Biomedical subjects

Cynthia Rosengard

Publications and source records attributed to Cynthia Rosengard.

13 recordsLinked to original sources

PubMed2006

Reproductive health care and family planning needs among incarcerated women.

OBJECTIVES: Women in correctional institutions have substantial reproductive health problems, yet they are underserved in receipt of reproductive health care. We assessed the level of risk for sexually transmitted diseases (STDs) and the reproductive health needs of 484 incarcerated women in Rhode Island to plan an intervention for women returning to the community. METHODS: We used a 45-minute survey to assess medical histories, pregnancy and birth control use histories, current pregnancy intentions, substance use during the past 3 months, histories of childhood sexual abuse, and health attitudes and behaviors. RESULTS: Participants had extremely high risks for STDs and pregnancy, which was characterized by inconsistent birth control (66.5%) and condom use (80.4%), multiple partners (38%), and a high prevalence of unplanned pregnancies (83.6%) and STDs (49%). Only 15.4% said it was not likely that they would have sexual relations with a man within 6 months after release. CONCLUSION: Reproductive health services must be offered to incarcerated women. Such interventions will benefit the women, the criminal justice systems, and the communities to which the women will return.

Adult↗

PubMed2006

Improving birth control service utilization by offering services prerelease vs postincarceration.

OBJECTIVES: We examined whether incarcerated women would substantially increase birth control initiation if contraceptive services were available within the prison compared with after their release back into the community. METHODS: During phase 1 of the study, a nurse educator met with women at the Rhode Island Adult Correctional Institute and offered them referrals for contraceptive services at a community health clinic after their release. During phase 2, contraceptive services were offered to women during their incarceration. RESULTS: The majority of the participants (77.5%) reported a desire to initiate use of birth control methods. Within 4 weeks of their release, 4.4% of phase 1 participants initiated use of a contraceptive method, compared with 39.1% of phase 2 participants (odds ratio [OR]=14.6; 95% confidence interval [CI]=5.5, 38.8). CONCLUSIONS: Provision of contraceptive services to women during their incarceration is feasible and greatly increases birth control initiation compared to providing services only in the community.

Adult↗

PubMed2006

Violence against women associated with arrests for sex trade but not drug charges.

The current study was designed to examine associations between gender-based violence and arrests due to sex trade or drug-related charges among a statewide sample of incarcerated women in Rhode Island. Incarcerated women were asked to participate in brief pre- and posttest surveys of their experiences of violence, sexual risk and substance use behaviors, as part of a study on the effectiveness of a family planning program in a state correctional facility; data from pretest surveys (N=447) were used for current analyses. Logistic regression analyses adjusted for demographics were used to assess significant associations between gender-based violence variables (i.e., adolescent intimate partner violence (IPV), adult IPV, childhood sexual assault (SA), adolescent SA, and adult SA) and arrests due to sex trade or drug-related charges. Significant relationships were observed between arrests for sex trade and adult SA (OR=2.1, 95%CI=1.2-3.6), adolescent IPV (OR=2.5, 95%CI=1.5-4.1), and adult IPV (OR=1.7, 95%CI=1.1-2.6); no significant associations were observed for drug-related charges. Findings from the current study demonstrate that experiences of gender-based violence are associated with arrests for sex trade but not drug-related charges. Interventions for incarcerated women are needed to consider and address history of victimization from gender-based violence and its relation to women's historic and future sex trade involvement.

Adolescent↗

PubMed2006

Correlates of condom use and reasons for condom non-use among drug users.

Two hundred and seventy-seven drug using adults were interviewed regarding details of their most recent sexual encounter. Demographic, attitudinal, and context variables were associated with condom use and non-use. Greater perceived risk of STDs/HIV and positive attitudes toward condoms' effect on sexual pleasure were associated with greater likelihood of reporting condom use. Common reasons for not using condoms included lower perceived risk of contracting HIV/STDs, negative attitudes toward condoms' effect on pleasure, and lack of condom availability. Tailoring messages to modifiable perceptions of risk and condom attitudes may be useful in reducing sexual risk among drug-using individuals.

Adolescent↗

PubMed2006

Fear of inability to conceive in pregnant adolescents.

OBJECTIVE: To estimate the demographic and health history differences between pregnant adolescents who had fears that they would not be able to conceive and those without these fears. METHODS: Three hundred pregnant adolescents presenting for their first prenatal visit participated in a cohort study that addressed attitudes about pregnancy. All participants were aged younger than 20 years and gave informed consent. The outcome of interest was a positive response to the question "Did you have any fears that you wouldn't be able to get pregnant?" Independent measures included health history and demographic variables. RESULTS: Among participants, 42% stated they had fears about not being able to conceive. The total sample included 20% 12-15 year olds, 39% 16-17 year olds and 41% 18-19 year-olds. There was no statistically significant difference in fear of not being able to conceive by maternal age, reported sexually transmitted disease rates, or age at first intercourse. More adolescents who expressed fear of infertility had a previous spontaneous abortion, previous pelvic examination, and were sexually active for a longer period of time compared with those without this fear. CONCLUSION: A large proportion of pregnant adolescents in this study expressed fear that they would not be able to conceive. Understanding the basis of the fear is critical to appreciating its association with current and future adolescent pregnancy and contraceptive use. LEVEL OF EVIDENCE: III.

