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PubMedDate not supplied

Socioeconomic disadvantage and adolescent women's sexual and reproductive behavior: the case of five developed countries.

CONTEXT: Differences among developed countries in teenagers' patterns of sexual and reproductive behavior may partly reflect differences in the extent of disadvantage. However, to date, this potential contribution has received little attention. METHODS: Researchers in Canada, France, Great Britain, Sweden and the United States used the most current survey and other data to study adolescent sexual and reproductive behavior. Comparisons were made within and across countries to assess the relationships between these behaviors and factors that may indicate disadvantage. RESULTS: Adolescent childbearing is more likely among women with low levels of income and education than among their better-off peers. Levels of childbearing are also strongly related to race, ethnicity and immigrant status, but these differences vary across countries. Early sexual activity has little association with income, but young women who have little education are more likely to initiate intercourse during adolescence than those who are better educated. Contraceptive use at first intercourse differs substantially according to socioeconomic status in some countries but not in others. Within countries, current contraceptive use does not differ greatly according to economic status, but at each economic level, use is higher in Great Britain than in the United States. Regardless of their socioeconomic status, U.S. women are the most likely to give birth as adolescents. In addition, larger proportions of adolescents are disadvantaged in the United States than in other developed countries. CONCLUSIONS: Comparatively widespread disadvantage in the United States helps explain why U.S. teenagers have higher birthrates andpregnancy rates than those in other developed countries. Improving U.S. teenagers' sexual and reproductive behavior requires strategies to reduce the numbers of young people growing up in disadvantaged conditions and to help those who are disadvantaged overcome the obstacles they face.

Adolescent↗

PubMedDate not supplied

Repeat abortion and use of primary care health services.

One-third (34%) of 2,001 women who sought an abortion in 1991-1992 in Wichita, Kansas, were repeat-abortion patients. Compared with first-time abortion patients, repeat-abortion patients were significantly older, more often black, and younger at their first pregnancy (p < .001). The two groups did not vary significantly by income or age at first intercourse. However, repeat-abortion patients were significantly more likely than first-time patients to have been using a contraceptive method at the time of conception (65% compared with 59%) and more likely to say they always or almost always used a method (63% and 53%, respectively). More than 40% of women in each group reported they had no personal physician. Further, 34% of repeat-abortion patients said they had no follow-up examination after their previous abortion, and 28% said they received no contraceptive counseling. Only half of women whose pregnancy was confirmed by their personal physician obtained an abortion referral from that physician.

Abortion Applicants↗

PubMedDate not supplied

Cancer patterns and risk factors in the African population of southwestern Zimbabwe, 1963-1977.

The incidence of cancer and the importance of some selected risk factors in its etiology were estimated from the data collected in the cancer registry of Bulawayo, Zimbabwe, during the period 1963-1977. Cancer cases were interviewed with a standard questionnaire, and more than 71% of these were complete. In men, the most frequent cancer sites were liver, esophagus, and lung, while in women, cervical cancer was the dominant malignant tumor, followed by cancers of the liver, breast, and bladder. Risk factors of cancer cases were estimated by case-control analysis in which other cancers (excluding tobacco-related cancers in men and hormone-related cancers in women) were considered as controls. In men, tobacco smoking was associated with increased risk of lung cancer (odds ratio OR2, 5.2) and esophagus cancer (OR, 5.6) in the highest consumption category (15 g of tobacco per day) compared to nonsmokers. Copper (OR, 1.5), gold (OR, 1.5), and nickel (OR, 2.6) miners had an increased risk of lung cancer, but no increase was found among asbestos miners (OR, 0.7). There was no independent effect of alcohol consumption on the risk of esophagus cancer. The presence of schistosomiasis was associated with a significantly increased risk of bladder cancer (OR, 3.9). The risk of invasive cervical cancer increased with number of children--the estimated odds ratio was 1.8 in women with six or more births--but no consistent association was found for first intercourse. In postmenopausal women, the risk of breast cancer increased with age at first pregnancy (but not in the highly fertile) and decreased with high parity, if age at first pregnancy was 19 or more.

