While 37% of the women said they wanted no more children, 63% said they were using the implant as a spacing method. The reasons for choosing the implant and concerns about it varied according to the user's age, educational level and race or ethnic group.
Adolescent↗
Hemodynamic changes in brain caused by local infusion of hyperosomolar solutions, in particular relation to blood-brain barrier opening.
The intracarotid infusion of hyperosmolar aqueous solutions such as urea is widely used to transiently open the blood-brain barrier in various animal species. In the present study in the rat an attempt was made to analyze the hemodynamic changes caused by the intracarotid infusions with special reference to possible mechanisms underlying the barrier opening. The cerebral blood flow (as reflected by the cerebral venous outflow rate) intracranial pressure, intracarotid pressure and systemic blood pressure were continuously measured during and following the infusions. It was found that intracarotid infusions of hyperosomolar solutions induce cerebral vasodilation and flow increase. Autoregulation is impaired. Probably, a direct vasodilator mechanism is involved but, depending on volume and osmolarity of the solution used, the changes may be heavily influenced by vascular distention due to intracarotid pressure effect, and by systemic pressure changes. These mechanisms are in common with other methods for barrier opening. The local vasomotor and systemic effects of a hyperosmolar solution of urea, capable of opening the barrier, are not normalized until about 6 min after the administration.
Animals↗
Childhood vaccine risk/benefit communication in private practice office settings: a national survey.
UNLABELLED: Communication about childhood vaccine risks and benefits has been legally required in pediatric health care for over a decade. However, little is known about the actual practice of vaccine risk/benefit communication. OBJECTIVES: This study was conducted to identify current practices of childhood vaccine risk/benefit communication in private physician office settings nationally. Specifically, we wanted to determine what written materials were given, by whom, and when; what information providers thought parents wanted/needed to know, the content of nurse and doctor discussion with parents, and the time spent on discussion. We also wanted to quantify barriers to vaccine risk/benefit discussion and to prioritize materials and dissemination methods preferred as solutions to these barriers. METHODS: We conducted 32 focus groups in 6 cities, and then administered a 27-question cross-sectional mailed survey from March to September 1998, to a random national sample of physicians and their office nurses who immunize children in private practices. Eligible survey respondents were active fellows of the American Academy of Pediatrics or American Academy of Family Physicians in private practice who immunized children and a nurse from each physician's office. After 3 mailings, the response rate was 71%. RESULTS: Sixty-nine percent of pediatricians and 72% of family physicians self-reported their offices gave parents the Centers for Disease Control and Prevention Vaccine Information Statement, while 62% and 58%, respectively, gave it with every dose. In ~70% of immunization visits, physicians and nurses reported initiating discussion of the following: common side effects, when to call the clinic and the immunization schedule. However, physicians reported rarely initiating discussion regarding contraindications (<50%) and the National Vaccine Injury Compensation Program (<10%). Lack of time was considered the greatest barrier to vaccine risk/benefit communication. Nurses reported spending significantly more time discussing vaccines with parents than pediatricians or family physicians (mean: 3.89 vs 9.20 and 3.08 minutes, respectively). Both physicians and nurses indicated an additional 60 to 90 seconds was needed to optimally discuss immunization with parents under current conditions. Stratified analysis indicated nurses played a vital role in immunization delivery and risk/benefit communication. To improve vaccine risk/benefit communication, 80% of all providers recommended a preimmunization booklet for parents and approximately one half recommended a screening sheet for contraindications and poster for immunization reference. The learning method most highly endorsed by all providers was practical materials (80%). Other desirable learning methods varied significantly by provider type. CONCLUSIONS: There was a mismatch between the legal mandate for Vaccine Information Statement distribution and the actual practice in private office settings. The majority of providers reported discussing some aspect of vaccine communication but 40% indicated that they did not mention risks. Legal and professional guidelines for appropriate content and delivery of vaccine communication need to be clarified and to be made easily accessible for busy private practitioners. Efforts to improve risk/benefit communication in private practice should take into consideration the limited time available in an office well-infant visit and should be aimed at both the nurse and physician.
Child↗
Sexual behaviour and condom acceptance among Nigerian drivers.
A survey of 180 randomly selected drivers was carried out in June 1994 in Ilorin, Nigeria in order to gain information about high-risk sexual behaviours, to ascertain condom use and to identify obstacles to condom acceptance so as to facilitate the design of an intervention to prevent Sexually Transmitted Diseases/Acquired Immuno-deficiency Disease in this target population. Data was collected through face-to-face interview. Three-quarters of the respondents were married. Multiplicity of sexual partners including casual and commercial contacts, was common. Half of the respondents engaged in high-risk sexual behaviour and a high proportion of them (60 percent) reported unwillingness to use the condom. This was mainly due to general dislike and lack of knowledge of the method. Risk perception was poor. These findings support the need for male reproductive health services especially for this sub-population.
