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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↗

Condom availability for adolescents.

Although abstinence should be stressed as the certain way to prevent STDs and pregnancy, sexually active teens, male and female, must nonetheless be taught to use condoms properly, effectively, and consistently. The latex condom should be made widely available to young people. Ideally, young persons should have access to education and counseling when contraception is dispensed. However, condoms should be made easily available without any requirement for education. Condoms should be available not only through families, medical facilities, and commercial channels, but also through other appropriate and informed persons, without cost if possible, at sites where adolescents congregate. These sites may include schools, clubs, and other youth-serving agencies. A clear message from the medical community supporting condom use will enhance compliance.

Adolescent↗

Determinants of trends in condom use in the United States, 1988-1995.

CONTEXT: Although overall condom use has increased substantially over the past decade, information is needed on whether dual method use has also become more common. In addition, there is little information on which characteristics of women influence condom use and dual method use, and on whether these characteristics have changed over time. METHODS: Data from the 1988 and 1995 National Surveys of Family Growth are examined to evaluate trends in condom use--either use alone or use with another highly effective method (dual method use). Logistic and multinomial regression analyses are presented to analyze the influence of women's characteristics on condom use. RESULTS: Current condom use rose significantly between 1988 and 1995, from 13% to 19% of all women who had had sex in the past three months. Dual method use increased from 1% in 1988 to 3% in 1995, still a very low level. In both years, current condom use was higher among women younger than 20 (32-34% in 1995) than among those aged 30 or older (less than 20% in 1995). Likewise, current condom use was most common among never-married women who were not cohabiting in both 1988 (20%) and in 1995 (34%). Multivariate analyses showed that women in the early stage of a relationship (six months or less in duration) were much more likely than those in a long-standing relationship (five years or more in length) to use the condom (odds ratio, 1.5). In both 1988 and 1995, younger women and better educated women were more likely to be currently using the condom than were older or less-educated women. For example, in 1995, women younger than 18 were 1.8 times as likely as 40-44-year-olds to be using condoms, and college graduates were 1.5 times as likely as high school graduates to do so. Further, women who were not in a union and either had never been married or were formerly married were more likely to be current condom users in 1995 than were married women (odds ratios, 1.5-1.9). Poor women were less likely than higher income women to be condom users in 1995 (odds ratios, 0.7-0.8), but poverty had made little difference in 1988. Groups likely to be dual method users were those also likely to be at greater risk of sexually transmitted disease: women in a union of less than six months duration (2.8), women younger than 20 (4.6-6.8), unmarried women (2.8-7.5) and women with two or more partners in the past three months (1.7). CONCLUSIONS: While the increase in condom use, especially among unmarried and adolescent women, is encouraging, condom use overall is substantially less than that needed to protect women and men against sexually transmitted diseases (including HIV). Moreover, steps need to be taken to understand why levels of dual method use are low and how they may be increased.

Adolescent↗

Acceptability of personal hormone monitoring for contraception: longitudinal and contextual variables.

A new contraceptive technology may advance the science of family planning but may do little to affect health if potential users do not deem it an acceptable method. The authors conducted an acceptability study of a newly developed contraceptive method--personal hormone monitoring. A sample of 480 English volunteers present at the 6th month of a 13-month longitudinal study completed surveys regarding their attitudes toward a personal hormone monitor for the purpose of contraception. The authors used the participants' responses to determine (a) the extent to which the participants accepted the monitor, (b) how their ratings of acceptability changed over time, (c) the extent to which contextual variables predicted changes in acceptability over time, and (d) whether those contextual variables predicted final acceptability of the monitor. Results suggested that no single method of family planning is best for everyone and specified the people for whom personal hormone monitoring may be most suitable.

Adult↗

Determinants of abortion among women undergoing artificial termination of pregnancy.

OBJECTIVES: In order to determine factors involved in the contraceptive practice of women undergoing artificial abortion, a prospective questionnaire survey was carried out. METHODS: Women (n = 800) requesting artificial abortion were compared with women (n = 1000) admitted to or visiting the department for reasons other than abortion. The SPSS program was used for statistical analysis between 1998 and 1999. Multiple logistic regression analysis was applied to evaluate the factors influencing the contraceptive practice of the aborters. RESULTS: Reliable contraceptive methods were used significantly less frequently by the aborters than by the control group (19.1% vs. 55%, p < 0.001, adjusted odds ratio (AOR), 0.46; 95% confidence interval (CI), 0.3-0.7). The contraceptive choice of the aborters depended significantly on their low income (AOR, 1.87; 95% CI, 1.5-2.4). The likelihood of abortion was significantly lower among those informed by a health-care provider (AOR, 0.56; 95% CI, 0.4-0.8) or the media (AOR, 0.51; 95% CI, 0.4-0.7). Awareness of reliable methods was also an important factor (AOR, 0.25; 95% CI, 0.1-0.5). CONCLUSIONS: It appears that a further decrease of the abortion ratio could be attained through an intensive media campaign and improved education.

Abortion, Induced↗

Post primary school teachers' view point on reproductive health and contraceptive practice among schoolgirls in Port Harcourt, Nigeria.

The view point of secondary school teachers on reproductive health, specifically, their attitude towards contraceptive practice among sexually active schoolgirls and general opinion on teenage pregnancy was examined. A sample survey of teachers was conducted in all the registered girls and mixed post primary schools in Port Harcourt. A substantial proportion of teachers were of the opinion that sexually active schoolgirls should not be encouraged to use contraceptives because they damage reproductive organs. A greater proportion (33.8%) of teachers was also of the opinion that schoolgirls should abstain from sex until they are married. This was closely followed by the suggestion that sexually active girls should use contraceptives (20.8%). The majority (48.3%) of teachers, however, advocated a sex education programme in the schools in order to prevent unwanted pregnancy.

Adolescent↗