Adolescent↗

PubMed1992

Risk factors for cervical cancer in Colombia and Spain.

A population-based case-control study of cervical cancer was conducted in Spain and Colombia to assess the relationship between cervical cancer and exposure to human papillomavirus (HPV), selected aspects of sexual and reproductive behaviour, use of oral contraceptives, screening practices and smoking. The study included 436 cases of histologically confirmed squamous-cell carcinoma and 387 age-stratified controls randomly selected from the general population that generated the cases. The presence of HPV DNA in cervical scrapes was assessed by PCR-based methods and was the strongest risk factor (OR = 23.8; 13.4-42.0). Risk estimates for any other factor were only slightly modified after adjusting for HPV status. Among women found positive for HPV DNA, only the use of oral contraceptives was a risk factor for cervical cancer (OR = 6.5; 1.3-31.4 for ever vs. never use). Patients with cervical cancer who were HPV DNA-negative retained most of the established epidemiological features of this disease. This suggests that some instances of HPV infection went undetected or that other sexually transmitted factor(s) contribute to the causation of cervical cancer. Early age at first intercourse (OR = 4.3; 2.1-9.0 for age < 16 vs. 24+) and early age at first birth (OR = 5.0; 1.8-14.2 for age < 16 vs. 24+) were associated with increased risk of cervical cancer; these effects were independent of one another. Low educational level was a risk factor (OR = 2.5; 1.6-3.9). Number of sexual partners was in our study a surrogate for HPV infection. Smoking and parity after age 24 were weakly and inconsistently associated with the risk of cervical cancer. Previous screening (OR = 0.7; 0.5-1.0) and ever having undergone a Caesarean section (OR = 0.4; 0.2-0.8) were protective factors.

Age Factors↗

PubMed2001

Cervical neoplasia risk in women provided hormonal contraception without a Pap smear.

The study was conducted to determine whether women using a demonstration program providing hormonal birth control without concurrent pelvic examination (First Stop) are at higher risk of cervical neoplasia compared to women using traditional family planning clinics. Using retrospective ion of medical charts, we compared risk factors for cervical neoplasia among 400 First Stop clients and 400 traditional site clients matched on age, race, and contraceptive method. We determined prevalence of these factors: previous abnormal cervical smear, <16 years at first intercourse, multiple sexual partners, high parity, history of sexually transmitted infections, and current cigarette smoking. First Stop clients were not at greater likelihood of having any risk factor for cervical neoplasia except high parity. First Stop clients who failed to follow through on a referral to a traditional clinic were not more likely to be of higher risk than those who did follow through. Of 13 First Stop clients with the highest risk profiles (previous abnormal cervical smear plus one other risk factor), one did not follow through with referral. First Stop clients choosing hormonal contraception without a pelvic examination do not appear to be at substantially higher risk of cervical neoplasia. Future research should quantify more precisely the risks and benefits of the general application of this strategy on a population level.

Adolescent↗

PubMed1995

High-risk behaviors in teenage male athletes.

This project studied high-risk activities in adolescent male athletes (ages 13-19) compared with a control group of adolescent male and female nonathletes. All athletes surveyed participated in one or more interscholastic sports. The prevalence of drug use by athletes compared to nonathletes was determined. Of the 19 drugs observed in this study, all were shown to have a lower prevalence of use among athletes in their senior year of high school, compared to the comparison group. Among the more commonly abused substances by the athlete population, beer, wine and whiskey, cigarettes, and marijuana were shown to have a lower use rate, by 25.5, 39.9, 57.5, and 57.7%, respectively. The prevalence of drug use by adolescent male athletes compared to adolescent nonathletes was also studied. Of the 19 individual drugs surveyed, all demonstrated a lower prevalence of use among athletes in their senior year of high school compared to the national data. The second high-risk activity measured was sexual activity. Of the athletes, 45.5% stated that they had never had sexual intercourse, compared to 50.0% of the nonathletes. Of the sexually active athletes, 81.9% had their first intercourse at between 13 and 15 years of age, whereas only 67.8% of the nonathlete control group had done so. This difference diminished significantly at age 16 and above. The results of this study suggest that participation in athletics by male athletes may lead to a significant decrease in drug and alcohol use and abuse but, also may increase early sexual contact. These trends were seen throughout all 4 years of high school in the athletes studied.

