Cognitive analysis of contraceptive behavior.
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Adolescent↗
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Results for “Contraceptive Usage--determinants”
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Contraceptive and condom use adoption and maintenance: a stage paradigm approach.
The Transtheoretical Model of Behavior Change was examined for its applicability to contraceptive and condom use adoption and maintenance using N = 248 heterosexually active college-age men and women. The model posits that individuals do not go directly from old behaviors to new behaviors to new behaviors, but progress through a sequence of stages: precontemplation, contemplation, preparation, action, and maintenance. The stages of change offer a temporal dimension that provides information regarding when a particular shift in attitudes, intentions, and behavior may occur. The model also postulates a set of or outcome variables--the pros and cons of change and self-efficacy. The results demonstrated that individuals were furthest along in the stages of change for general contraceptive use, followed closely by condom use with other (e.g., casual) partners, and then condom use with main partners. Although no sex differences were found for the stages for the three separate contraceptive behaviors, males and females differed on the pros and cons and levels of self-efficacy when engaging in intercourse with the two types of partners. MANOVA/ANOVA results indicated that the relationship between stages and other constructs follows predicted patterns suggesting that the transtheoretical model may provide a useful framework or paradigm for understanding contraceptive and condom use behavior.
Adolescent↗
STD patients' knowledge about AIDS and attitudes toward condom use.
Patients (N = 71) from a sexually transmitted disease (STD) clinic in an urban setting were surveyed to determine their knowledge about acquired immune deficiency syndrome (AIDS) and attitudes toward condom use. Overall knowledge scores were high with a mean score of 22 on the 28-item true-false questionnaire. No statistical significance was found between AIDS-knowledge scores and condom-use behavior. The majority of subjects or their partners had STD symptoms and multiple partners within a 6-month period. Thirty percent of the respondents reported using condoms at least 25% of the time. In response to open-ended statements about condoms, 10 beliefs were mentioned most frequently. The majority of subjects reported protection against sexually transmitted disease and preventing pregnancy as the most important reasons for condom use. "Avoids getting AIDS" only ranked as the eighth most salient belief and few subjects with multiple partners in the previous 6-month period even cited this belief. Other significant beliefs about condom use included decreased feeling, worry about breakage, decreased pleasure for partner, uncomfortable, feeling safe, inconvenient, and not romantic. The most significant referent (normative belief) influencing condom-use decision making was "mother" in younger subjects and "sexual partner" for older subjects. The sexual partner had unfavorable attitudes toward condom use. These results indicate the need to incorporate attitudes and normative beliefs to change condom-use behavior.
Acquired Immunodeficiency Syndrome↗
Contraceptive use in Matlab, Bangladesh: the role of gender preference.
Research in several Asian societies has suggested that sons are generally preferred over daughters. The implications of gender preferences for actual fertility behavior have not been adequately investigated, however. This analysis examines the effect of the sex composition of surviving children on the acceptance and discontinuation of contraception in a sample of 3,145 women in Matlab, Bangladesh, who were observed for 60 months. Hazards regression analyses are employed in the analysis. Strong and highly significant effects of gender preference on contraceptive use are observed. The preference is not monotonically son-biased but is moderated toward a balanced composition, because parents desire to have several sons and at least one daughter. These findings suggest that gender preferences, particularly a preference for sons, represent a significant barrier to fertility regulation in rural Bangladesh.
Bangladesh↗
Tailoring family planning services to the special needs of adolescents.
Experimental service protocols tailored to the needs of teenage family planning patients were developed that emphasized indepth counseling, education geared to an adolescent's level of development, and the provision of reassurance and social support. These protocols were tested against usual service delivery practices in a study involving 1,261 patients under 18 years of age at six nonmetropolitan family planning clinics. A comparison with teenagers obtaining services at control sites found that six months after their first clinic visit, patients at the experimental sites were more likely to be using a method, were less likely to experience difficulty in dealing with problems, were more likely to continue using their method despite problems and had learned more during the educational session. Teenage patients at the experimental clinics were also less likely to have become pregnant within one year than those who went to control clinics. Attrition during the year following the first study visit was similar among both groups; patient satisfaction was very high, and equivalent at experimental and control sites. The data show that the extra time and effort required to meet the special needs of teenagers is justified by their improved contraceptive use, greater knowledge and lower pregnancy rates.
Adolescent↗
Fertility on the US-Mexico border.
Using Bongaarts' model, the relative importance of the proximate determinants of fertility is explored in five populations on the US-Mexico border. For the groups closest to natural fertility (the two Mexican groups), lactation, use of contraception, and marriage all were moderately important in terms of their direct effect on fertility. For the group with lowest fertility (Anglo-American), contraceptive use was an important factor inhibiting fertility; marriage was important but not nearly as important as contraceptive use. For the two US Mexican-American groups, contraceptive use was an important intermediate variable, not as important as for Anglo-Americans, but more important than it was for the two populations in Mexico. The proportion married was a moderately important factor for the Mexican-American groups. For these five populations the principal differences in fertility rates result from substantial differences in the use of effective contraception. Bongaarts' model proved very useful as an analytical framework in this study.
