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PubMed1997

Contraceptive use among adolescent mothers at 6 months postpartum.

OBJECTIVE: To assess patterns and predictors of reliable and unreliable contraceptive use among adolescent mothers in the first 6 months following delivery. METHODS: We surveyed 462 women, 18 years of age or younger, at delivery and again at 6 months postpartum. Contraceptive behaviors were evaluated among the 359 adolescents who stated they were sexually active and not trying to conceive. RESULTS: Method discontinuation and switching were common during the 6-month interval. Only 100 of 189 adolescents (53%) initially prescribed oral contraceptives were still using this method 6 months after delivery; ten of these 100 stated that they had missed at least three pills in the last cycle. Twelve (10%) of the 115 adolescents who initiated depot-medroxyprogesterone acetate failed to obtain a second injection within 4 months of the initial injection or use an alternative method. In contrast nine of the ten women who received levonorgestrel implants were still using this method 6 months after delivery. Overall, 76% of the sample reported using reliable contraception at last intercourse. Multivariate analyses identified seven factors as predictive of reliable contraceptive use: school enrollment, not having failed a grade in school, adequate support, belief that pregnancy is likely without birth control, attendance at postpartum visit, prior abortion, and the adolescent's desire to wait at least 2 years before having another child. CONCLUSION: Interventions designed to reduce rapid repeat pregnancy during the adolescent years should address emotional, financial, and educational, as well as contraceptive, needs.

Adolescent↗
PubMed1999

Factors affecting contraceptive use and behavior in Kocaeli, Turkey.

This study aimed to investigate contraceptive use and its determinants in Kocaeli, Turkey. A questionnaire was applied to 922 randomly selected sexually active women of reproductive age, in order to extract information concerning contraceptive use and sociodemographic factors affecting behavior and contraceptive use. Knowledge of at least one method was nearly universal. Intrauterine devices and withdrawal were the most commonly used methods. Illiterate women and housewives had less knowledge about some modern methods. The number of children (p < 0.001), nuclear type family (p < 0.05), and approval of family planning (p < 0.001) were the factors most predictive of contraceptive use. Husbands were involved in family planning via discussing family size (79.4%) and method (85.5%) 38.2% of males participated actively by using withdrawal or condom. Increasing the literacy of both male and female partners significantly increased both contraceptive use and the participation of husbands in family planning descision making. In conclusion, increasing the education level of couples and the status of women would result in increased contraceptive use in the future. Since the contraceptive behavior of women is influenced by their husbands' attitudes, family planning programs should be focused on the needs of both partners.

Adolescent↗
PubMed1993

The relationship between HIV infection and cervical intraepithelial neoplasia among women attending two family planning clinics in Nairobi, Kenya.

OBJECTIVE: To determine the relationship between HIV-1 infection and cervical intraepithelial neoplasia (IN) among women at relatively low risk for both conditions. DESIGN: A case-control study comparing women with cytological evidence of IN (cases) with those without IN (controls) and HIV-1 serostatus as the principal exposure of interest. METHODS: A total of 4058 women attending two family planning clinics in Nairobi, Kenya between October 1989 and May 1991 were enrolled following HIV pretest counseling and informed consent. Structured interviews by trained nurses and medical students were used to obtain data on social, demographic, contraceptive practice and sexual behavior variables. A Papanicolaou smear specimen for cervical cytology and an endocervical swab for gonorrhea culture were obtained. HIV-1 serostatus was determined by enzyme-linked immunosorbent assay and confirmed by Western blot; syphilis serostatus was determined by the rapid plasma reagin test. RESULTS: Eighty-two of the 4058 (2.02%) women had cytological evidence of IN. We observed a significant positive association between HIV-1 infection and IN that remained after controlling for sexual behavior, contraceptive practices and other potential confounding variables (odds ratio, 2.78; 95% confidence interval 1.32-5.85). clinical symptoms and signs were uncommon among the HIV-1-seropositive women, suggesting that they were still in the early stages of the infection. CONCLUSION: The risk of IN among women even in the early stages of HIV-1 infection is increased.

Adolescent↗
PubMed1999

Abortion service in Amsterdam: deciding and coping in a liberal system.

