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Title: Expanding access to injectable contraception.
Author: Family Health International [FHI]
Source: [Unpublished] [2009]. 12 p.
Abstract: A number of technological developments can make injections safer for administration, whether by health personnel, trained community workers or the women themselves: sub-cutaneous injections, which have less complications than intra-muscular injections; non-reusable disposable syringes Distribution by community health workers needs special attention to: the possibility that a woman is already pregnant (or seeking an abortion by using an injectable); the screening of women with pre-existing conditions or on medications; the need for counselling for side-effects (in particular: vaginal bleeding irregularities, amenorrhea, weight gain, delay in return to fertility); the safety of injections to the woman and to the health worker; the possible confusion between different injectables --provided by public and private sectors. To complement pre-service and in-service training, a number of job aids are available to support community workers providing injectables: medical eligibility criteria wheel to screen for eligibility; pregnancy checklist; simplified material for the management of side-effects (bleeding, amenorrhea, weight changes, etc). (Excerpt)
Language: English
Keywords:
GLOBAL | TABLES AND CHARTS | INJECTABLES | DEPO-PROVERA | CONTRACEPTIVE EFFECTIVENESS | CONTRACEPTIVE PREVALENCE | CONTRACEPTIVE AVAILABILITY | PROGRAM ACCESSIBILITY | COMMUNITY-BASED DISTRIBUTION | CONTRACEPTIVE SAFETY | MATERNAL MORTALITY | CAUSES OF DEATH | Contraceptive Methods | Contraception | Family Planning | Medroxyprogesterone Acetate | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraceptive Usage | Program Evaluation | Programs | Organization and Administration | Nonclinical Distribution | Distributional Activities | Program Activities | Safety | Public Health | Health | Mortality | Population Dynamics | Demographic Factors | Population
Document Number: 331838

Title: Community-based distribution of injectable contraceptives. Approaches that work.
Author: Futures Group International. Health Policy Initiative
Source: Washington, D.C., Futures Group International, Health Policy Initiative, 2009 Apr. [1] p.
Abstract: Contraceptive prevalence rates in many sub-Saharan African countries surged in the mid-1990s. Much of this increase can be attributed to additional resources devoted to family planning (FP) programs and the uptake of specific methods, including injectable contraceptives. For example, use of injectables in Malawi grew from 2 percent in 1992 to 18 percent in 2004. Surveys in many African countries have found that women prefer injectable contraceptives; in some cases, preference for injectables is 2-1 over oral contraceptives and other methods. In recent years, however, these same countries have experienced a stagnation or decline in overall contraceptive prevalence. Particularly in rural areas, modern contraceptives are often scarce, and few trained professionals are available to provide FP services. One way to increase access to and use of family planning is to promote community-based distribution (CBD) of injectables. Countries struggling with stagnating contraceptive prevalence can begin to alterthis trend by training and empowering community-based workers to provide injectable contraceptives.
Language: English
Keywords:
DEVELOPING COUNTRIES | SUMMARY REPORT | CONTRACEPTIVE PREVALENCE | INJECTABLES | ORAL CONTRACEPTIVES | COMMUNITY-BASED DISTRIBUTION | PRIVATE SECTOR | HEALTH SERVICES | Contraceptive Usage | Contraception | Family Planning | Contraceptive Methods | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Macroeconomic Factors | Economic Factors | Delivery of Health Care | Health
Document Number: 331532