Adolescent↗

PubMedDate not supplied

Fertility and family planning in the United States: insights from the National Survey of Family Growth.

A review of about 50 studies based on the 1982 National Survey of Family Growth (NSFG) illustrates the ways in which the survey sheds new light on trends and differentials in such areas as fertility, contraceptive use, infertility and the use of family planning services in the United States. The total fertility rate declined by nearly 50 percent between 1960 and 1973, from 3.6 to 1.9 births per woman, and changed little from then until 1982. It would appear that growing use of the pill, the IUD and sterilization--but principally the pill--is the prime factor in the dramatic decline in unwanted and mistimed births among married couples. Their increasing reliance on sterilization between 1973 and 1982 reduced the proportion of unwanted births at ages 35 or older by half, but had little impact on overall birthrates because only about five percent of all births occurred at those ages in 1981. Although overall fertility has declined, the rate of premarital pregnancy has risen since the early 1960s. Research based on the NSFG suggests that this is a result both of the rapid increase in the percentage of women who have premarital intercourse and of the increasing length of exposure to premarital pregnancy. The latter trend is probably related both to earlier intercourse and to delayed marriage. Despite the increasing levels of premarital exposure, however, there was actually a decline in teenage birthrates in the 1970s, which was due in part to the rising abortion rates among teenagers. Finally, although racial differences in fertility have narrowed, black women still have higher fertility than whites. The 1982 NSFG data suggest that four factors are principally responsible for the higher birthrates of black women: Blacks begin having intercourse earlier than whites; black women are one-third less likely to use contraceptives at first intercourse; they are more likely to be currently exposed to the risk of unplanned pregnancy and not using a method; and they have higher pregnancy rates when they are using no contraceptives or less-effective methods, such as the condom, rhythm and withdrawal.

Adolescent↗

PubMed1998

[Patterns of sexual behavior in Chilean women].

BACKGROUND: Sexuality has an individual connotation, is influenced by biological, environmental and cultural factors and is present throughout all life. AM: To assess the sexual behavior of a group of Chilean women. SUBJECTS AND METHODS: A specially devised inquiry was applied to 301 women, aged 20 to 70 years old, that consulted in a medical service. RESULTS: Seventy seven percent of women were sexually active. These figures ranged from 80% of women aged 40-44 years old to 40% of women over 60. Sixty percent of women living together, 53.7% of single women, 65.6% of divorced women, 94.2% of married women and 100% of widows were sexually active. Women aged 25 to 29 years old had a mean of 8.4 relations per month compared with 3.3 relations among women older than 55. The frequency of sexual intercourse was higher in women living together and lower in widows. The mean age at the first intercourse was 20.6 +/- 4.5 years. Ninety three percent had experienced sexual desire and the percentage of satisfactory sexual relations does not change with age. Less educated women had a lower frequency of orgasms. CONCLUSIONS: Age and legal status of women are related to their sexual behavior and less educated women have a less satisfactory sexual life.

Adult↗

PubMed2003

Is child sexual abuse declining? Evidence from a population-based survey of men and women in Australia.