OBJECTIVES: The Netherlands have liberal abortion laws and contraceptives are easily available. In the AMC, a service protocol is designed to facilitate decision-making. In this context, the following questions arise: Do our abortion clients know what went wrong with their contraceptive behavior? Did they decide for more effective contraception afterwards? How did they feel about their own decision and about our services, which include obligatory counselling? STUDY DESIGN: A questionnaire was sent to 23 consecutive clients, who were willing to cooperate. The questionnaire consisted of a scale with 26 items and two open-ended essay-questions. RESULTS: The response rate was 45% (11 complete questionnaires). Seven women had used contraceptives, six knew what had gone wrong, five had decided to improve their contraception, four women had not used contraceptives, out of which two decided to start, seven women found the abortion decision difficult, seven women (not the same) were content with their decision, and one of them felt bereaved. The four who were not, on the whole, content with their decision felt bereaved. Eight appreciated our services, ten had used the essay-questions to tell their own story. One woman explicitly regretted her decision and would have liked more intensive counselling. CONCLUSIONS: Our system does not yet function as it should. The reasons may be psychological (unexplored ambivalence), sociocultural (difficulties in using effective contraception) and cognitive (some women were very young and not adequately informed). On a methodological level, we conclude that open-ended questions on these subjects generate more accurate and subtle information.

Abortion, Legal↗
PubMed1979

Self-esteem, locus of control, and adolescent contraception.

The relationships between locus of control, self-esteem, and attitudes to contraception and contraceptive behaviors were assessed for 486 single women of ages 13 to 20, attending 10 birth control centers in Southern Ontario, Canada. The Ss voluntarily filled out a questionnaire, and the data were measured with the Fatalism scale of Reid and Ware's I-E scale, a Likert-type self-esteem scale, and a semantic differential birth control pill scale. There were no significant relationships between locus of control and any of the contraception variables. Ss with high self-esteem were found to have positive attitudes toward using birth control pills, to be less embarrassed about obtaining contraception, and to be more effective and consistent contraceptive users.

Adolescent↗
PubMedDate not supplied

Determinants of contraceptive choice among single women in the United States.

Data from the 1983 National Survey of Unmarried Women are used to analyze characteristics that affect contraceptive decision-making among single women aged 20-29 who are exposed to the risk of pregnancy. Factors found to affect whether these women use a relatively effective method such as the pill or the IUD, use coitus-dependent methods or use no method include family structure at age 15, educational level, work status, religious affiliation, fertility relative to desired fertility, and past contraceptive failure. Bivariate analyses revealed notable differences between whites and blacks in contraceptive behavior. Multivariate analyses showed that while the decision to use a contraceptive method was somewhat affected by race, method choice was not. Overall, contraceptive decision-making was relatively unaffected by race, length of the relationship and current living arrangement.

Adult↗
PubMed2003

[Contraceptive use among adolescents at public schools in Brazil].

OBJECTIVE: There has been a growing interest in patterns of contraceptive use among adolescents, due, in particular, to the social relevance attached to pregnancy in this age group. Therefore, the objective of the study was to investigate factors associated with the use of contraceptive methods among female and male adolescent students. METHOD: A cross-sectional study was conducted, by means of self-applied questionnaires, among 4,774 students ranging from 11 to 19 years of age. Prevalence with respect to the use of contraceptive methods during the first experience of sexual intercourse as well as the most recent one was calculated both separately, that is, for each of these events, and in conjunction as a measure of consistent use. Logistic regression was carried out for simultaneous analysis of factors associated with the use of contraceptive methods and in order to calculate adjusted measures. RESULTS: Among the 1,664 students who reported being sexually active, the factors positively associated with the consistent use of contraceptive methods among male students included a) postponing their first experience of sexual intercourse and interaction with a stable partner, b) the family as a potential supplier of contraceptive methods, and c) access to health services. On the other hand, among female students factors positively associated with the consistent use of contraceptive methods included a) recent sexual initiation, and b) having a father as their source of information regarding sexuality, contraception and STD/AIDS prevention. Pregnancy was reported by 6.4% of the boys and 18.1% of the girls, its absence was associated with the consistent use of contraceptives by them (the girls) (Odds Ratio=3.83; 2.06-7.15). CONCLUSIONS: The results confirm the complexity of determining contraceptive behavior among adolescents and therefore reinforce the need to include multi-dimensional aspects of this theme in order to ensure the efficacy of sex education programs.