Peer Reviewed

Title: Sexual activity and contraceptive use among young female students of tertiary educational institutions in Ilorin, Nigeria.
Author: Abiodun OM; Balogun OR
Source: Contraception. 2009 Feb;79(2):146-9.
Abstract: BACKGROUND: A survey was conducted to evaluate the pattern of sexual behavior and contraceptive use among female students aged 15 to 24 years attending tertiary institutions in Ilorin, Nigeria. STUDY DESIGN: A valid and reliable semistructured questionnaire was self-administered to a sampled population of 600 students aged 15 to 24 years. RESULTS: Of the 600 students, 562 (93.7%) completed the questionnaire. Most (98.6%) of the respondents were unmarried, 77.6% have had sexual intercourse, 67.8% have had an unwanted pregnancy while 63.5% have had induced abortion. All the respondents were aware of contraceptives, but only 25.4% have ever used any contraceptive method. The most common sources of information about contraception among the respondents were friends/relatives (73.7%), while the fear of side effects of modern contraceptives was the most common reason (77.5%) for nonuse. CONCLUSION: The fear of side effects is the main reason for low contraceptive prevalence among young female students of tertiary institutions in Ilorin. Reproductive health services should focus more on delivery of adequate and accurate information about contraceptives to improve use among young women.
Language: English
Keywords:
NIGERIA | RESEARCH REPORT | QUESTIONNAIRES | ADOLESCENTS, FEMALE | YOUTH | CONTRACEPTIVE USAGE | SEXUALITY | SEX BEHAVIOR | CONTRACEPTIVE PREVALENCE | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Adolescents | Age Factors | Population Characteristics | Demographic Factors | Population | Contraception | Family Planning | Personality | Psychological Factors | Behavior
Document Number: 329609

10.

11.

Title: Condom use for preventing STI/HIV and unintended pregnancy among young men in sub-saharan Africa.
Author: Bankhole A; Singh S; Hussain R; Oestreicher G
Source: American Journal of Men's Health. 2009 Mar;3(1):60-78.
Abstract: The condom is the only known method that provides simultaneous protection against unplanned pregnancy and some sexually transmitted infections (STIs), including HIV, among sexually active people. Using data from the Demographic and Health Surveys from 18 Sub-Saharan African countries, this study examined condom use and reasons for using the method at last intercourse among sexually active young men aged 15 to 29. Most young men were aware of the condom (73%-98%), but its use at last intercourse was quite variable, ranging from 6% in Madagascar to 74% in Namibia. In 10 countries, more young men reportedly used condoms for preventing STIs alone than they did for preventing pregnancy alone. In 6 countries, at least one third of the users used the method for both purposes. Use of the condom at last intercourse was associated with union status, education, residence, and exposure to television in at least two thirds of the countries.
Language: English
Keywords:
AFRICA, SUB SAHARAN | RESEARCH REPORT | KAP SURVEYS | DEMOGRAPHIC AND HEALTH SURVEYS | CROSS-CULTURAL COMPARISONS | YOUTH | MEN | CONDOM USE | SEXUALLY TRANSMITTED DISEASE PREVENTION | HIV PREVENTION | PREGNANCY, UNPLANNED | KNOWLEDGE | CONTRACEPTIVE PREVALENCE | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Comparative Studies | Age Factors | Population Characteristics | Risk Reduction Behavior | Behavior | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | HIV Infections | Viral Diseases | Reproductive Behavior | Fertility | Sociocultural Factors | Contraceptive Usage | Contraception | Family Planning
Document Number: 329249

12.

Title: Integrating population, health, and environment in Uganda.
Author: Bremner J; Zuehlke E
Source: Washington, D.C., Population Reference Bureau [PRB], 2009 Jun. 6 p. (Policy Brief)
Abstract: After decades of instability and civil conflict, Uganda has enjoyed relative stability, sustained economic growth, and great improvements in health over the last 20 years. During the same period, Uganda's population has grown rapidly, and in 2009 surpassed 30 million people. This rapid population growth is contributing to the degradation of Uganda's natural resources, the backbone of the country's economy and household livelihoods. Continued reductions in poverty depend in large part on finding innovative and integrated solutions to the complex population, health, and environment problems affecting Uganda's poorest people.
Language: English
Keywords:
MIDDLE EAST | AFRICA, NORTH | CRITIQUE | EVALUATION | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | ABORTION | PREGNANCY, UNWANTED | ABORTION LAW | FAMILY PLANNING POLICY | CONTRACEPTIVE PREVALENCE | CONTRACEPTIVE METHODS CHOSEN | POSTABORTION CARE
Document Number: 342029

13.