OBJECTIVE: Substantiated cases of child sexual abuse (CSA) in the United States have declined significantly over the past decade. This may, or may not, reflect change in the underlying rate in the general population. This study examines age-cohort differences in the prevalence of self-reported CSA experiences of men and women aged 18-59 years in a community-based sample from a comparable western nation. METHOD: In April 2000, we completed a cross-sectional, telephone-based survey of a randomly selected national sample of men and women in Australia. Volunteers (876 males, 908 females) answered a range of questions about health status and sexuality, including unwanted sexual experiences before the age of 16 years. Of selected adults with publicly-listed telephone numbers, 61% agreed to participate. There were few differences between the volunteers and the Australian population on demographic variables and health indicators. RESULTS: Non-penetrative CSA was twice as common among women (33.6%) than men (15.9%). Approximately 12% of women and 4% of men reported unwanted penetrative experiences. CSA was reported significantly less often by younger males, with a linear decline from the oldest to youngest men. Among all females who had intercourse before age 16, older women were much more likely than younger women to say they were an unwilling partner on the first occasion. If first intercourse occurred at age 16 or later, there were no age-cohort differences in risk of first-time abuse. Self-reported "openness" and "comfort" during the telephone interviews was not systematically related to prevalence of CSA. CONCLUSION: These population-based findings provide evidence of a decline in the underlying rate of CSA in Australia. Although every measure of CSA inevitably is flawed to some extent, these trends in self-report complement official statistics that show substantial decline in recent years.

Adolescent↗

PubMed2004

The potential protective effects of youth assets from adolescent sexual risk behaviors.

PURPOSE: To examine the relationship among individual youth assets and adolescent sexual risk behaviors. METHODS: Cross-sectional, in-home interview data from randomly selected inner-city neighborhood teenagers (N = 1253) and their parents (N = 1253) were analyzed. Demographic information (e.g., age, parental income, family structure) was statistically controlled for while investigating the relationships among youth asset and sexual activity outcomes using logistic regression analyses. Potential interactions between the demographic variables and the assets were also examined. The five sexual risk behaviors included "never had sexual intercourse," current sexual activity, number of lifetime sexual partners, current use of birth control, and age at first intercourse. RESULTS: Youth mean age was 15.4 (+/- 1.7) years; 52% were female; 49% were Non-Hispanic Caucasian, 23% Non-Hispanic African-American, 19% Hispanic and 10% Non-Hispanic Native American. Sixty-three percent reported never having had sexual intercourse. Multiple logistic regression analyses indicated that, after controlling for the demographic variables and the other significant assets, Non-Parental Adult Role Models, Peer Role Models, Use of Time (Religion), and Future Aspirations were independently significantly related (p <.05) to whether or not youth had ever participated in sexual intercourse. Individual multiple logistic regression analyses indicated that, after controlling for the demographic variables, Peer Role Model and Family Communication assets were each significantly associated with birth control use by sexually active youth (p <.05). CONCLUSIONS: Specific youth assets may have a protective effect from certain sexual risk behaviors.

Adolescent↗

PubMedDate not supplied

The association between multiple youth assets and sexual behavior.

PURPOSE: To investigate the possible positive cumulative effects that youth assets may have on youth sexual behaviors. DESIGN: Cross-sectional data were collected from a randomly selected population by in-home, in-person interviews. Mantel-Haenszel chi-square test and logistic regression were conducted to determine the potential cumulative effects that youth assets may have on youth sexual behaviors and to test for significant asset by sexual risk behavior trends. SETTING: Racially diverse inner-city neighborhoods in two midwestern cities. Subjects. Teenagers (n = 1350; mean age = 15.2 years) and parents of the teenagers (n = 1350). The response rate was 51%. MEASURES: Demographic factors, nine youth assets, and five sexual behavior outcomes. RESULTS: Significant (p < .05) trends and odds ratios (ORs) were found for three of the five youth sexual behavior outcomes. Youths with more assets were more likely to have never participated in sexual intercourse (OR = 1.32). Of sexually active youths, those with more assets were more likely to have delayed first intercourse until at least 17 years of age (OR = 1.47) and to have used birth control at last sexual intercourse (OR = 1.18). Nonsignificant (p > .05) results were found for current sexual activity and number of sexual partners. CONCLUSIONS: The results generally support the notion that the more assets adolescents possess, the more likely they are to engage in positive behavior. Practitioners planning asset-based teenage pregnancy prevention programs might consider promoting several specific youth assets.

Adolescent↗

PubMed2003

Contraceptive choices in medically ill adolescents.

