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Effects of a community-based sex education and reproductive health service program on contraceptive use of unmarried youths in Shanghai.

PURPOSE: To evaluate the effectiveness of a youth-friendly intervention in promoting one safe sex behavior-contraception and condom use among unmarried young people aged 15-24 years in Shanghai, China. METHODS: The study was conducted in two towns of a suburban area of Shanghai (one as the intervention and the other as the control), with comparable socio-cultural-economic and demographic characteristics. The intervention intended to build awareness and offer counseling and services related to sexuality and reproduction among unmarried youths, in addition to the routine program activities, which were exclusively provided in the control site. Baseline surveys were conducted in both sites before the implementation of the intervention, and similar surveys were conducted in both sites 20 months after the intervention had been initiated to test the feasibility and effectiveness of the intervention. In total, 1220 unmarried young people from the intervention site and 1007 from the control site, including 1304 out-of-school youths and 923 high school students, were recruited, and about 92% of them were successfully followed up. Four main measures were examined (i.e., ever contraceptive use, current regular contraceptive use, ever condom use, and contraceptive use at onset of sexual intercourse-if it occurred during the course of the intervention). The reasons for nonuse of contraceptives, the status of joint decision on contraception and the first method used were also assessed. Data were analyzed using Logistic regression models with dichotomous measures of contraceptive use and Generalized Estimating Equations (GEEs) with repeated measures. RESULTS: At baseline, there was no statistical difference in contraceptive use between the intervention and control groups. After intervention, the proportions reporting regular contraceptive use and condom use in the intervention group were much higher than that in the control group (p <.001). A group x time interaction effect (p <.0001) was found for regular contraceptive use and ever condom use. Logistic regression analysis with dichotomous measures of contraceptive use and GEEs with repeated measures showed similar results. The regular contraceptive use and ever condom use were correlated with subject's occupation and family economic status, respectively. After adjusting for demographic factors, the subjects from the intervention group were 14.58 (OR) times as likely to use contraceptives at onset of intercourse as those from the control group (95%CI: 8.55-24.87, p <.0001). Similar results were found for both females and males. CONCLUSIONS: A multifaceted intervention program that provided information and skills, as well as counseling and services, appears to have positive influences on contraceptive practice and condom use among unmarried young females and males in suburban Shanghai.

Adolescent↗

Involving men in reproductive health: the Young Men's Clinic.

OBJECTIVES: This report describes the population of young men who use the Young Men's Clinic in New York City, presents a profile of their reproductive behaviors, and describes the clinic's model of service delivery. METHODS: Data were gathered through a routine clinic visit form administered by clinic staff. RESULTS: The clinic sees approximately 1200 predominately Dominican young men each year for a wide range of clinical and mental health services. Two thirds of clients had ever been sexually active, three quarters had ever used birth control, and 69% had used birth control at their last sexual encounter. CONCLUSIONS: The Young Men's Clinic may serve as a model for health care delivery to adolescent and young adult males.

Adolescent↗

Young people's sexual and reproductive health rights.

The world's population contains more young people than ever, with almost half under the age of 25 years. Millions every year enter their 'reproductive age'. Many do this in a safe and controlled way, and manage to balance life goals, education and sexual maturity as essential positive elements of human life. However, in developing countries, many young people are exposed to the increasing risks of unprotected sexual practice, such as exposure to human immunodeficiency virus/acquired immunodeficiency syndrome, other sexually transmitted diseases, unwanted or unplanned pregnancies, sexual abuse and rape, and mental health problems related to unwanted sexual exposures. Some, especially the poor and uneducated, enter into sexual activities without proper information or access to protective services. There are cultural and moral reasons for this lack of information. Worldwide, evidence demonstrates that informed young people demonstrate more protective behaviour than uninformed young people. This paper addresses how one can meet the reproductive rights of young clients, especially females, in a human rights and reproductive rights framework, as well as in clinical practice and also safeguard their health and ensure their sexual safety.

Adolescent↗

Reproductive health of homeless adolescent women in Seattle, Washington, USA.

OBJECTIVES: Homeless adolescent women are at high risk for negative health outcomes including early unplanned pregnancy and sexually transmitted diseases. The purpose of this study was to hear the perspectives of homeless adolescent females on the topics of health issues, self-care and fertility control, as well as on lessons from being homeless. DESIGN: The rescarch was descriptive, using semi-structured interviews and focus groups with a purposeful sample of 20 clinic-based female youth ages 15-23 years. The data were coded and analyzed following standard qualitative tcchniques. RESULTS: The youth described female-specific health issues of being homeless, such as problems with hygiene, sexual exploitation, survival sex. Most knew of homeless female youth who had tried self-induced abortions through drugs, herbs or physical abuse. They spoke of fertility control practices of young women living on the streets. The women also spoke of the lessons they had learned while being homeless, including the development of self-sufficiency. CONCLUSIONS: The young women in this study were willing to discuss their perspectives and experiences of being homeless. Health care providers should receive increased training in how to ask about sensitive subjects such as survival sex and the practice of self-induced abortions. Programs should be structured to ensure engagement of the women in healthy relationships with adults.

Abortion, Induced↗

Occupational mercury exposure and male reproductive health.

This retrospective cohort study was designed to investigate the relationship of male occupational exposure to elemental mercury and several reproductive outcomes. All subjects worked at least 4 months between 1953 and 1966 at a plant that used elemental mercury; 247 white male employees who had the highest exposures were compared to 255 matched nonexposed employees. Individual exposure to mercury was estimated from urinary mercury measurement records. Information on reproductive history and potential confounding variables was obtained through personal interview with each of the employees and with a subset of their wives. No associations were demonstrated between mercury exposure and decreased fertility or increased rates of major malformations or serious childhood illnesses. After controlling for previous miscarriage history, mercury exposure was not a significant risk factor for miscarriage. Because of this study's potential problems with long-term recall, further studies of the effect of mercury on pregnancy outcome are warranted in other populations.

Abortion, Spontaneous↗