Title: Zambia: National long term forecasting and quantification for family planning commodities, 2009-2015.
Author: Bwembya M; Mbewe RK
Source: Arlington, Virginia, John Snow [JSI], DELIVER, 2009. 23 p. (USAID Contract No. GPO-I-01-06-00007-00)
Abstract: In December 2008, the Ministry of Health (MOH) and the Society for Family Health (SFH), with technical assistance from the USAID | DELIVER PROJECT, conducted a national long term quantification of contraceptive needs from 2009 -2015. The quantification's overall objective was to calculate the contraceptive requirements for each year of the forecast period and to use those requirements to mobilize resources for the country to support contraceptive commodity security. This report presents the findings of the quantification as well as the methodology used and assumptions made to arrive at these findings.
Language: English
Keywords:
ZAMBIA | SUMMARY REPORT | RESEARCH METHODOLOGY | TECHNICAL ASSISTANCE | USAID | NEEDS ASSESSMENT | CONTRACEPTIVE PREVALENCE | CONTRACEPTIVE SECURITY | COLD CHAIN | LOGISTICS | FUNDS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Programs | Organization and Administration | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Evaluation | Contraceptive Usage | Contraception | Family Planning | Contraceptive Availability | Management | Financial Activities | Economic Factors
Document Number: 331474

14.

Peer Reviewed

Title: One versus multiple packs for women starting oral contraceptive pills: a comparison of two distribution regimens.
Author: Chin-Quee D; Otterness C; Wedderburn M; McDonald O; Janowitz B
Source: Contraception. 2009 May;79(5):369-74.
Abstract: BACKGROUND: Despite World Health Organization and International Planned Parenthood Federation recommendations to provide multiple pill cycles to new users, many programs in developing countries still give only one pill cycle to new acceptors. STUDY DESIGN: To compare provision of a single versus multiple packs of pills, new pill users in 20 matched public sector clinics in Jamaica were assigned to one of two pill regimens in which they received either one (then subsequently three) or four pill cycles at method initiation. The primary outcome was the proportion of women who used pills beyond 4 months. RESULTS: Among 655 women, those receiving one cycle of pills at initiation, followed by counseling and a three-pack resupply, were no more likely to be using pills after 4 months than women who received four packs at initiation (odds ratio=1.33; 95% confidence interval=0.88-2.0). In both pill regimen groups, returning late to the clinic for resupply was a problem. However, more women in the 1+3-pack regimen group returned late to study clinics to obtain their fifth cycle of pills than their counterparts in the 4-pack regimen group (53% vs. 28%). CONCLUSION: Our findings support the recommendation that pill users should be given more than one cycle to start, because an extra visit for resupply contributes to clinic and provider costs. Moreover, providing more pill cycles at initiation would decrease the likelihood that women experience a gap in pill use between cycles.
Language: English
Keywords:
JAMAICA | RESEARCH REPORT | CONTRACEPTIVE PREVALENCE SURVEYS | COMPARATIVE STUDIES | WOMEN IN DEVELOPMENT | CONTRACEPTIVE DISTRIBUTION | PACKAGING | ORAL CONTRACEPTIVES | TIME FACTORS | COUNSELING | USER COMPLIANCE | CONTRACEPTIVE PREVALENCE | CONTRACEPTION CONTINUATION | Caribbean | Americas | Developing Countries | Family Planning Surveys | Family Planning | Studies | Research Methodology | Economic Development | Economic Factors | Distributional Activities | Program Activities | Programs | Organization and Administration | Marketing | Contraceptive Methods | Contraception | Population Dynamics | Demographic Factors | Population | Clinic Activities | Behavior | Contraceptive Usage
Document Number: 330940

15.

