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Biomedical subjects

L S Zabin

Publications and source records attributed to L S Zabin.

At least 19 recordsLinked to original sources
PubMed2000

Trends and determinants of contraceptive use in Rakai District, Uganda, 1995-98.

A prospective study conducted between 1995 and 1998 assessed trends in contraceptive use in rural Rakai District, Uganda. Over a period of 30 months, women's use of modern contraceptives increased significantly from 11 percent to 20 percent. Male condom use increased from 10 percent to 17 percent. The prevalence of pregnancy among sexually active women 15-49 declined significantly from 15 percent to 13 percent. Women practicing family planning for pregnancy prevention were predominantly in the 20-39-year age group, married, better educated, and had higher parity than others, whereas women or men adopting condoms were predominantly young, unmarried, and better educated. Condom use was particularly high among individuals reporting multiple sexual partners or extramarital relationships. Contraceptive use was higher among women who desired fewer children, among those who wished to space or terminate childbearing, and among women with previous experience of unwanted births or abortions. Self-perception of HIV risk increased condom use, but HIV testing and counseling had only modest effects. Contraception for pregnancy prevention and for HIV/STD prophylaxis are complementary.

Abortion, Induced↗
PubMed1998

The health consequences of adolescent sexual and fertility behavior in sub-Saharan Africa.

This article reviews the literature on health consequences of adolescent sexual behavior and child-bearing in sub-Saharan Africa, and the social and cultural context in which they occur. It suggests that, in addressing the most serious health sequelae, sexual intercourse that occurs in early marriage and premaritally must both be considered. Some limitations of the data are noted. Despite the excess risk to which adolescents are exposed, due both to custom and age-related vulnerability, differences between health effects among adult and adolescent women are often differences in degree. They are attributable to behavioral, social, and biological causes, exist in traditional and nontraditional settings, in union and out of union, and are exacerbated by declining ages at menarche, pressures of HIV/AIDS and STDs, and a dearth of appropriate services-especially for young people. Some current interventions are discussed, and the need for policy as well as medical intervention is stressed.

Adolescent↗
PubMed1996

Adolescents with negative pregnancy test results. An accessible at-risk group.

OBJECTIVE: To estimate nationally what percentage of young women receive negative pregnancy test results before becoming pregnant, to explore their fertility and test histories, and to estimate the potential for intervention at the time of a negative test result. DESIGN: A cross-sectional study in which young women presenting to clinics for pregnancy tests were asked to complete a self-administered questionnaire before test results were known that explored prior pregnancy tests, pregnancies, sexual and contraceptive histories, and childbearing attitudes. SETTING: Fifty-two clinics including hospital, health department, Planned Parenthood, and independent facilities. PARTICIPANTS: A total of 2926 patients aged 17 years or younger requesting pregnancy tests at presentation. RESULTS: Among young women who had ever conceived, 34.2% had a prior negative pregnancy test result and 24.4% had a prior negative test result at a clinic. Almost three of five of the adolescent girls, including both those who had and those who had not conceived, received a negative test result at a clinic before they ever became pregnant. By the age of 14 years, the probability of a negative test result was substantially greater than the chance of a positive test. Many presented for tests even though they were quite certain that they were not pregnant. CONCLUSIONS: Adolescent girls with a negative pregnancy test result may be an appropriate target group for intervention. One fourth of adolescent girls who have a negative pregnancy test may be identified by the health care system on that occasion in time to prevent early childbearing.

Adolescent↗
PubMed1995

Durations of adolescent sexual relationships before and after conception.

PURPOSE: To explore durations of young couples' relationships between meeting and first intercourse, before first conception and for two years following conception and the associations between these durations; to describe the association between these durations and the young women's perceptions of the nature of these relationships. METHODS: Three hundred and seven adolescent women were enrolled in a prospective study while presenting for pregnancy tests (the index event); they were followed for two years in three groups--those with negative tests, those who terminated the pregnancy and those who bore a child. Retrospective information about durations of relationships with first partners and partners at the index event was obtained at baseline; follow-up data was obtained on continuing relationships with the index partner. RESULTS: Durations of relationships between adolescent females and their partners in this sample, both before and after conception, are rarely brief; the median duration of a girl's prior relationship with a partner with whom she conceives is almost two years. Similarly, almost half of the sample is still in a relationship at two years following the index event, a proportion that rises to two-thirds among those who bore a child together. CONCLUSIONS: Contrary to common belief or practice, there may be sufficient time and commitment to include many male partners in intervention programs before, and in parenting programs after, a first conception--a practice which could have positive implications for both adolescent partners and, potentially, for their child.

Adolescent↗
PubMed1992

Abortion among adolescents: research findings and the current debate.

Utilizing research that focuses on adolescents as well as findings in samples which might have special relevance to young, unmarried women, this report summarizes research on the consequences of abortion among adolescents. It discusses prior literature in the area of parental notification and parental consent, subjects on which public opinion is not divided along familiar pro-choice/anti-choice lines. Following a discussion of methodological problems identified in prior research, it reports on a study designed to address these problems in an adolescent population; it discusses implications for the current debate of this and other studies' findings that there are no identifiable adverse sequelae of the abortion process.

Abortion, Induced↗
PubMed1991

Reasons for delay in contraceptive clinic utilization. Adolescent clinic and nonclinic populations compared.

