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Sexual behavior has changed during the last decades. Teenage fertility rate, and the number of gonococcal infections are both extremely high; the incidence of HIV-infections is increasing. Preventive measures include sex education. Sex education may help the adolescents to identify their own goals for sexual behavior, to avoid unintended and unwanted pregnancy, and to avoid sexually transmitted diseases.
Adolescent risk taking, preventive behavior, and contraceptive use were investigated using a self-administered questionnaire in a sample of 260 inner-city high school students targeted by a school-based health clinic. Multivariate models consisting of individual and environmental variables significantly predicted sexual activity and contraceptive use. Older age at first intercourse, higher number of welfare benefits received by the household (including Medicaid, food stamps, and free or reduced price lunch), and use of the school-based clinic were significant positive predictors of more frequent contraceptive use by adolescents. Results of our study suggest that programs may be having some success in encouraging and enabling sexually active adolescents to use contraception and to use it more consistently. Rigorous program evaluations should help program planners and policy makers design and refine adolescent pregnancy-prevention efforts.
This study examines contraceptive delivery characteristics and their association with contraceptive behavior. Data were collected in telephone interviews from a national sample of 1057 women who were using female contraceptives. The overwhelming majority of the sample obtained contraceptive services from gynecologists and other physician specialists and were seen in private facilities. Whereas nearly half of the providers recommended use of specific methods, only one-fourth discouraged use of particular methods. The pill was both the most frequently recommended and most commonly discouraged method. With regards to the provision of contraceptive information, practitioners were most likely to discuss the effectiveness of a method. In three of the four categories examined, a higher percentage of non-MDs than MDs gave information to their patients. Although the majority of women reported they were satisfied with the quality of care, mean satisfaction ratings were higher for female providers compared to male providers.
The contraceptive behavior of 213 sexually active never-married U.S. college students was examined using multiple regression analyses. The type of relationship--casual or steady--was a major determinant of contraceptive use: 77 percent of the respondents involved in steady relationships reported using condoms or the pill, compared with 58 percent of the respondents involved in casual relationships. Frequency of intercourse was the best predictor of contraceptive method used within steady relationships. Several variables emerged as predictors of contraceptive method used within casual relationships, including method used at first coital experience, age, and frequency of intercourse. Situational and background factors were found to have an important impact on adolescent contraceptive behavior and to warrant further research.
Drawing on a theoretical model of adolescent contraceptive behavior, we examined the relationships between various social and behavioral variables and contraceptive use by sexually active female adolescents. Hypotheses were tested with the use of a national random sample of sexually active female adolescents (n = 1426), aged 15 to 20 years, from Cycle III of the National Survey of Family Growth. The data were analyzed with Pearson correlation coefficients and multiple regression analysis. Noncompliance with the initial birth control method was the strongest predictor of the adolescents' contraceptive behavior at the time of the interview. Not acquiring birth control at the initial family planning visit and the frequency of family planning visits during the previous 12 months were the second and third best predictors of subjects' contraceptive use. Coital frequency and the length of time between first coitus and the initiation of birth control each explained a small amount of additional variation in the regression model. When combined, these five variables explained 40% of the variation in the contraceptive behavior of this representative sample of sexually active female adolescents. The findings could be useful for clinicians in providing more effective birth control counseling to adolescent patients.
This paper reports on a survey that was aimed at obtaining information for use in designing programs to reduce the incidence of adolescent pregnancy in Liberia. The sample of 1,488 never-married adolescents aged 14-21 was divided into subgroups based on age, sex, student status, and (for non-students) level of education. Although 57-93 percent of respondents claimed to have received information on reproductive health, only 2-21 percent could identify the monthly fertile period. Thirty to 49 percent of females ages 14-17 years have sexual relations at least once a month; over 80 percent of female non-students ages 18-21 years are sexually active. Highest levels of current contraceptive use were reported for 18-21-year-old female students (51 percent). Never-use of contraception among sexually active respondents was 97 percent for 14-17-year-old non-student females with a low educational level. Insufficient information about family planning methods and inaccessibility were the main reasons cited for non-use. Half of females ages 14-21 years who are currently attending school have been pregnant, as have 67 percent of those not in school. These results indicate a substantial unmet need on the part of Liberian adolescents with respect to reproductive health knowledge, information, and access to contraceptive methods.
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The purpose of this study was to examine those factors associated with the contraceptive behavior of a national representative sample of Hispanic female adolescents. The subjects included all (n = 85) unmarried, sexually active Hispanic women, aged 15 to 19, from the 1982 National Survey of Family Growth. Contraceptive behavior was measured on a normalized scale, ranging from oral contraceptives to no contraception. Mexican/American and Central/South American background females were more likely (p less than 0.031) to use effective birth control than Puerto Rican, Cuban, and other Hispanic background subjects. Twenty additional social, behavioral, and demographic variables were found to be significantly associated (p less than 0.05) with contraceptive behavior. Based on multiple regression analysis, seven of these variables were found to explain 62% (p less than 0.0001) of the variation in the contraceptive behavior of this sample. Poorer contraceptive behavior was associated with noncompliance with the initial birth control method used (33.8%), lower coital frequency (8.3%), older postmenarchial age (5.7%), failure to use birth control at first coitus (4.6%), fewer years dating (4.0%), lower frequency of church attendance (3.3%), and never having experienced a pregnancy scare (2.0%). These findings suggest that the contraceptive behavior of Hispanic female adolescents is a dynamic process that can be understood in the context of previous sexual and contraceptive behavior.
