[Effects of oral contraceptives on sexual behavior].
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The results of the Manchester study and its reinforcement from data from the multicenter study indicate that the ring is a well-tolerated delivery system for low-dose progestagens. The expulsion rate is low and vaginal tolerance satisfactory. The pregnancy rate and bleeding pattern is of the same order as oral low-dose progestagens. Indeed, there is an indication that the pregnancy rate and abnormal bleeding rate may be even lower. Data from other more extensive phase 3 studies will be required to confirm this impression. The subjective assessment is that the majority of patients are enthusiastic about this method of contraception, bearing in mind that many of them had become disenchanted with existing marketed contraceptive methods. Because of its high level of acceptability, the gap between theoretical and use-effectiveness in narrowed and once inserted, a high degree of motivation is not required since the existing ring only needs to be reinserted after 90 days of use. The acceptability of vaginal methods of contraception as evidenced by the rapid uptake of the vaginal sponge suggests that there is considerable potential for increased use of vaginal methods. In the present state of knowledge, it would appear that the woman for whom the progestagen only conception is particularly appropriate is the one who is lactating or for the older woman whose fertility is on the wane. For the woman who wishes to space her family, the progestagen only contraceptive is also appropriate. With increased refinements and experience of this method, there is a likelihood that the ring may extend the use and application of progestagen only contraception to a wider range of potential patients.
Results from focus-group discussions with a population of university students who have convenient access to emergency contraceptive pills show that basic awareness about this method is high, although specific knowledge on appropriate use, such as the time limit for use, the level of effectiveness and the possible side effects, is lacking. Approval of the method is widespread among both female and male students, although students did voice anxieties about irresponsible use and the lack of protection against the human immunodeficiency virus and other sexually transmitted diseases. Many of their concerns stem from incomplete information about how the regimen works. Students noted how rarely emergency contraceptive pills are discussed, and were curious to know more. They asked for routine education on the method, as well as more general discussion.
In the former Soviet Union, there was a lack of valid and reliable social research on knowledge, attitudes, and practice of contraception. The few available studies have not been published outside the Soviet Union. This article reviews five surveys that were conducted in Moscow and two other cities (Saratov and Tartu) during the period 1976-84. In addition, some data from a large-scale survey conducted in 1990 and covering the entire former Soviet Union are presented. The surveys indicate that the rhythm method, condoms, vaginal douches, and withdrawal were the main contraceptive methods used; only 1 to 3 percent of the women interviewed were using oral contraceptives, and about 10 percent used intrauterine devices. The low prevalence of use of reliable modern methods may explain the high incidence of induced abortion in Russia. The chronic unavailability of reliable contraceptives is one of the main factors of poor family planning. Lack of knowledge and negative opinions about modern contraception also play an important role. Some possibilities for improving the family planning situation in Russia are discussed.
The knowledge and estimated retrospective use of postcoital contraception was ascertained from health professionals in Tower Hamlets in the summer of 1988 using a postal questionnaire. Eighty five per cent of general practitioners responded and 91% of these had received requests for postcoital contraception within the previous six months. Only one third of general practitioners had information about postcoital contraception available in their surgeries. Family planning doctors and nurses had the most accurate knowledge of the method but many health professionals appeared to lack sufficient knowledge to ensure appropriate prescribing and to publicize this method to their women patients. It is concluded that if the high rate of abortion in the borough is to be reduced, health professionals as well as women need to be further educated as part of a postcoital contraception publicity campaign. Use of the term 'emergency contraception' rather than the non-medical term 'the morning after pill' may be more effective and reduce the present confusion among both groups.
When women talk with each other about family planning outside the clinic, are they really only spreading myths and rumors? If nurses give good information about family planning, why do women go and talk with other women? Why would a woman instructed by a nurse at a workshop want to talk to the workshop cleaner as well? To answer these questions, findings are used from a household survey and in-depth interviews that examine the role of informal social interaction in influencing the use of contraceptives in rural Kenya. The women in the study area are found to be ambivalent about family planing, and they supplement providers' instructions with the experiences of women whose bodies and circumstances are similar to their own. Family planning programs could improve their effectiveness by viewing clients and providers not only as individuals but also as members of informal networks that are meaningful to them.
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A convenient sample of 32 women seeking abortion was studied to determine the relationship between a woman's use of birth control and her perception of her chance and ability of conceiving. Subjects were between the ages of 16 and 29 years, white, unmarried, and gravida one. The Consistency Chance and Ability inventory, a self-report questionnaire, was completed by each subject. The data show a relationship between a woman's use of birth control and her perception of her chance and ability of conceiving. How nurses can assist women in making choices about contraceptive use is discussed.
The author examines the impact on contraceptive and reproductive behavior of a social program designed to teach trade skills and family planning to women in rural Bangladesh. The focus is on "whether a social program that is designed to use a particular group as catalysts brings about any change in [the] contraceptive and reproductive behaviour of the community that is indirectly exposed to the program." A sample of 625 women indirectly exposed to the program and 312 women from non-program, control villages were interviewed; baseline data are from the 1976 Bangladesh Fertility Survey. It is found that "the indirectly exposed and unexposed women are very similar in their contraceptive and reproductive behaviour. The impact of the directly exposed women (trained women) in family planning was trivial even after three years of program operation. Socio-economic and demographic characteristics of both the groups are also similar....The current use among the indirectly exposed women was only 12% as compared to 10% for the unexposed women."
An analysis of the various contraceptive methods practiced by a total of 462 student midwives from the Northern and Southern parts of Nigeria over a 3-years period is presented. The differences in age distribution, the type of contraceptive agents used, the reasons for using them, and the side effects in the two groups are statistically significant. The need to provide acceptable contraceptive advice to the rural communities by the midwives is discussed.