Adolescent↗
PubMed1983

Contraceptive use by adolescent females in relation to knowledge, and to time and method of contraceptive counseling.

Contraceptive behavior of adolescent females was examined in relation to their level of knowledge, and time and method of contraceptive counseling. Subjects were 122 subscribers to a prepaid health plan, 13-18 years of age, unmarried, sexually active, and not desiring pregnancy. Contraceptive counseling was offered to 62 adolescents following receipt of a negative pregnancy test and to 60 adolescents following a routine medical visit. The 80 adolescents who chose to participate in the study were randomly assigned to a conventional or developmental method of counseling. The effectiveness of their contraceptive practice was measured 1 year later. Two hypotheses were not upheld: Sexually active adolescents were not more likely to accept contraceptive counseling at the time of a negative pregnancy test than at a time of a routine medical visit, and did not subsequently become more effective users of contraceptives. Two hypotheses were upheld: Effective and ineffective users of contraception did not differ in level of knowledge, and adolescents counseled by a developmental method practiced contraception more effectively than those counseled by a conventional method. Findings are discussed in terms of the theory of adolescent development and the proposition that a pregnancy scare motivates teenagers to control fertility.

Adolescent↗
PubMed2002

Factors related with induced abortion among primigravid women in Ho Chi Minh City, Vietnam.

A case-control study was conducted between July and August 2001 in Ho Chi Minh City to investigate factors associated with having induced abortions among primigravid women aged 16 to 38 years. Interviews were conducted with 87 women undergoing abortion (cases) and 81 pregnant women coming for antenatal care (controls). Multiple logistic regression analysis revealed that older age (odds ratio [OR] = 0.84) and being married (OR = 0.05) decreased the risk of getting unintended pregnancy leading to abortion. Risk factors of obtaining an abortion were not being exposed to family planning promotion on television (OR = 2.28) and not knowing the adverse effects of abortion (OR = 10.26). Descriptive analysis of contraceptive behavior showed that 41% of cases had never used contraceptives and the reason for non-usage was lack of knowledge of any type of contraceptives in 43% of the cases. Additionally, only 24% of cases had discussed about family planning with their partners. Effective contraceptive methods should be promoted among young population, both females and males, and they need to be informed of the consequences of abortion. Television programs might be an effective mode of providing the information.

Abortion, Induced↗
PubMedDate not supplied

Sex, contraception and childbearing among high-risk youth: do different factors influence males and females?

CONTEXT: The likelihood that adolescents will engage in sexual activity, use contraceptives or become parents is influenced by a range of attitudes and behaviors. These factors may differ for males and females. METHODS: Data on female respondents to the 1979-1992 waves of the National Longitudinal Survey of Youth and the linked 1994 young adult data file on their children provided background information on 959 adolescents who had been born to young mothers. Partial correlation analysis was used to examine the factors related to sexual behavior, contraceptive use and childbirth, controlling for maternal and familial characteristics, in this relatively disadvantaged sample. RESULTS: Youth who are inclined toward risk-taking and those who have run away from home are more likely than others to be sexually active. For young women, having intercourse at an early age, not using contraceptives and having a child are linked with depression, low self-esteem and little sense of control over their lives. The results for young men are less consistent and often in the opposite direction. Young people who have become parents evidence greater maturity than their childless peers; women are less likely to consume alcohol or to spend time with friends who drink, and men are more likely to participate in socially productive work. CONCLUSIONS: Although sexual behavior is tied to risk-taking in both adolescent males and females, some noticeable psychological differences are evidenced early. Behaviorally, there is room for optimism, in that young parents appear to adopt more mature traits.

Adolescent↗
PubMed1994

[Contraception among adolescents].