Because delay in accessing contraceptive services is a serious obstacle to prevention of unintended pregnancy in adolescence, reasons for delay are probed in a junior and senior high school population and compared with results obtained among 435 young black women previously surveyed in 32 U.S. clinics. The 388 students surveyed before exposure to pregnancy prevention services are compared with 422 surveyed after greater than or equal to 2 years exposure to a successful educational/clinical intervention program. Particular attention is paid to reasons cited by those who never utilized services; important reasons cited by all groups include fear that contraception is dangerous (cited by 40.0% at baseline), fear of parental discovery (30.5%), and awaiting "closer" partner relationships (31.3%). The last reason was often cited a year or more after initiating coitus. That the perception of birth control as dangerous is a barrier to contraception is confirmed by the large proportions who cited it among those who had never used clinical services. Programmatic implications of the findings are discussed.

Adolescent↗
PubMed1990

Differential characteristics of adolescent pregnancy test patients: abortion, childbearing and negative test groups.

Studies of the consequences of adolescent childbearing report many negative sequelae, but the effects of induced abortion are less studied, and most studies lack appropriate controls for preexisting characteristics. This paper uses baseline data from the intake interview into a longitudinal study of 360 innercity black women (less than or equal to 17 years old) presenting for a pregnancy test at two sites in Baltimore to examine baseline differences between three groups: young women who terminated the index pregnancy and, as controls, those who carried to term and those whose tests were negative. They were interviewed before being told the test result. Education aspirations/achievement, economic well-being, sexual/contraceptive history, psychologic characteristics, and desire for a child were compared. Negative test patients often reveal characteristics suggesting a particularly high risk of pregnancy, e.g., more prior pregnancy tests and a greater desire to conceive. Implications are discussed, emphasizing the need to intervene after a negative pregnancy test with counseling to help avert a future undesired conception.

Abortion, Legal↗
PubMed1989

The effect of sexual behavior and a pregnancy on contraceptive method switching among black female teens.

Little is known about determinants of contraceptive method switching and few reports use data that can link events that occur close in time. Using retrospective information from the sexual calendars of black female teens who attended a reproductive health clinic, determinants of method switching in four areas were investigated. Method switchers, those who switched from an unprepared to a prepared method (n = 62) and those who switched from a prepared to an unprepared method (n = 18), were matched with nonswitchers who used the same initial method. Associations between switching and changes in the frequency of intercourse, sexual abstinence, and pregnancy were found. It is suggested that abstinence may have a different role in switching from each type of method. Counselors need to emphasize the importance of method continuation, even when sex has not occurred for a short period of time.

Adolescent↗
PubMed1986

A study of women requesting interval contraceptive sterilization who do and do not return for surgery.

With the use of initial records of 1128 women who presented for interval tubal ligation, characteristics of those who were sterilized were juxtaposed with characteristics of those who did not return for surgery. Follow-up telephone interviews were conducted to explore regret after sterilization among 268 sterilized women. The subsequent histories of 144 women who did not return for surgery were examined, to determine whether failure to return might have screened, selectively, the women at greatest risk of regret. High levels of subsequent unwanted conception and pregnancy wastage were found in the nonreturn group. Institutional factors were often implicated in failure to return. Variables available at initial presentation are proposed to identify women who risk adverse consequences of postponed sterilization, to facilitate return without increasing regret.

Adult↗
PubMed1986

Adolescent pregnancy-prevention program. A model for research and evaluation.

Despite the increased interest in the effects of adolescent pregnancy-prevention programs, most interventions lack the research design and data essential for evaluation. This article describes a model in which evaluative research was incorporated in program design. The derivation of the model, the selection of measurable parameters, characteristics of the population reflected in baseline and subsequent data, and problems in quantifying and interpreting appropriate variables are discussed. Clinic data and aggregate data from three self-administered surveys is used. The surveys were completed by students in the inner-city junior and senior high schools that cooperated in the education and clinical program. We demonstrate how these two types of data augment one another in assessing program effects. The study explores the evaluation and the timing of change in sexual knowledge, attitudes, and behavior (coital, contraceptive, and clinic) and thus may contribute to the design of measurable, replicable interventions.

Adolescent↗
PubMed1986

Substance use and its relation to sexual activity among inner-city adolescents.

A study of inner-city Black and Caucasian males and females in two junior and two senior high schools provided data on sexual knowledge, attitudes and behaviors, and substance use based on over 2500 anonymous, voluntary self-administered questionnaires. Substance use was high among Caucasians, particularly females. Females smoked more cigarettes than males and men drank more alcohol. Marijuana smoking showed only small racial, age, and gender differences. Compared to Blacks, Caucasians used more hard drugs. Using an index scoring types of substances and frequencies of use, sexually active students were higher than virgins in all subgroups, with those who initiated intercourse early appearing highest on the index. A regression model explaining 21% of the variance in substance use showed independent effects of age, race, gender, and sexual activity. The importance of an index for screening early use is discussed, and research on the relationship of low-level youthful experimentation with future dysfunctional use is proposed.

Adolescent↗
PubMed1984

The association between smoking and sexual behavior among teens in US contraceptive clinics.

A study of teenage women in 32 contraceptive clinics in the United States shows a strong negative relationship between age of first intercourse and the level of cigarette smoking; the association is strong enough to reverse the usual correlation of smoking and age during the teenage years. Preventive, timely contraceptive behavior is also negatively associated to smoking. These findings suggest that interventions could well be designed and located in settings which take this association into account.

Adolescent↗