Adolescent↗
Parents' behavioral norms as predictors of adolescent sexual activity and contraceptive use.
The influence of parental factors on adolescent sexual behavior and contraceptive use has been examined previously, and findings have been contradictory. Previous studies, which found little relationship between parental norms and adolescent sexual activity, have been limited by their failure to recognize developmental differences in the relative weight of parent and peer influences between younger and older teens and by use of selected samples, resulting in a restriction of range. The current study differs in that it utilizes a clustered sample household survey of 329 males and females, aged 14 to 17, and 470 of their parents. Using multiple regression analysis, it was found that parents' reported behavioral norms account for 5% of the variance in whether adolescents have had intercourse, and for 33% of the variance in use of contraception at last intercourse. The study suggests that while parents' normative beliefs have limited effect in the decision to become sexually active, they have considerable impact on later contraceptive use.
Adolescent↗
Adolescent cognitive and contraceptive behaviors.
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Adolescent↗
Ethnic differences in contraceptive use in Sri Lanka.
In Sri Lanka in 1975, the majority Sinhalese had a much higher use of contraception than either the Sri Lanka Tamils or the Moors. This study uses a national sample of women of childbearing age gathered by the Sri Lanka World Fertility Survey in 1975 to assess four possible reasons for differential contraceptive use: (1) differences in socioeconomic position; (2) cultural differences; (3) minority status; and (4) differential access to family planning services. The first three explanations focus on differences in the demand for contraception while the fourth explanation focuses on differences in the availability of contraceptives. The socioeconomic, cultural, and minority status hypotheses fail to explain the higher contraceptive use among the Sinhalese. The evidence is consistent with the idea that ethnic differences in contraceptive use were largely caused by differential access to family planning services.
Adult↗
Sources of prescription contraceptives and subsequent pregnancy among young women.
For more than four in 10 teenage women who first obtained a prescription contraceptive from a private doctor or family planning clinic prior to pregnancy, marriage or interview in 1979, that method was the first they had ever used. Whites were over two times more likely to have previously used a nonprescription method than were blacks. Blacks, on the other hand, were two times more likely than whites to have been virgins before first using a prescription method. Slightly more than half of all young women who used a prescription method first obtained it from a family planning clinic, and the remainder got it from a private physician. Blacks were much more likely to have gone to a clinic than were whites. Nine in 10 of those who obtained a prescription method chose the pill. Among blacks, there was no appreciable difference between those who got the method from a clinic and those whose source was a private doctor. Whites who obtained their method from a private doctor, however, were somewhat more likely to choose the pill than were those who got it from a clinic. Of all who had been sexually active before ever using a prescription method, about eight out of 10 whites, but only about five in 10 blacks, had previously used a nonprescription method. Overall, there was an interval of about one year between first intercourse and the time the young women first got a prescription method. Among whites, there was no difference in parental education or family stability between clinic and private physician patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗
The question of access.
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Contraception Behavior↗
Factors influencing family planning use in Ilorin, Nigeria.
Over a three-year period (1990-1992), the factors influencing the use of family planning among the 7,902 clients attending the Planned Parenthood Federation of Nigeria (PPFN) Clinic in Ilorin were studied. The patients were predominantly females (74.1%). Urban residents (66.1%), educated clients (77.4%), clients aged 25-39 years (73%), and those with three or more children (74.8%) are more likely to use family planning. More Moslems (61%) than Christians (39%) appear to embrace family planning practice in Ilorin.
Adolescent↗
The relationship of substance use with sex to the use of condoms among young adults in two urban areas of Scotland.
The relationship of the use of alcohol or drugs in conjunction with sexual activity and the use of condoms and other contraceptives was examined among 1378 respondents in a household survey of two urban areas of Scotland. In bivariate analyses, respondents who reported having had sex under the influence of alcohol or drugs were no less likely than respondents with no such experience to report consistent use of condoms, and having had sex under the influence of substances was positively related to lifetime condom use. Multivariate analyses that included gender and urban area as predictors yielded similar findings. The results suggest that individuals who combine sex with alcohol or drugs are not necessarily more likely to engage in riskier sex.
Adolescent↗
Health belief and self-efficacy models: their utility in explaining college student condom use.