Peer Reviewed

Title: Contraception in historical and global perspective.
Author: Cleland J
Source: Best Practice and Research. Clinical Obstetrics and Gynaecology. 2009 Apr;23(2):165-176.
Abstract: This chapter describes the rise in contraceptive practice and fall in fertility from around 1880 to the present day. Two main phases are identified: the first confined to European populations and involving methods of low efficacy, and the second embracing the whole planet involving modern methods. Today, sub-Saharan Africa is the only region where low levels of contraceptive use and high fertility persist. Nevertheless, nearly half of pregnancies worldwide are still unintended, and much scope remains for improvement in contraceptive protection. The main international priority is Africa, where demographic factors jeopardize the goals of reducing poverty and hunger.
Language: English
Keywords:
AFRICA | RESEARCH REPORT | CONTRACEPTIVE PREVALENCE | SOCIAL MARKETING | POPULATION GROWTH | CONTRACEPTIVE METHODS CHOSEN | PREGNANCY, UNPLANNED | COMMUNITY-BASED DISTRIBUTION | CONTRACEPTION | FAMILY PLANNING PROGRAMS | Developing Countries | Contraceptive Usage | Family Planning | Marketing | Economic Factors | Population Dynamics | Demographic Factors | Population | Reproductive Behavior | Fertility | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration
Document Number: 329659

16.

Title: Adolescents: contraceptive knowledge and use, a Brazilian study.
Author: Correia DS; Pontes AC; Cavalcante JC; Egito ES; Maia EM
Source: theScientificWorldJournal. 2009;9:37-45.
Abstract: The purpose of this study was to identify the knowledge and use of contraceptive methods by female adolescent students. The study was cross-sectional and quantitative, using a semi-structured questionnaire that was administered to 12- to 19-year-old female students in Maceio, Brazil. A representative and randomized sample was calculated, taking into account the number of hospital admissions for curettage. This study was approved by the Human Research Ethics Committee, and Epi Info software was used for data and result evaluation using the mean and chi-square statistical test. Our results show that the majority of students know of some contraceptive methods (95.5%), with the barrier/hormonal methods being the most mentioned (72.4%). Abortion and aborting drugs were inaccurately described as contraceptives, and 37.9% of the sexually active girls did not make use of any method. The barrier methods were the most used (35.85%). A significant association was found in the total sample (2,592) between pregnancy and the use of any contraceptive method. This association was not found, however, in the group having an active sexual life (559). The study points to a knowledge of contraceptive methods, especially by teenagers who have already been pregnant, but contraceptives were not adequately used. The low use of chemical methods of contraception brings the risk of pregnancy. Since abortion and aborting drugs were incorrectly cited as contraceptive methods, this implies a nonpreventive attitude towards pregnancy.
Language: English
Keywords:
BRAZIL | RESEARCH REPORT | KAP SURVEYS | CROSS SECTIONAL ANALYSIS | CONTRACEPTIVE PREVALENCE SURVEYS | ADOLESCENTS, FEMALE | KNOWLEDGE | CONTRACEPTIVE PREVALENCE | CONTRACEPTIVE METHODS | ABORTION | Developing Countries | South America, Eastern | South America | Latin America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Family Planning Surveys | Family Planning | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Sociocultural Factors | Contraceptive Usage | Contraception | Fertility Control, Postconception
Document Number: 329595 Notification

