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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.

Adolescent↗

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↗

Changes in adolescent males' use of and attitudes toward condoms, 1988-1991.

Data from more than 1,000 sexually active young males interviewed in 1988 for the National Survey of Adolescent Males at ages 15-19 and reinterviewed in 1990-1991 at ages 17-22 show that as the respondents grew older, their condom use declined. Although respondents' attitudes about the effects of condoms on pregnancy risk, partner appreciation, sexual pleasure and embarrassment became more favorable toward condom use over time, their degree of worry about AIDS and their perceived likelihood of getting AIDS declined. When data on males aged 17.5-19 in each time period were contrasted, the level of condom use was found to be essentially constant. Several condom-related attitudes among this age-group had become more favorable, although their perceived risk of acquiring AIDS had diminished. Multivariate analyses revealed that decreased worry about AIDS and increased denial of the seriousness of AIDS were modestly associated with a decline in condom use. Change in condom use was also affected by change in perceived reduction in sexual pleasure and by female partner's appreciation of condom use.

Acquired Immunodeficiency Syndrome↗

Exploring norms and beliefs related to AIDS prevention among California Hispanic men.

A focus-group study gathered qualitative information from Hispanic males in California regarding ethnic factors that might enhance or interfere with AIDS prevention efforts. A predominantly working-class convenience sample of 75 men aged 18-40 participated in seven groups of 10-12 participants each. Three groups were composed of single men, three of married men and one was composed of homosexual and bisexual men. Four groups included only participants born outside the United States; and Spanish was the preferred language in five of the groups. Evaluation of the discussions indicates that while AIDS awareness is high among this population, condom use is sporadic. Few participants knew that someone infected with the human immunodeficiency virus could appear healthy; most believed they could easily determine if a woman is risky by her appearance or social standing. Although many participants thought HIV could be transmitted through casual contact, the homosexual and bisexual men were more likely to acknowledge that they were at some risk of infection; most of the heterosexual men did not perceive themselves as being at risk, even those who engaged in sex with prostitutes or women they met at bars. The participants had ambivalent attitudes toward women who suggested condom use and were often reluctant to initiate condom use themselves. Religion did not seem to play a major role in the men's attitudes about AIDS, sexuality and condom use.

AIDS Serodiagnosis↗

Women's socioeconomic position and contraceptive behavior in Togo.

Few studies have examined empirically the influence of women's position on contraceptive behavior in sub-Saharan Africa. Using data from the 1988 Togo Demographic and Health Survey, this article explores the linkages between various indicators of women's position and spousal communication about family planning and contraceptive use. The results highlight the importance to their contraceptive behavior of women's economic power and individual control over choice of partner. The likelihood of spousal communication about family planning and modern contraceptive use is significantly higher among women who exercised complete control over selection of partner than among those with arranged marriages. Women who work for cash are significantly more likely than those who do not to communicate with their spouses about family planning, particularly if they participate in rotating credit or savings schemes. Such participation also increases significantly the likelihood of ever using traditional and modern methods of contraception.

Adolescent↗

Stage of behavior change for condom use: the influence of partner type, relationship and pregnancy factors.

A theoretical model was used to examine the influence of relationship factors, pregnancy intentions, contraceptive behavior and other psychosocial characteristics on stages of behavior change in condom use among heterosexual black women of reproductive age. Data from an inner-city street survey compared women who were not contemplating condom use, women who were attempting to use condoms or had used them consistently for short periods of time, and those who had achieved long-term consistent use. Women's relationship with their main partner appears to be an important factor in understanding their use of condoms both with main partners and with other partners. For condom use with the main partner, factors such as emotional closeness and partner support were significant predictors of the likelihood that women would be attempting to use condoms rather than not contemplating use. Cohabitation and the belief that condom use builds trust were significant predictors of long-term consistent condom use. Having a regular or main partner was strongly associated with intentions to use condoms with other partners. Women who wanted to become pregnant were much less likely to intend to use condoms with their main partner, and women using oral contraceptives were less likely to be long-term consistent condom users.

Adolescent↗

Intention to use contraceptives and subsequent contraceptive behavior in Morocco.

In this article, the relationship between stated intention to use contraceptives and subsequent use during a three-year period in Morocco is examined. Longitudinal data are drawn from two Demographic and Health Surveys: the 1992 Morocco DHS and the 1995 Morocco Panel Survey. Reported contraceptive intentions in 1992 have a strong predictive effect on subsequent contraceptive use even after controlling for other characteristics of respondents, and the strength of the effect is second only to that of previous contraceptive use. Women who in 1992 said they intended to use contraceptives in the future but did not do so are the most likely to have had an unmet need for contraception in 1995. Weakly held fertility preferences reported by some of the women surveyed in 1992 appear to have been a contributing factor in the subsequent failure of these women to act upon their intention to practice contraception.

Adolescent↗

Women's position and family planning in Egypt.

In this report, data from the 1988 Egypt Demographic and Health Survey are used to address some of the most frequently raised questions about the relationship between gender inequality and reproductive behavior. The findings from binomial and multinomial logit models show that while the relationship between women's position and fertility control in Egypt is complex, some clear, broad patterns exist that have important theoretical and policy implications. First, although women's status in Egypt is clearly multidimensional, the reproductive aspect of women's position has a strong connection with the nonreproductive dimensions. Second, the case of the continued use of education and employment as proxies of women's position, especially in relationship to fertility control, is considerably discredited by the results. Finally, the findings indicate that Egyptian culture supports gender equality in the form of interaction and negotiation rather than women's autonomy.

Adolescent↗

Contraceptive knowledge, contraceptive use, and self-esteem among Navy personnel.

This study evaluated the sexual knowledge (including contraceptive and reproductive knowledge), contraceptive use, and self-esteem among a sample of 158 male and female United States Navy sailors assigned to Navy ships. In spite of the fact that men and women viewed themselves as relatively knowledgeable with respect to contraception, results showed substantial knowledge deficits. Women demonstrated significantly greater sexual knowledge than men, and contraceptive/ reproductive knowledge was highly correlated with self-reported use of contraceptives. Finally, self-esteem was highly correlated with sexual knowledge and certain contraceptive use behaviors.

Adolescent↗

Sexual activity and contraceptive use among children entering out-of-home care.

This study explored the prevalence of reported sexual activity of a cohort of children entering out-of-home care and the ability of selected factors to explain reported sexual activity and use or nonuse of contraceptives. It found that children as young as age 8 reported sexual activity, and that more than one-third of the children age 8 to 18 reported being sexually active. Of those who were sexually active, more than one-third were not using contraceptives. Using logistic regression, five variables are identified as having importance in explaining sexual activity. Two variables had some limited ability to explain contraceptive use. Implications of these findings are discussed and suggestions for policy and practice are made.

Adolescent↗