This investigation tested the ability of the Health Belief Model (HBM), dimensions of self-efficacy, various behavioral variables (i.e., number of sex partners in the past 12 months, frequency of drunkenness during sexual intercourse, and number of diagnosed sexually transmitted diseases), and demographic measures to distinguish between three condom user groups (i.e., nonusers, sporadic users, and consistent users). The usable sample consisted of 366 college students, ages 18 to 24. The study operationalized the following HBM components: perceived susceptibility, perceived benefits, and perceived barriers. The multidimensional Condom Use Self-Efficacy Scale (CUSES) was also used in this investigation. Results from a discriminant analysis indicated that sporadic users were best distinguished from both consistent and nonusers by number of sex partners in the past year, frequency of drunkenness during sexual intercourse, perceived susceptibility to HIV/AIDS and other STDs, and a self-efficacy factor labeled Assertive. The sporadic users had significantly more sex partners, were drunk more often when engaging in sexual intercourse, perceived themselves as more susceptible to HIV/AIDS and other STDs, and were less confident in their ability to discuss and insist on condom use with a partner. It was also discovered that each condom user group was best defined by different subsets of discriminating variables. Implications of these findings for campus-based prevention programs and future research are discussed.
Adolescent↗
Combined use of condoms with other contraceptive methods among inner-city Baltimore women.
Data from a street survey conducted among 717 women aged 17-35 in two inner-city Baltimore communities in 1991-1992 indicate that 17% of the entire sample, 38% of women using the pill and 11% of users of methods other than the pill used a condom in addition to another method the last time they had intercourse. Although adolescents reported the highest rate of combined condom and pill use (22% of 17-19-year-olds), condom use was significantly associated with pill use among adult women (odds ratio of 1.57) but not among adolescents (odds ratio of 1.03). Condom use was negatively associated with use of methods such as the diaphragm, the IUD, the implant and the sponge (odds ratio of 0.21) among both adolescents and adults. Logistic regression analyses show that positive attitudes toward safer sex, ever having refused sex without a condom and believing in condom efficacy all significantly predicted use of the condom with another method. Having ever been tested for HIV was negatively related to combined use, while behavioral risk factors showed no association.
Acquired Immunodeficiency Syndrome↗
Program- and method-related determinants of first DMPA use duration in rural Bangladesh.
This article examines the determinants of first-time use durations of the injectable contraceptive Depo Medroxy Progesterone Acetate (DMPA) for rural Bangladeshi women. The method's side effects were defined by 200 first-time users in Matlab district during lengthy, open-ended interviews. Women with many children used the method longer than did women of low parity. Those who experienced side effects had shorter use durations than those who did not, and those who cited heavy bleeding as their main problem discontinued use soonest. Women whose husbands approved of family planning had significantly longer use durations than those whose husbands disapproved. Respondents who adopted DMPA because of perceived positive aspects of the drug used it longer than those who chose it for other reasons. Results of the study underscore the importance of viewing side effects in a specific social and cultural context. Expanded side-effects counseling for women and their husbands is needed.
Adult↗
Attitudes, knowledge, and behavior regarding condom use in urban black adolescent males.
This study was conducted to determine male adolescent behavior, attitudes, and knowledge concerning the use of condoms. Subjects were 241 sexually active black adolescent males attending an inner-city adolescent medicine clinic who were surveyed using a structured interview technique. Factors associated with condom use included higher grade level, > or = 2 sexual partners in the past six months, communication about contraception with sexual partner(s), desire for sexually transmitted disease (STD) prevention when contracepting, and parental suggestion to use condoms. Variables not associated with condom use included older age, minimal level of knowledge about condom use, history of having impregnated a partner or of having contracted an STD, desire for pregnancy prevention, suggestion by friends to use condoms, or partner dissatisfaction with condoms. Using multivariate logistic regression analysis, the following variables in combination were able to correctly classify respondents as condom users or nonusers in 74% of cases: higher knowledge score, reported communication about contraception with one's partner(s), > or = 2 partners in the past six months, and higher socioeconomic status. These findings suggest that, for the study population, interventions directed toward improving knowledge about condoms, school achievement, and communication with parents and partners may be effective in increasing condom use.
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Cognitive, psychosocial, and reported sexual behavior differences between pregnant and nonpregnant adolescents.
A wide variety of variables have been related to the occurrence of adolescent pregnancy. However, many previous studies have produced conflicting results and are univariate in nature. The purpose of this study was to assess differences in pregnant and nonpregnant adolescents on variables from three domains: cognitive, psychosocial, and reported sexual behavior. Sixty-nine pregnant adolescents and 58 comparison adolescents filled out nine questionnaires presented on microcomputers. Significant differences were found on 10 of 24 univariate tests. The strongest differences concerned areas of scholastic functioning and reported sexual behavior; pregnant teenagers were more likely than nonpregnant peers to be doing poorly in school and less likely to use contraceptives. In addition, pregnant teenagers were more likely to have a relative or friend who was an adolescent mother and to expect child rearing to be easier than did the nonpregnant adolescents. A discriminant analysis was computed which correctly classified 83% of the sample, based on variables from each of the three domains. This study has served to replicate, refute, and expand on previous findings concerning the antecedents of teenage pregnancy. More importantly, this study has empirically demonstrated the multivariate and interrelated nature of variables associated with teenage pregnancy.
Adolescent↗