17.
Peer Reviewed

Title: Contraceptive discontinuation and non-use in Santarem, Brazilian Amazon.
Author: D'Antona Ade O; Chelekis JA; D'Antona MF; Siqueira AD
Source: Cadernos De Saude Publica. 2009 Sep;25(9):2021-32.
Abstract: In this paper we discuss the causes of non-adherence to reversible contraceptives, especially hormonal methods, among women in rural Santarem in the Brazilian Amazon. The analysis is based on questionnaires with 398 women and visits to health centers. We consider the motives reported by women who: never used contraception; used some method in the past; and who at the time of the survey were using a different method from the ones they used in the past. The results indicate a rejection of hormonal contraception and a preference for female sterilization, an option possibly influenced by the characteristics of health services in the region. The side effects of hormonal contraceptive use reported by part of the interviewees contribute to a generalized fear of the side effects even among women who have never used such methods. To improve women's health services in the Amazon, we recommend further studies of the relationship between reported side effects and available services and prescriptions, as well as an analysis of women's discourse and perceptions.
Language: English
Keywords:
BRAZIL | RURAL AREAS | RESEARCH REPORT | WOMEN | CONTRACEPTION TERMINATION | CONTRACEPTIVE METHODS CHOSEN | MOTIVATION | CONTRACEPTIVE AGENTS, FEMALE | CONTRACEPTIVE AGENTS, SIDE EFFECTS | FEAR | FEMALE STERILIZATION | CONDOM USE | CONTRACEPTIVE PREVALENCE | PROGRAM ACCESSIBILITY | South America, Eastern | South America | Latin America | Americas | Developing Countries | Geographic Factors | Population | Demographic Factors | Contraception | Family Planning | Contraceptive Usage | Psychological Factors | Behavior | Contraceptive Agents | Emotions | Sterilization, Sexual | Risk Reduction Behavior | Program Evaluation | Programs | Organization and Administration
Document Number: 342777

18.

Peer Reviewed

Title: A 15-Minute Interactive, Computerized Condom Use Intervention With Biological Endpoints.
Author: Grimley DM; Hook EW 3rd
Source: Sexually Transmitted Diseases. 2009 Feb;36(2):73-78.
Abstract: BACKGROUND:: Brief face-to-face-behavioral interventions have been shown to be efficacious, but are costly to sustain and to widely disseminate. This study evaluated the efficacy of a 15-minute theory-based behavioral intervention designed to increase condom use and reduce new cases of Neisseria gonorrhoeae and Chlamydia trachomatis. METHODS:: Participants were randomly assigned via the computer to the intervention or the comparison group stratified by gender and their baseline stage of change (motivational readiness) for using condoms consistently (100%) with their main partners. Behavioral data and biologic specimens for testing of Neisseria gonorrhoeae and Chlamydia trachomatis were obtained at baseline and at 6 months post intervention. The intervention was delivered via an audio, multimedia, computerized application that provided individualized interventions to patients based on their responses to assessment items; comparison patients interacted with a 15-minute, computerized, multiple health risk assessment with no intervention. RESULTS:: The majority of the sample (N = 430) was black (88%); 54.5% women; with a mean age = 24.5. Assuming all participants who did not return to the clinic at 6 months were not using condoms consistently, 32% of the treatment group versus 23% in the comparison group reported consistent condom use (P = 0.03). The combined Neisseria gonorrhoeae and Chlamydia trachomatis incidence declined to 6% in the intervention group versus 13% in the comparison group (P = 0.04). Results from a regression analysis revealed that the only statically significant predictor of sexually transmitted diseases infection at the follow-up was group assignment (OR = 1.91, 95% confidence index = 1.09-3.34; P = 0.043). CONCLUSIONS:: These findings suggest that brief, interactive, computer-delivered interventions provided at the evaluation visit increase condom use and reduce sexually transmitted diseases without putting additional burden on clinicians or staff.
Language: English
Keywords:
ALABAMA | RESEARCH REPORT | KAP SURVEYS | CASE CONTROL STUDIES | STATISTICAL REGRESSION | THEORETICAL MODELS | BLACKS | COMPUTER PROGRAMS AND PROGRAMMING | GONORRHEA | CHLAMYDIA | CONDOM USE | AUDIOVISUAL AIDS | TIME FACTORS | RISK ASSESSMENT | CONTRACEPTIVE PREVALENCE | Developed Countries | United States of America | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Data Analysis | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Information Processing | Information | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Risk Reduction Behavior | Behavior | Educational Methods | Educational Activities | Education | Population Dynamics | Evaluation | Contraceptive Usage | Contraception | Family Planning
Document Number: 329674

19.