Adolescence is a period of which the contraception is difficult, because of lower compliance of the teenagers to this methods. The authors were observed the contraceptive uses in 792 pregnant adolescent girls, 264 of which with abortions (group A) and 528 teen-age mothers (group B). Only 12.88% of all patients have used birth control methods, usually with low and middle effects. We founded only 15 patients (1.89%) practiced hormonal contraception and 1 case (0.13%) with Intrauterine devise. The condoms for men was the most popular and useful in teenagers (4.23%), and Natural family planning methods were practiced from 52 (6.57%) patients. There was the statistically differences between adolescent girls included in group A and B about their contraceptive behaviors and live standards (p < 0.01). By the kind of contraceptive methods, there was a high differences in the teenagers with a hormonal uses (p < 0.05).

Adolescent↗
PubMed1992

A Health Belief Model-Social Learning Theory approach to adolescents' fertility control: findings from a controlled field trial.

We evaluated an 8- to 12-hour Health Belief Model-Social Learning Theory (HBM-SLT)-based sex education program against several community- and school-based interventions in a controlled field experiment. Data on sexual and contraceptive behavior were collected from 1,444 adolescents unselected for gender, race/ethnicity, or virginity status in a pretest-posttest design. Over 60% completed the one-year follow-up. Multivariate analyses were conducted separately for each preintervention virginity status by gender grouping. The results revealed differential program impacts. First, for preintervention virgins, there were no gender or intervention differences in abstinence maintenance over the follow-up year. Second, female preintervention Comparison program virgins used effective contraceptive methods more consistently than those who attended the HBM-SLT program (p less than 0.01); among males, the intervention programs were equally effective. Third, both interventions significantly increased contraceptive efficiency for teenagers who were sexually active before attending the programs. For males, the HBM-SLT program led to significantly greater follow-up contraceptive efficiency than the Comparison program with preintervention contraceptive efficiency controlled (p less than 0.05); for females, the programs produced equivalent improvement. Implications for program planning and evaluation are discussed.

Adolescent↗
PubMed1997

An impact evaluation of project SNAPP: an AIDS and pregnancy prevention middle school program.

OBJECTIVES: A theory-based curriculum designed to delay the onset of intercourse and increase use of condoms was implemented in the classrooms of six Los Angeles middle schools. METHODS: The curriculum activities were very interactive, emphasized skill building, and were implemented by well trained peer educators, including young HIV-positive males and teen mothers. To evaluate the impact of the curriculum, 102 classrooms of students were randomly assigned to receive either the existing curriculum or the existing curriculum plus the intervention curriculum. Students completed confidential questionnaires before program implementation, five months later, and 17 months later. A total of 1,657 students completed both the baseline and 17-month follow-up questionnaires. RESULTS: Analyses of these data revealed that the curriculum significantly increased knowledge, significantly improved only two out of 21 attitudes or beliefs, and did not significantly change sexual or contraceptive behaviors. CONCLUSIONS: Well implemented programs that are based on upon theory, use interactive activities, and utilize well-trained peer educators do not always change important sexual attitudes and behaviors among middle school youth.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

The role of sexual self-concept in the use of contraceptives.

Sexual self-concept--defined as an individual's evaluation of his or her own sexual feelings and actions--is proposed as an important predictor of contraceptive behavior among teenagers, and a scale measuring the concept is described. In exploratory analyses among university students, sexual self-concept is found to be associated with frequency of contraceptive use and use at most recent intercourse. It is also associated with their choice of contraceptive--students who had used prescription methods at last coitus had significantly higher scores on the sexual self-concept scale than did those who had used nonprescription methods or no method. These findings, together with the finding from analysis among high school students that sexual self-concept appears to improve with age, suggest that younger teenagers may be poorer users of contraceptives because of a lower sexual self-concept. Counseling and sex education that address social and psychological issues may help improve adolescent contraceptive practice by addressing teenagers' views of their own sexuality.

Adolescent↗
PubMed1980

Twenty-seven strategies for teaching contraception to adolescents.

This article summarizes research on the effects of education on adolescents' contraceptive behaviors and suggests strategies to enhance teaching for contraception. Learning about birth control methods in sex education classes does not necessarily enable teenagers to use them effectively. In addition to needing accurate, unbiased information about contraceptive technology, teenagers need help in clarifying their values so that their social behaviors are congruent with their moral codes. Adolescents also benefit from understanding how contraception relates to sexual behavior and how family planning may enable them to become parents at the time of their choice. Twenty-seven strategies for teachers are listed, each one related to a particular contraceptive problem adolescents encounter.

Adolescent↗