Adolescent↗

PubMed2006

Pregnancy attitudes and contraceptive plans among women entering jail.

Unplanned pregnancies are an important and costly public health problem. Women entering jail are at particularly high risk for unplanned pregnancies when they leave jail, given the high rates of poverty, substance abuse and sexually transmitted infections (STIs) in this population, all of which are associated with unplanned pregnancies. Attitudes toward pregnancy vary substantially, influencing openness of incarcerated women to starting a birth control method. This study was conducted as part of a Title X service evaluation and examined varying attitudes towards pregnancy and associated plans to use contraceptives. The current study included 223 women entering jail who were, under 36 years of age, fertile, sexually active with men, and not planning to become pregnant in the near future. Nearly half of the women had negative pregnancy attitudes (PAs), indicating that they did not want to become pregnant, while 41.3% endorsed ambivalent PAs. Compared to those with ambivalent PAs, those with Negative PAs were more likely to report a previous unplanned pregnancy (90.6% vs. 75.4%), a previous pregnancy termination (40.0% vs. 22.8%), and recent consistent use of contraceptives (37.0% vs. 21.7%). Women with negative PAs were significantly more likely to want to start or to continue a birth control method compared to those with ambivalent PAs (66% vs. 47%). Tailoring services to women's specific pregnancy attitudes during periods of incarceration may aid in preventing unplanned pregnancies in populations of high-risk women.

Abortion, Induced↗

PubMed2006

Concepts of the advantages and disadvantages of teenage childbearing among pregnant adolescents: a qualitative analysis.

OBJECTIVE: We sought to enhance our understanding of pregnant adolescents' concepts of the advantages and disadvantages of teen pregnancy and childbearing. METHODOLOGY: This is a qualitative study of 247 pregnant adolescents recruited during their first prenatal health care visit to a women's primary care clinic in Providence, Rhode Island. Participants responded in writing to open-ended questions assessing their ideas about what was advantageous and disadvantageous about having an infant during their teen years rather than waiting until they were older. Themes and patterns in responding were coded, and subgroup differences based on age, ethnicity, intendedness of current pregnancy, and pregnancy/parenting history were assessed. RESULTS: Themes related to advantages of teen pregnancy included enhancing connections, positive changes/benefits, and practical considerations. Themes related to disadvantages included lack of preparedness, changes/interference, and others' perceptions. Differences among groups based on age, ethnicity, intendedness of the current pregnancy, and pregnancy/parenting history were examined and noted. CONCLUSIONS: Pregnant adolescents do not represent a homogeneous group. Considering differences in how pregnancy and childbearing are conceptualized along developmental, cultural, attitudinal, and experiential lines will strengthen our ability to tailor pregnancy-prevention messages.

Adolescent↗

PubMed2005

Adolescent partner-type experience: psychosocial and behavioral differences.

CONTEXT: Adolescents behave differently with main and casual sexual partners. These differences in behavior may be due to how adolescents perceive main and casual partners, but may also be informed by which types of partners adolescents have had experience with. METHODS: Data were collected in interviews with 276 sexually experienced STD clinic attendees in 1996-1998. Chi square tests and one-way analyses of variance were conducted to compare risk and protective variables among groups with different types of partner experience (main only, casual only, main and casual). Post hoc analyses determined differences between pairs of groups. RESULTS: Adolescents with different partner-type experiences evidenced different risk and protective factors. For example, adolescents who had had only main partners perceived a greater risk of contracting STDs from both main and casual partners than those who had had both partner types. Women in the casual-only group were the least likely to have been pregnant. Adolescents who had had main and casual partners intended a significantly shorter delay in initiating sex with a new main partner than did those in the main-only group; they also more strongly intended to have a side partner than did those who had had only main partners. CONCLUSIONS: The design of risk reduction and prevention interventions for at-risk sexually experienced adolescents ought to consider adolescents' sexual partner-type experiences and tailor messages to capitalize on associated protective factors and address or minimize associated risk factors.

Adolescent↗

PubMed2005

Correlates of partner-specific condom use intentions among incarcerated women in Rhode Island.

CONTEXT: Few studies of incarcerated women have examined potential associations between risky sexual behavior and relationship context factors; thus, little is known about the correlates of intentions to use condoms with main and casual partners in this underserved population. METHODS: A sample of 221 women incarcerated in a Rhode Island Department of Corrections facility in 2002-2003 were interviewed. Multiple linear regression analysis was performed to assess associations between selected demographic, psychosocial and behavioral variables and participants' reported intentions to use condoms with main and casual sexual partners in the first six months after their release. RESULTS: Condom use at last sex with a main partner, sexually transmitted disease (STD) history, no strong desire to currently be pregnant, belief that others influence one's health and perceived STD risk were positively associated with women's intention to use condoms with main partners. Pregnancy history was negatively associated with intention to use condoms with a main partner. Condom use at last sex with a casual partner was positively associated with intention to use condoms with casual partners, whereas binge drinking and believing in the role of chance in determining one's health were negatively associated with intention to use condoms with casual partners. CONCLUSIONS: Whether incarcerated women define a partner as main or casual may influence their decisions about the need to protect themselves by using condoms. Programs that focus on the importance of condom use with all partners could greatly benefit incarcerated women and the communities to which they return.