Peer Reviewed

Title: Condom use and high-risk sexual acts in adult films: a comparison of heterosexual and homosexual films.
Author: Grudzen CR; Elliott MN; Kerndt PR; Schuster MA; Brook RH; Gelberg L
Source: American Journal of Public Health. 2009 Apr;99 Suppl 1:S152-6.
Abstract: OBJECTIVES: We compared the prevalence of condom use during a variety of sexual acts portrayed in adult films produced for heterosexual and homosexual audiences to assess compliance with state Occupational Health and Safety Administration regulations. METHODS: We analyzed 50 heterosexual and 50 male homosexual films released between August 1, 2005, and July 31, 2006, randomly selected from the distributor of 85% of the heterosexual adult films released each year in the United States. RESULTS: Penile-vaginal intercourse was protected with condoms in 3% of heterosexual scenes. Penile-anal intercourse, common in both heterosexual (42%) and homosexual (80%) scenes, was much less likely to be protected with condoms in heterosexual than in homosexual scenes (10% vs 78%; P < .001). No penile-oral acts were protected with condoms in any of the selected films. CONCLUSIONS: Heterosexual films were much less likely than were homosexual films to portray condom use, raising concerns about transmission of HIV and other sexually transmitted diseases, especially among performers in heterosexual adult films. In addition, the adult film industry, especially the heterosexual industry, is not adhering to state occupational safety regulations.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | QUALITATIVE RESEARCH | MEN HAVING SEX WITH MEN | HETEROSEXUALS | CONDOM USE | FILM AND VIDEO | CONTRACEPTIVE PREVALENCE | OCCUPATIONAL HEALTH | ANAL SEX | ORAL SEX | Developed Countries | North America | Americas | Research Methodology | Sex Behavior | Behavior | Risk Reduction Behavior | Mass Media | Communication | Contraceptive Usage | Contraception | Family Planning | Health
Document Number: 330956

20.

21.

Peer Reviewed

Title: Sexual partnerships in britain: characteristics differ by gender and predict likelihood of condom use.
Author: Hollander D
Source: Perspectives on Sexual and Reproductive Health. 2009 Mar;41(1):64-5.
Abstract: Men and women in Britain report many differences in the characteristics of their heterosexual partnerships, and some differences in partnership characteristics are reflected in the likelihood of risky behavior. For example, men are more likely than women to have casual partners, and they are less likely than women to have partners of roughly their own age. Condom use is more likely in casual partnerships than within marriage; even so, the level of use in casual relationships suggests that many men and women are inadequately protected against the risk of STD infection. Additionally, condom use the first time a couple has sex is more likely if the partners are about the same age than if the male is five or more years older than the female. In nearly one-quarter of men's new partnerships, but only one in 10 of women's, first sex with a new partner occurs within 24 hours after the couple's meeting. These are among the findings of an analysis based on data from Britain's 1999-2001 National Survey of Sexual Attitudes and Lifestyles.1 The survey was based on a stratified probability sample of more than 11,000 British residents aged 16-44, who participated in face-to-face interviews and computer-assisted self-interviews. A total of 9,598 respondents reported having had at least one heterosexual partner in the past year; investigators used data on this subsample to study partnership formation, and they employed logistic regression to assess associations between partnership characteristics and condom use.
Language: English
Keywords:
UNITED KINGDOM | RESEARCH REPORT | KAP SURVEYS | STATISTICAL REGRESSION | SEXUAL PARTNERS | CONDOM USE | SEX FACTORS | SEX BEHAVIOR | MARITAL STATUS | AGE FACTORS | CONTRACEPTIVE PREVALENCE | Developed Countries | Europe, Western | Europe | Surveys | Sampling Studies | Studies | Research Methodology | Data Analysis | Behavior | Risk Reduction Behavior | Population Characteristics | Demographic Factors | Population | Nuptiality | Contraceptive Usage | Contraception | Family Planning
Document Number: 330702

22.