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CONTEXT: Despite the fact that choosing a contraceptive method is often a decision made by couples, little is known about how men and women differ in their perceptions of the characteristics of various method types, and in the importance that they attach to those characteristics when choosing a contraceptive method. METHODS: The data analyzed here are subsets from two companion surveys conducted in 1991--1,189 men aged 20-27 who were surveyed in the National Survey of Men and 740 women aged 20-27 who were surveyed in the National Survey of Women. Multivariate ordered logit analysis is used to examine how gender is related to both the importance that individuals assign to seven specific contraceptive characteristics when choosing a method, and to perceptions about the extent to which five common method types possess each of these characteristics. RESULTS: Women rank pregnancy prevention as the single most important contraceptive characteristic when choosing a method, with 90% citing it as "very important." The health risks associated with particular methods and protection from sexually transmitted diseases (STDs) are rated as the second most important characteristics by women (each mentioned as "very important" by 77%). In contrast, men consider STD prevention for themselves and their partner to be just as important as pregnancy protection (each mentioned as "very important" by 84-86%), and they rank STD prevention as more important than other health risks (by 72%). Women, but not men, rank both ease of use and the need to plan ahead as being more important characteristics than a method's interference with sexual pleasure. Both men and women have an accurate understanding of the strengths and weaknesses of particular methods, but differ enough in their perceptions to alter the relative attractiveness of each method. In particular, women have more favorable perceptions than men about the pill, being somewhat more likely than men to believe that the pill is "very good" at preventing pregnancy (75% vs. 67%) and to say that it is very good at not interfering with sexual pleasure (82% vs. 76%). In contrast, women have generally less favorable perceptions than men about other reversible methods, including the condom: Women were less likely than men to consider the condom very good at pregnancy prevention (29% vs. 46%) or at having no need for advance planning (22% vs. 38%). Gender differences in perceptions about the specific characteristics of contraceptive methods often vary by marital status. CONCLUSIONS: Men and women have somewhat different priorities when choosing a contraceptive method. Despite many similarities between women and men in their perceptions about the characteristics of each method type, numerous differences between them may have an important influence on how couples make their method choices.
BACKGROUND: For the first time, models using multilevel analysis of Indian data and related simulation results are reported. They take hierarchical structure into account and incorporate variables from all levels to get correct analysis and proper interpretation of data on current contraceptive use (including sterilization and modern methods). METHODS: The data from an Indian State, Uttar Pradesh (UP), collected by the National Family Health Survey (NFHS) conducted during 10 October 1992 to 22 February 1993 was used. For model I, 7851 currently married women who were neither pregnant nor had continuing post-partum amenorrhoea (PPA) were considered. For model II, these women with at least one child (n = 6748) were used. Two-level logistic regression analysis was carried out for which women's level (level 1) and PSU (Primary Sampling Unit) level (level 2) variables were considered. The results were considered significant at the 5% level of significance. Simulation analysis using each model was also carried out. RESULTS: Model I reveals that those more likely to adopt contraception were women exposed to a TV message (odds ratio [OR] = 1.3; 95% CI: 1.1-1.6); whose houses were pucca (bricks and mortar) (OR = 1.3; 95% CI: 1.1-1.5); who were educated to high school level and above (OR = 2.9; 95% CI: 2.2-3.7); whose husbands were literate with schooling of > or =11 years (OR = 1.7; 95% CI: 1.4-2.1); and who had > or =2 living sons (OR = 2.2; 95% CI: 1.1-4.4). Muslim and other religious women were less likely than Hindu women to adopt contraception (OR = 0.5; 95% CI: 0.4-0.6). Also, the PSU level availability of all weather road was positively associated with contraceptive adoption (OR = 1.4; 95% CI: 1.1-1.7). The PSU level variance, which is the unexplained PSU level variation after controlling for the considered characteristics, was significantly higher. The simulation results revealed that public health education (a TV message) was found to be more effective among less educated women. The PSU level availability of all weather road was as effective as public health education. Similar results were evident from the analysis of second data set (model II) with the noticeable finding that those whose last child is surviving are most likely to adopt contraception (OR = 8.82; 95% CI: 1.01-77.38). CONCLUSIONS: These results reveal that the survival status of the last child has a marked effect on the adoption of contraception in UP. They further support the idea that public health education (a TV message) is more effective among less educated women. Also, the PSU level presence of all weather road is equally effective. Consideration of higher level variables provides not only more accurate results but also important public health clues to help the policy planners.
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Of sexually active delinquent male adolescents admitted to a detention facility over a 6-month period from 1987 to 1988, 69% reported condom usage. Review of the medical records of a similar group of detainees from the same facility in 1984 revealed a 44% reported condom usage rate, suggesting a marked increase in utilization. Stated reasons for condom use in 1987-1988 included prevention of sexually transmitted diseases (63%) and pregnancy (33%). More than one reason was given by 20%.
PURPOSE: This study is to investigate the influencing factors in the consistent use of contraception methods by comparing consistent and inconsistent users on partner communication, contraceptive control perception, and sexual autonomy among married Korean women. METHOD: This study consists of 243 married women living in Korea. A convenient sampling technique was used and data were collected by self report questionnaires from September 14, 2000 to October 20, 2000. RESULT: Only 41.6% of women were using contraception methods consistently and the rest of them were using contraception methods inconsistently. Between the two groups, statistical significances were noted in sexual communication(t=-2.5, p=.01), perceived contraceptive control(t=-7.5, p=.00) and sexual autonomy(t=-3.1, p=.00). As for general communication, it was not statistically significant(t=-1.0, p=.31). CONCLUSION: Family planning program advisors should recognize that intervention programs for the promotion of consistent contraceptive behavior should focus on the sexual communication, perceived contraceptive control, and sexual autonomy.