More than 50% of all women in the United States have had sexual intercourse by 18 years of age. Up to one half of these adolescents do not use contraception at first intercourse. Although chronically ill adolescents may differ slightly from these norms, such differences are probably minor. Prevention of adolescent pregnancy remains a challenge in the medical community, and this can be especially difficult for the chronically ill adolescent. In some cases, medications taken for certain chronic conditions may alter the effectiveness of hormonal contraception, and pregnancy in these cases may pose substantial risks to the mother as well as her fetus.

Adolescent↗

PubMed2002

Contraceptive use among Jamaican teenage mothers.

OBJECTIVE: To compare the prevalence of contraceptive use among teenage mothers who were participating, and teenage mothers who were not participating, in a program in Jamaica that had been established to deal with the country's serious problem of repeat pregnancies among adolescents. METHODS: A historical cohort design was used to assess the impact that the Women's Centre of Jamaica Foundation (WCJF) Programme for Adolescent Mothers had on contraceptive use among the target population of adolescents 16 years and under who had experienced a first live birth in 1994. RESULTS: Contraceptive use at first intercourse was found to be higher among WCJF program participants (44%) than among nonparticipants (37%), but this difference was not significant (P = 0.35). Contraceptive use after first live birth was also higher among WCJF program participants (94%) than among nonparticipants (86%), and this difference was significant (P = 0.04). Contraceptive prevalence at last intercourse (in 1998) did not differ between participants and nonparticipants (both 69%). CONCLUSIONS: Contraceptive use among this population in Jamaica was highest when the respondents' perception of vulnerability to pregnancy was most acute, that is, after the first live birth. All adolescents, both males and females, need to be educated about the importance of sustained and effective use of contraception in order to reduce the risk of unintended pregnancy and sexually transmitted diseases.

Adolescent↗

PubMedDate not supplied

The effect of partners' characteristics on teenage pregnancy and its resolution.

CONTEXT: Although the determinants of whether a teenage woman has a nonmarital pregnancy and how such a pregnancy is resolved have been widely investigated, little is known about the effect of her partner's characteristics or the joint influence of the two partners' characteristics on nonmarital teenage pregnancy. METHODS: Data from the 1995 National Survey of Family Growth are used to examine whether the characteristics of teenage women and their partners affect the likelihood of a nonmarital pregnancy and how the pregnancy is resolved. The data are corrected for underreporting of abortions. RESULTS: More than 17% of teenage women are estimated to have become pregnant during their first nonmarital teenage sexual relationship. About 44% of these pregnancies result in a nonmarital birth and about 18% in a marital birth, while 37% end in an abortion. The likelihood of nonmarital pregnancy declines as age at first intercourse rises, but age does not affect how such a pregnancy is resolved. Women who are older than their first partner are more likely to become pregnant than those who are the same age, and their pregnancies are less likely to end in abortion than in a marital birth. Women who are younger than their first partner are no more likely to become pregnant than other women after the effects of other characteristics are taken into account. The male partner's education is negatively associated with the likelihood of nonmarital pregnancy but is positively associated with the likelihood of abortion if a pregnancy occurs. Differences between partners in race or ethnicity do not affect the likelihood of a nonmarital pregnancy but do increase the likelihood that such a pregnancy will end in abortion or a nonmarital birth rather than in a marital birth. CONCLUSIONS: The characteristics of teenage women and their partners appear to play a role in nonmarital teenage pregnancy and its outcome. However, the estimated relationships between one partner's characteristics and the probability of a nonmarital pregnancy and its resolution are generally little affected by whether the other partner's characteristics are also taken into account.

Abortion, Legal↗

PubMedDate not supplied

Adolescent sexual attitudes and behavior: are they consistent?