Peer Reviewed

Title: Unmet need for contraception among sex workers in Madagascar.
Author: Khan MR; Turner AN; Pettifor A; Van Damme K; Rabenja NL; Ravelomanana N; Swezey T; Williams D; Jamieson D; Behets F
Source: Contraception. 2009 Mar;79(3):221-7.
Abstract: BACKGROUND: The study was conducted to investigate past and future pregnancy preferences and contraceptive need among Malagasy sex workers. STUDY DESIGN: We analyzed data on pregnancy and contraceptive use collected during the baseline visit of a randomized, prospective formative trial which assessed diaphragm and microbicide acceptability among sex workers. To be eligible, women could not be pregnant or planning pregnancy for the next 2 months. RESULTS: Women (N=192) from four cities (Antananarivo, Antsiranana, Mahajanga and Toamasina) reported a median of 10 sex acts per week. Fifty-two percent reported a prior unwanted pregnancy, 45% at least one induced abortion and 86% that preventing future pregnancy was moderately to very important. During the last sex act, 24% used a hormonal method, 36% used a male condom, 2% used a traditional method and 38% used no method. Nearly 30% of participants reported that pregnancy prevention was moderately or very important but used no contraception at last sex; these women were categorized as having "unmet need" for contraception. In multivariable binomial regression analyses, factors associated with unmet need included low knowledge of contraceptive effectiveness [age- and site-adjusted prevalence ratio (PR): 2.1; 95% confidence interval (CI): 1.4-3.0] and low self-efficacy to negotiate condom use (age- and site-adjusted PR: 2.0; 95% CI: 1.4-3.0). CONCLUSIONS: Among these women, prior unwanted pregnancy and induced abortion were common and preventing future pregnancy was important, yet gaps in contraceptive use were substantial. Contraceptive knowledge and self-efficacy should be improved to promote contraceptive use by sex workers.
Language: English
Keywords:
MADAGASCAR | RESEARCH REPORT | KAP SURVEYS | PROSPECTIVE STUDIES | MULTIVARIATE ANALYSIS | SEX WORKERS | WOMEN IN DEVELOPMENT | FERTILITY PREFERENCES | CONTRACEPTIVE USAGE | NEEDS ASSESSMENT | PREGNANCY, UNWANTED | ABORTION RATE | CONTRACEPTIVE PREVALENCE | CONTRACEPTIVE METHODS CHOSEN | KNOWLEDGE | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Data Analysis | Sex Behavior | Behavior | Economic Development | Economic Factors | Fertility | Population Dynamics | Demographic Factors | Population | Contraception | Family Planning | Evaluation | Reproductive Behavior | Fertility Control, Postconception | Sociocultural Factors
Document Number: 330055 Notification

23.