Information about contraceptive usage and sexual experiences was sampled in 1985-86 from 16-20-year-old Danish females admitted for legally induced abortion on Funen (N = 140). In attempts to elucidate the causal relations behind undesired pregnancy among teenagers, data were in the present context compared with answers to the same questions from a representative Danish sample of sexually experienced, non-pregnant females of the same age (N = 201). Of the reference sample, 83.6% were using contraceptives at the time of the interview--mostly oral contraceptives (O.C.). Of the abortion sample, 90.7% said they had used contraception earlier in their reproductive life. Approximately one third conceived in spite of contraception (most frequently the condoms). O.C. was the contraceptive method used most recently (by 43.6%). Thus, a pause in an effective contraceptive often precedes an unintended pregnancy, pointing to the need for follow-up counselling when O.C. is prescribed to teenagers. Only the minority could state the total number of times they had experienced sexual intercourse. Significantly more females in the abortion sample were in an alliance with a male partner with whom they had regular sexual intercourse. However, they also reported a higher average number of different sexual partners, indicating an association between changing sexual relationships and undesired pregnancy. In the abortion sample significantly more pregnancies prior to the index pregnancy were reported during a corresponding period of risk of conception lasting only a few years. Taking the widespread use of contraception into account, it is possible that an increased fecundity might be a co-factor behind unsuccessful contraception.
This study investigated the premarital contraceptive behavior of 222 male and female college students. Contraceptive practice was examined in relation to dating patterns, level of emotional involvement with the sex partner was heightened, the intercourse was planned, and the individual and prior sexual experience.
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The psychological determinants of sexual and contraceptive behavior among young women are complex, variable over time, and individually unique. While the approach of an individual clinician or clinical program can be shaped by certain common developmental sequences, a given individual's behavior is determined by many factors which come together in a unique way at a given point in time, and thus the most successful encounter will be that which involves face-to-face, one-to-one contact between client and practitioner.
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BACKGROUND: Inconsistencies between intent and action in the area of birth control are often attributed, in both theory and medical practice, to female ignorance and lack of contraceptive skills. In the light of prevailing theories, this survey examines the contraceptive behavior of 1,425 Jerusalem clients of the Pregnancy Counseling and Follow-up Service. METHODS: The majority of clients were "in crisis" due to unplanned pregnancies and had turned to the counseling service for help in crisis resolution. The data are based on intake questionnaires and clinical records filled in by counselors. Recorded information included age, education, marital status, religious observance, previous pregnancies and abortions, contraceptives ever used and methods used prior to pregnancy, age of fetus, initial attitude, treatment process, and outcome. RESULTS: The results suggest that the women in the sample became pregnant not because they lacked the skills to avoid it, but because they failed to use those skills effectively. Younger, unmarried, and less educated women and those with many children were especially prone to risk-taking. They also waited longer than others before turning to counseling.
The demographics of fertility-related behavior of youth ages 10-18 are reviewed. Data were collected from U.S. vital statistics, and birth rates, contraceptive use, sexual behavior, number and types of sexual partners, patterns of sexual initiation and sexual intercourse, and sexually transmitted diseases were examined. Despite data limitations, the demographic profile of adolescent sexual intercourse is striking. Age clearly is the single most important predictor of sexual debut.
Structural interviews conducted with 532 female clients of a teen contraceptive clinic revealed a moderate level of coital activity i(in terms of both frequency of intercourse and number of partners) which typically began at age 15. Prior use of contraception was sporadic and almost exclusively confined to nonprescription methods. Primary reasons for nonuse of birth control included fear of lessening the pleasure of intercourse and lack of access to contraception. The data indicate that a combination of comprehensive sex education and ready access to birth control is necessary to prevent unintended adolescent pregnancy.
The utility of a rational model of contraceptive use in adolescents was evaluated in a cohort of 325 sexually active adolescents aged 14 to 19 years. Adolescents were interviewed regarding their beliefs about the consequences of using each of four methods of contraception, evaluation of those consequences, perception of the wishes of others regarding use of each method, motivation to comply with those wishes, general attitude toward using the method, view of general social expectations regarding their use of the method, and their intention to use the method during the next year. They were reinterviewed 1 year later to determine actual use. The results support the utility of this model for understanding adolescent behavior. Significant associations were found between intentions to use contraceptive methods and their actual use. Intentions were significantly related to adolescents' attitudes toward using the methods and their perception of social expectations regarding use. General attitudes were significantly related to a summary score reflecting the adolescents' beliefs about specific consequences of use weighted by their evaluations of them. General social perceptions were significantly related to a summary score of perceived desires of specific individuals multiplied by the adolescent's desire to comply with those desires. These findings indicate that physicians can be more effective in clinical practice by querying adolescents about their beliefs and intentions and about their perceptions of significant individuals in their lives.