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Determinants of contraceptive choice among single women in the United States.

Data from the 1983 National Survey of Unmarried Women are used to analyze characteristics that affect contraceptive decision-making among single women aged 20-29 who are exposed to the risk of pregnancy. Factors found to affect whether these women use a relatively effective method such as the pill or the IUD, use coitus-dependent methods or use no method include family structure at age 15, educational level, work status, religious affiliation, fertility relative to desired fertility, and past contraceptive failure. Bivariate analyses revealed notable differences between whites and blacks in contraceptive behavior. Multivariate analyses showed that while the decision to use a contraceptive method was somewhat affected by race, method choice was not. Overall, contraceptive decision-making was relatively unaffected by race, length of the relationship and current living arrangement.

Adult↗

Contraceptive use by adolescent females in relation to knowledge, and to time and method of contraceptive counseling.

Contraceptive behavior of adolescent females was examined in relation to their level of knowledge, and time and method of contraceptive counseling. Subjects were 122 subscribers to a prepaid health plan, 13-18 years of age, unmarried, sexually active, and not desiring pregnancy. Contraceptive counseling was offered to 62 adolescents following receipt of a negative pregnancy test and to 60 adolescents following a routine medical visit. The 80 adolescents who chose to participate in the study were randomly assigned to a conventional or developmental method of counseling. The effectiveness of their contraceptive practice was measured 1 year later. Two hypotheses were not upheld: Sexually active adolescents were not more likely to accept contraceptive counseling at the time of a negative pregnancy test than at a time of a routine medical visit, and did not subsequently become more effective users of contraceptives. Two hypotheses were upheld: Effective and ineffective users of contraception did not differ in level of knowledge, and adolescents counseled by a developmental method practiced contraception more effectively than those counseled by a conventional method. Findings are discussed in terms of the theory of adolescent development and the proposition that a pregnancy scare motivates teenagers to control fertility.

Adolescent↗

Factors related with induced abortion among primigravid women in Ho Chi Minh City, Vietnam.

A case-control study was conducted between July and August 2001 in Ho Chi Minh City to investigate factors associated with having induced abortions among primigravid women aged 16 to 38 years. Interviews were conducted with 87 women undergoing abortion (cases) and 81 pregnant women coming for antenatal care (controls). Multiple logistic regression analysis revealed that older age (odds ratio [OR] = 0.84) and being married (OR = 0.05) decreased the risk of getting unintended pregnancy leading to abortion. Risk factors of obtaining an abortion were not being exposed to family planning promotion on television (OR = 2.28) and not knowing the adverse effects of abortion (OR = 10.26). Descriptive analysis of contraceptive behavior showed that 41% of cases had never used contraceptives and the reason for non-usage was lack of knowledge of any type of contraceptives in 43% of the cases. Additionally, only 24% of cases had discussed about family planning with their partners. Effective contraceptive methods should be promoted among young population, both females and males, and they need to be informed of the consequences of abortion. Television programs might be an effective mode of providing the information.

Abortion, Induced↗

Sex, contraception and childbearing among high-risk youth: do different factors influence males and females?

CONTEXT: The likelihood that adolescents will engage in sexual activity, use contraceptives or become parents is influenced by a range of attitudes and behaviors. These factors may differ for males and females. METHODS: Data on female respondents to the 1979-1992 waves of the National Longitudinal Survey of Youth and the linked 1994 young adult data file on their children provided background information on 959 adolescents who had been born to young mothers. Partial correlation analysis was used to examine the factors related to sexual behavior, contraceptive use and childbirth, controlling for maternal and familial characteristics, in this relatively disadvantaged sample. RESULTS: Youth who are inclined toward risk-taking and those who have run away from home are more likely than others to be sexually active. For young women, having intercourse at an early age, not using contraceptives and having a child are linked with depression, low self-esteem and little sense of control over their lives. The results for young men are less consistent and often in the opposite direction. Young people who have become parents evidence greater maturity than their childless peers; women are less likely to consume alcohol or to spend time with friends who drink, and men are more likely to participate in socially productive work. CONCLUSIONS: Although sexual behavior is tied to risk-taking in both adolescent males and females, some noticeable psychological differences are evidenced early. Behaviorally, there is room for optimism, in that young parents appear to adopt more mature traits.

Adolescent↗

[Contraception among adolescents].