Adult↗

PubMed2005

Psychosocial correlates of adolescent males' pregnancy intention.

OBJECTIVE: To identify psychosocial differences between sexually experienced male adolescents who indicate intentions to get someone pregnant and those who do not. METHODOLOGY: Cross-sectional study of 101 sexually experienced adolescent males recruited from a sexually transmitted disease clinic in northern California. We used Student's t tests and regressions to examine psychosocial differences between males who reported any intention versus no intention to get someone pregnant in the next 6 months, and we used analyses of variance to examine differences among different combinations of pregnancy plans/likelihood. RESULTS: Adolescents' reports of their plans for getting someone pregnant differed from their assessments of the likelihood that they would do so (chi2 = 24.33; df = 1). Attitudes toward pregnancy and participants' mothers' educational attainment differentiated those with clear pregnancy intentions (planning and likely) from those with clear intentions to avoid pregnancy (not planning and not likely) CONCLUSIONS: To reduce the rates of adolescent childbearing, males' pregnancy intentions must be assessed and asked about in multiple ways.

Adolescent↗

PubMed2005

Rates of voluntary paternity establishment for infants born to unmarried adolescents.

OBJECTIVE: To investigate factors associated with voluntary paternity establishment for infants born to teenagers. STUDY DESIGN: The medical records of 402 unmarried women aged 13-19 years and delivering between January 1 and July 31, 2000, were reviewed, including prenatal charts, delivery records, birth worksheets, affidavits of parentage and infant birth certificates. The primary outcome was voluntary paternity establishment, as defined by having the father's name on the infant's birth certificate. RESULTS: Separate documents from the medical records of teen mothers had different rates of identifying the father of the infant: 80% of prenatal records had the father's name, as did 76% of birth worksheets and 60% of birth certificates. Maternal age < 16 years was associated with lower rates of paternity establishment as compared with 18-19-year-old mothers (OR 2.9, 95% CI 1.2, 6.7). CONCLUSION: A significant proportion of birth certificates on children born to teenagers do not identify the father of the infant; however, the majority of mothers identified them, on either the prenatal record or birth worksheet. In order to develop effective programs that will affect rates of paternity establishment, we must understand barriers inherent in the process itself.

Adolescent↗

PubMed2004

Adolescent pregnancy intentions and pregnancy outcomes: a longitudinal examination.

PURPOSE: (a) To examine different methods of assessing pregnancy intention; (b) to identify psychosocial differences between those who indicate pregnancy intentions and those who do not; and (c) to examine the relationship between pregnancy intentions and subsequent pregnancy at 6-month follow-up in nonpregnant (at baseline), sexually experienced adolescent females. METHODS: Longitudinal cohort study of 354 sexually experienced female adolescents attending either a STD clinic or HMO adolescent medicine clinic in northern California. Student's t-tests and regressions examined psychosocial differences between females who reported "any" and "no" pregnancy intentions. ANOVAs examined differences among different combinations of pregnancy plans/likelihood. Chi-square analyses assessed associations between baseline pregnancy intentions and subsequent pregnancy. RESULTS: Adolescents' reports of their pregnancy plans and their assessments of pregnancy likelihood differed from one another (chi2 = 50.39, df = 1, p < .001). Pregnancy attitudes and baseline contraceptive use differentiated those with inconsistent pregnancy intentions (Not Planning, but Likely) from those with clear pregnancy intentions (Planning and Likely, and Not Planning and Not Likely) (Pregnancy Attitudes: F [2,338] = 68.96, p < .0001; Contraceptive Use: F [2,308] = 14.87, p < .0001). Suspected pregnancies and positive pregnancy test results were associated with baseline pregnancy intentions (Suspected: chi2 = 19.08, df = 2, p < .01; Positive Results: chi2 = 8.84, df = 2, p = .015). CONCLUSIONS: To reduce adolescent childbearing we must assess pregnancy intentions in multiple ways. Information/education might benefit those female adolescents with inconsistent reports of pregnancy intentions.

Adolescent↗

PubMed2004

Intravenous drug users' HIV-risk behaviors with primary/other partners.

The objective of this study was to determine how injection drug users' (IDUs) HIV-risk behavior differs with primary and other sex partners. Interviews were conducted with injection drug users from a needle exchange program (n = 243). Those with one sexual partner were more likely to report never using condoms with primary partners than were those with more than one partner (74% vs. 54%, p < 0.001). Those with more than one partner differed, between primary and other sexual partners, in their disclosure of HIV and IDU status, condom use, and drug use in combination with sex. Primary sexual partners of IDUs are placed at risk from IDUs' risk behavior with other sexual partners. Those planning HIV-risk reduction interventions for IDUs should consider risk behavior with primary partners separately from behavior with other partners. Evaluation of intervention effects should use partner-specific assessments of risk behavior.

Adolescent↗