Relationships between sexual attitudes and behavior among adolescents were studied in data collected by self-administered questionnaires from approximately 3,500 junior and senior high school students attending four inner-city schools during 1981-1982. An analysis of the results by sex, race and age found that 83 percent of sexually experienced adolescents cite a best age for first intercourse that is older than the age at which they themselves experienced that event, and 43 percent of them report a best age for first coitus older than their current age. In addition, 88 percent of young women who have had a baby say the best age at which to have a first birth is older than the age at which they first became mothers. Thirty-nine percent of the women and 32 percent of the men say that they believe premarital sex is wrong. Among those who are virgins, the proportions are much higher. However, even among those who have had intercourse, approximately 25 percent of both sexes say they believe sex before marriage is wrong. Women desire stronger relationships before having intercourse than do men, and women claim to have had a stronger relationship with their last sexual partner. Very few teenagers believe neither partner is responsible for pregnancy prevention, which tends to be viewed as a joint responsibility. Those who see it as a shared responsibility are slightly more likely than those who assign the responsibility to one or the other partner to have used a method at last intercourse, and they are considerably more likely to have used a method than are those who believe contraception is neither partner's responsibility.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1986

Prospective study on the relationship between cervical neoplasia and herpes simplex type 2 virus. III. Presence of herpes simplex type-2 antibody in sera of subjects who developed cervical neoplasia later in the study.

Paired sera taken from 63 subjects who developed cervical neoplasia in the course of a prospective study on this disease were examined for the presence of herpes simplex virus type 2 (HSV-2) antibody. The first serum was taken at enrollment into the study, while the second was obtained after development of the disease, i.e. 2-4 years later. Simultaneously, paired sera from a group of control subjects, who remained free of any cytological and colposcopical abnormalities throughout the study, were also investigated. Controls were matched with patients by age, age at first intercourse, number of sexual partners, smoking habits and history of diathermoelectrocoagulation of ectopic epithelium and transformation zone of the cervix. The first sera from these subjects were obtained at enrollment while the second ones were taken at the end of the study, i.e. 5 to 7 years later. Antibody titres were remarkably stable in both patients and control subjects. Seroconversions from HSV-2 negativity to HSV-2 positivity as measured by the increase in the II/I ratio or development of antibody reactive with HSV-2-specific glycoprotein G were rare and no significant differences between the patients and control subjects were detected. This indicates that the development of the disease was apparently not followed by immediate or early activation of latent HSV-2 infection.

Antibodies, Viral↗

PubMed2001

Adolescent contraceptive non-use and covariation among risk behaviors.

PURPOSE: To investigate whether adolescent contraceptive non-use is associated with other risk behaviors. METHODS: A multistage sampling procedure produced a sample of 913 sexually active high school students. They completed a self-administered questionnaire that required mainly "yes" or "no" answers to questions involving participation in a range of risk behaviors. A series of multivariate logistic regression models investigated the relationships between contraceptive non-use and selected hypothesised correlates, controlling for key demographic variables. RESULTS: Contraceptive non-use was not significantly associated with use of cigarettes, alcohol, or inhalants; perpetration or being a victim of violence; exposure to risk of physical injury; and suicidality. For males only, there was a significant inverse association between contraceptive non-use and use of cannabis in the previous month. This was not the case for lifetime cannabis use for either gender. There was a significant inverse relationship between contraceptive non-use and knowing the most recent partner for more than 7 days, but no association for the number of partners nor duration since the last intercourse. For females only, there was a significant inverse association between contraceptive non-use and both age and age of first intercourse. CONCLUSIONS: This study does not support the hypothesis that contraceptive non-use is a component of the "risk behavior syndrome." Decisions to participate in intercourse and to use contraception have different psychosocial foundations. Prevention efforts should prioritize relationships with new partners and younger girls who commence intercourse early.

Adolescent↗

PubMed1987

[Young girls and contraception. A survey conducted in the MFPF family planning center, Strasbourg, in 1985].

The results of a survey on contraception among 513 adolescent women attending a family planning clinic in Strasbourg, France, in 1985 are presented. "Eighty percent of them were attending school. In over half the cases, this was their first consultation for contraceptive advice. 33% of the subjects did not return after this initial consultation. The age at which sexual intercourse first occurred was between 14 and 17, with a peak at 15-16 years of age. Most of the girls attending this Family Planning Center were told about it by friends or a sister (78%) and they rarely told their parents what they were doing (76%). Most of them (63%) preferred a woman doctor for a contraceptive consultation." (SUMMARY IN ENG)

Adolescent↗