Adolescence is a period of which the contraception is difficult, because of lower compliance of the teenagers to this methods. The authors were observed the contraceptive uses in 792 pregnant adolescent girls, 264 of which with abortions (group A) and 528 teen-age mothers (group B). Only 12.88% of all patients have used birth control methods, usually with low and middle effects. We founded only 15 patients (1.89%) practiced hormonal contraception and 1 case (0.13%) with Intrauterine devise. The condoms for men was the most popular and useful in teenagers (4.23%), and Natural family planning methods were practiced from 52 (6.57%) patients. There was the statistically differences between adolescent girls included in group A and B about their contraceptive behaviors and live standards (p < 0.01). By the kind of contraceptive methods, there was a high differences in the teenagers with a hormonal uses (p < 0.05).

Adolescent↗

A Health Belief Model-Social Learning Theory approach to adolescents' fertility control: findings from a controlled field trial.

We evaluated an 8- to 12-hour Health Belief Model-Social Learning Theory (HBM-SLT)-based sex education program against several community- and school-based interventions in a controlled field experiment. Data on sexual and contraceptive behavior were collected from 1,444 adolescents unselected for gender, race/ethnicity, or virginity status in a pretest-posttest design. Over 60% completed the one-year follow-up. Multivariate analyses were conducted separately for each preintervention virginity status by gender grouping. The results revealed differential program impacts. First, for preintervention virgins, there were no gender or intervention differences in abstinence maintenance over the follow-up year. Second, female preintervention Comparison program virgins used effective contraceptive methods more consistently than those who attended the HBM-SLT program (p less than 0.01); among males, the intervention programs were equally effective. Third, both interventions significantly increased contraceptive efficiency for teenagers who were sexually active before attending the programs. For males, the HBM-SLT program led to significantly greater follow-up contraceptive efficiency than the Comparison program with preintervention contraceptive efficiency controlled (p less than 0.05); for females, the programs produced equivalent improvement. Implications for program planning and evaluation are discussed.

Adolescent↗

An impact evaluation of project SNAPP: an AIDS and pregnancy prevention middle school program.

OBJECTIVES: A theory-based curriculum designed to delay the onset of intercourse and increase use of condoms was implemented in the classrooms of six Los Angeles middle schools. METHODS: The curriculum activities were very interactive, emphasized skill building, and were implemented by well trained peer educators, including young HIV-positive males and teen mothers. To evaluate the impact of the curriculum, 102 classrooms of students were randomly assigned to receive either the existing curriculum or the existing curriculum plus the intervention curriculum. Students completed confidential questionnaires before program implementation, five months later, and 17 months later. A total of 1,657 students completed both the baseline and 17-month follow-up questionnaires. RESULTS: Analyses of these data revealed that the curriculum significantly increased knowledge, significantly improved only two out of 21 attitudes or beliefs, and did not significantly change sexual or contraceptive behaviors. CONCLUSIONS: Well implemented programs that are based on upon theory, use interactive activities, and utilize well-trained peer educators do not always change important sexual attitudes and behaviors among middle school youth.

Acquired Immunodeficiency Syndrome↗

The role of sexual self-concept in the use of contraceptives.

Sexual self-concept--defined as an individual's evaluation of his or her own sexual feelings and actions--is proposed as an important predictor of contraceptive behavior among teenagers, and a scale measuring the concept is described. In exploratory analyses among university students, sexual self-concept is found to be associated with frequency of contraceptive use and use at most recent intercourse. It is also associated with their choice of contraceptive--students who had used prescription methods at last coitus had significantly higher scores on the sexual self-concept scale than did those who had used nonprescription methods or no method. These findings, together with the finding from analysis among high school students that sexual self-concept appears to improve with age, suggest that younger teenagers may be poorer users of contraceptives because of a lower sexual self-concept. Counseling and sex education that address social and psychological issues may help improve adolescent contraceptive practice by addressing teenagers' views of their own sexuality.

Adolescent↗

Twenty-seven strategies for teaching contraception to adolescents.

This article summarizes research on the effects of education on adolescents' contraceptive behaviors and suggests strategies to enhance teaching for contraception. Learning about birth control methods in sex education classes does not necessarily enable teenagers to use them effectively. In addition to needing accurate, unbiased information about contraceptive technology, teenagers need help in clarifying their values so that their social behaviors are congruent with their moral codes. Adolescents also benefit from understanding how contraception relates to sexual behavior and how family planning may enable them to become parents at the time of their choice. Twenty-seven strategies for teachers are listed, each one related to a particular contraceptive problem adolescents encounter.

Adolescent↗

Parent-child communication and adolescent sexual behavior.

Data collected over a two-year period from more than 500 teenagers and their mothers indicate that neither parental attitudes toward premarital sex nor parent-child communication about sex and contraception appear to affect teenagers' subsequent sexual and contraceptive behavior. Teenagers are often ignorant of their parents' attitudes toward sex-related issues, and they and their parents often contradict one another in describing the kinds of sex-related conversations they have had. In only two cases was a significant relationship found between communication and adolescent behavior: Girls whose mothers reported that they had discussed sex with their daughters were less likely to subsequently initiate coitus; and girls who reported that their mothers had discussed birth control with them were more likely to use effective contraceptives. However, the former association disappeared when it was the daughters who reported the communication, and the latter disappeared when it was the mothers who reported it.