Acquired Immunodeficiency Syndrome↗
Photoneutron production in the primary barriers of medical accelerator rooms.
Several radiation surveys, at medical linear accelerator facilities where lead or steel had been used with concrete to fabricate the primary barriers, revealed the existence of a sizable neutron field outside the shielding. This neutron field is produced by photoneutrons generated in the metal portion of the shield when the primary x-ray beam is aimed at the barrier. A method was developed to calculate the neutron dose-equivalent rate expected outside a primary shield when it is irradiated by a high-energy x-ray beam. It was found that the minimum photoneutron dose was produced when the metal part of the shield was positioned inside the treatment room in front of the concrete and also by using steel in place of lead. A thickness of less than or equal to 17 cm of metal on the inner surface of the shield produced only a slight increase in the neutron dose equivalent outside the barrier.
Health Facility Environment↗
Trends in the contraceptive practices of women seeking abortions in the 1980s.
The demographic features and contraceptive practices of 1000 women attending Parkview clinic of Wellington Hospital for termination of pregnancy were studied over an eight month period in 1988-9. Comparisons were made with a previous study at the same clinic in 1980-1. The overall abortion rate has increased from 6.8/1000 women in the Wellington statistical area in 1981 to 9.8 in 1989. The proportion of Pacific Island and Asian women presenting for abortions is high and has increased disproportionately between 1981 and 1989. The abortion rate has also increased in lower socioeconomic groups in 1989. The proportion of women using contraception at the time of conception increased from 50% in 1981 to 68.5% in 1989. The methods used by women presenting for abortion have changed significantly. There has been an increase in the proportion of women using condoms (from 13.3% to 36.2%) and the oral contraceptive pill from (14% to 21.4%).
Abortion Applicants↗
[Condoms and adolescents. A prospective study of a new method of teaching].
A prospective investigation was carried out with the object of assessing the effect of supplementary sex education for 1.3 hours in addition to the compulsory sex education in Danish elementary schools. One doctor did the teaching and practice with a condom was introduced as a new method of teaching. On an average, seven weeks before and seven weeks after this teaching session, these pupils completed a questionnaire. Altogether 451 pupils from the eighth and ninth classes participated. Great changes had occurred in the methods of contraception employed by the adolescents and in their attitudes to these from 1982 to date. Many more of the adolescents consider today that condoms provide the best form of contraception as compared with oral contraception. Nevertheless, only 9% of the adolescents were able to use a condom correctly. After the teaching session, knowledge about the correct use of a condom was significantly better and more had a positive attitude to condoms. A balance in information about methods of contraception is recommended and the young people should be sent to their own general practitioners for individual advice. On the basis of the results of this investigation, this teaching should be given already to pupils in the eighth classes.
Adolescent↗
Determinants of condom use to prevent HIV infection among youth in Ghana.
PURPOSE: To identify the psychosocial and behavioral factors that influence condom use to reduce the risk of human immunodeficiency virus (HIV) infection among young men in Ghana. METHODS: This study used a cross-sectional design in which data on a community-based sample of 601 young men, 15-24 years of age, were collected by a household survey instrument. For a conceptual framework, the study used constructs from the Health Belief Model (HBM) and Social Learning Theory (SLT) in the Ghanaian context. RESULTS: While 65% of the sexually active male respondents had used condoms at least once, only 25% had used condoms at last intercourse. Findings from multiple logistic regression analysis indicate that perceived susceptibility to HIV infection, perceived self-efficacy to use condoms, perceived barriers to condom use, and perceived social support were significant predictors of condom use. The most important finding, however, is that perceived barriers significantly interacted with perceived susceptibility and self-efficacy. Subjects who perceived a high level of susceptibility to HIV infection and a low level of barriers to condom use were almost six times as likely to have used condoms at last intercourse, compared to others. Similarly, young men who perceived a high level of self-efficacy to use condoms and a low level of barriers to condom use were nearly three times more likely to have used condoms at last intercourse when compared to others. CONCLUSION: These results suggest that HIV prevention programs for youth should emphasize personal vulnerability to acquired immunodeficiency syndrome, instill in youth the self-belief that they can use condoms any time, and address how to overcome barriers to condom use.
Adolescent↗