Adolescent↗

Stage of behavior change for condom use: the influence of partner type, relationship and pregnancy factors.

A theoretical model was used to examine the influence of relationship factors, pregnancy intentions, contraceptive behavior and other psychosocial characteristics on stages of behavior change in condom use among heterosexual black women of reproductive age. Data from an inner-city street survey compared women who were not contemplating condom use, women who were attempting to use condoms or had used them consistently for short periods of time, and those who had achieved long-term consistent use. Women's relationship with their main partner appears to be an important factor in understanding their use of condoms both with main partners and with other partners. For condom use with the main partner, factors such as emotional closeness and partner support were significant predictors of the likelihood that women would be attempting to use condoms rather than not contemplating use. Cohabitation and the belief that condom use builds trust were significant predictors of long-term consistent condom use. Having a regular or main partner was strongly associated with intentions to use condoms with other partners. Women who wanted to become pregnant were much less likely to intend to use condoms with their main partner, and women using oral contraceptives were less likely to be long-term consistent condom users.

Adolescent↗

Racial differences in contraceptive choice: complexity and implications.

Previous research has failed to generate consensus about why black fertility has persistently exceeded that of whites in the United States. In an effort to shed light on this question, this article examines black/white differences in sociodemographic factors affecting contraceptive choice. Using data from the 1976 and 1982 National Surveys of Family Growth, we find a complex pattern of black/white differences. Not only does contraceptive choice vary by race, but the effects of such variables as age, marital status, and education also differ between blacks and whites. For example, compared with whites, black married women avoid coital methods, and compared with blacks, white women shift contraceptive behavior more as they change marital status. The complex nature of the racial differences in contraceptive choice are interpreted as reflecting differences in marriage patterns and trends.

Adult↗

The sexual and contraceptive socialization of black adolescent males (black adolescent sexuality).

The major source, quantity, and quality of sex and contraceptive information African-American males received as teenagers, and the impact of that information on sexual and contraceptive behavior, were examined among 250 males ranging in age from 12 to 70 years. Mothers were the major sources of sex and birth control information for the adolescent, young adult, and middle adult groups. Fathers and male friends were the second sources most indicated. All of the sample received sex information, and only a small proportion received no birth control information. The amount of sex information received was found to be a significant predictor (P = 0.0018) of the age at first intercourse and the regularity of use of birth control after that. The amount of birth control information received was also a significant predictor (P = 0.0093) of the regularity of use of birth control after the first coitus. Because parents influence their children's behavior through a socialization process, their support of their teenage sons in matters of sexuality and contraception may be of potential value in mitigating the effects of early, unprotected sex.

Adolescent↗

Adolescent women's contraceptive decision making.

A modified rational decision model incorporating salient events and social influences (particularly from sexual partners) is used to analyze adolescent women's consistent use of oral contraceptives (OCs) over a six-month period. Data are taken from a panel study of 308 clients of an inner-city family planning clinic. Expected OC use was computed for each subject on the basis of subjective expected utility (SEU) theory, and is found in multivariate analyses to be a significant predictor of actual OC use. In addition, variables representing baseline and follow-up partner influences, the salience of pregnancy for the subject, and positive side effects of OCs during the first months of use are found to predict OC use. Partner's support of OC use during follow-up and positive side effects of OCs are found to predict OC use among subjects for whom OC use was not the expected decision according to baseline SEU. Implications of the findings for models of adolescents' contraceptive behavior and for clinicians are discussed.

Adolescent↗

Attitudes of men towards family planning in Mbeya region, Tanzania: a rural-urban comparison of qualitative data.

Family planning programmes in Tanzania date back to the 1950s. By the early 1990s, however, only 5-10% of women of childbearing age used contraceptives in the country. Low contraceptive prevalence in Tanzania is reportedly attributable to men's opposition to family planning. This paper employs focus groups to explore the role of Tanzanian men in family planning. More specifically, it presents a rural-urban comparison of the attitudes of men in Mbeya region, Tanzania, to family size preference, sex composition, partners' communication on family planning matters and contraceptive behavior. Findings indicate that men express positive attitudes towards fertility-regulating methods. There is, moreover, little rural-urban variation in male attitudes towards family planning in the study area. Possible reasons for this normative convergence (including structural similarities and rural-urban migration between the two communities) are discussed.

Adolescent↗