Peer Reviewed

Title: Contraceptive use in women enrolled into preventive HIV vaccine trials: experience from a phase I/II trial in East Africa.
Author: Kibuuka H; Guwatudde D; Kimutai R; Maganga L; Maboko L; Watyema C; Sawe F; Shaffer D; Matsiko D; Millard M; Michael N; Wabwire-Mangen F; Robb M
Source: PLoS One. 2009;4(4):e5164.
Abstract: BACKGROUND: HIV vaccine trials generally require that pregnant women are excluded from participation, and contraceptive methods must be used to prevent pregnancy during the trial. However, access to quality services and misconceptions associated with contraceptive methods may impact on their effective use in developing countries. We describe the pattern of contraceptive use in a multi-site phase I/IIa HIV Vaccine trial in East Africa (Uganda, Kenya and Tanzania) and factors that may have influenced their use during the trial. METHODS: Pregnancy prevention counseling was provided to female participants during informed consent process and at each study visit. Participants' methods of contraception used were documented. Methods of contraceptives were provided on site. Pregnancy testing was done at designated visits during the trial. Obstacles to contraceptive use were identified and addressed at each visit. RESULTS: Overall, 103 (31.8%) of a total of 324 enrolled volunteers were females. Female participants were generally young with a mean age of 29(+/-7.2), married (49.5%) and had less than high school education (62.1%). Hormonal contraceptives were the most common method of contraception (58.3%) followed by condom use (22.3%). The distribution of methods of contraception among the three sites was similar except for more condom use and less abstinence in Uganda. The majority of women (85.4%) reported to contraceptive use prior to screening. The reasons for not using contraception included access to quality services, insufficient knowledge of certain methods, and misconceptions. CONCLUSION: Although hormonal contraceptives were frequently used by females participating in the vaccine trial, misconceptions and their incorrect use might have led to inconsistent use resulting in undesired pregnancies. The study underscores the need for an integrated approach to pregnancy prevention counseling during HIV vaccine trials. TRIAL REGISTRATION: ClinicalTrials.gov NCT00123968.
Language: English
Keywords:
AFRICA, SUB SAHARAN | RESEARCH REPORT | CLINICAL TRIALS | CONTRACEPTIVE PREVALENCE SURVEYS | WOMEN IN DEVELOPMENT | VACCINES | CONTRACEPTIVE USAGE | HIV PREVENTION | CONTRACEPTIVE AGENTS, FEMALE | CONDOM USE | CONTRACEPTIVE PREVALENCE | ABSTINENCE | KNOWLEDGE | PROGRAM ACCESSIBILITY | Africa | Developing Countries | Clinical Research | Research Methodology | Family Planning Surveys | Family Planning | Economic Development | Economic Factors | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraception | HIV Infections | Viral Diseases | Diseases | Contraceptive Agents | Risk Reduction Behavior | Behavior | Family Planning, Behavioral Methods | Sociocultural Factors | Program Evaluation | Programs | Organization and Administration
Document Number: 330944

24.

Peer Reviewed

Title: A multilevel analysis of condom use among adolescents in the European Union.
Author: Lazarus JV; Moghaddassi M; Godeau E; Ross J; Vignes C; Ostergren PO; Liljestrand J
Source: Public Health. 2009 Feb;123(2):138-144.
Abstract: OBJECTIVES: This study examined which individual and national factors affect condom use among adolescents. STUDY DESIGN: Multilevel analysis. METHODS: This study reviewed the data on bullying, alcohol use and condom use provided by 18 European countries and subnational entities in the Health Behaviour in School-Aged Children survey. Another eight contextual variables were also analysed. Three multilevel logistic regression models were applied consecutively (analysing for crude geographical and school variance in condom use, adjusting for gender and adjusting all variables for one another). RESULTS: Among the 15-year-olds studied, 7.0% of the total variance in condom use was explained by school-related factors (intraschool-level correlation) and 5.8% by national/subnational factors. In the empty model, condom use was significantly associated with gender, alcohol consumption, predominant national religion and national prevalence of human immunodeficiency virus (HIV). In the full model, there was also a significant association with the Human Development Index ranking, gross domestic product, Gini coefficient and the Gender-related Development Index. CONCLUSIONS: This study suggests that while alcohol, gender, human development level, income, religion and HIV prevalence affect condom use in young Europeans, these factors do not explain all or even most of the variation. Nonetheless, since some of these factors are not traditionally associated with young people's sexual and reproductive health, these findings should enable more nuanced health policy programming.
Language: English
Keywords:
EUROPEAN UNION | RESEARCH REPORT | CONTRACEPTIVE PREVALENCE SURVEYS | CROSS-CULTURAL COMPARISONS | STATISTICAL REGRESSION | ADOLESCENTS | CONDOM USE | CONTRACEPTIVE PREVALENCE | PSYCHOLOGICAL ABUSE | ALCOHOL USE AND ABUSE | SECONDARY SCHOOLS | SEX FACTORS | RELIGION | HIV INFECTIONS | PREVALENCE | Organizations | Political Factors | Sociocultural Factors | Family Planning Surveys | Family Planning | Comparative Studies | Studies | Research Methodology | Data Analysis | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Risk Reduction Behavior | Behavior | Contraceptive Usage | Contraception | Aggression | Schools | Education | Viral Diseases | Diseases | Measurement
Document Number: 329662

25.

Peer Reviewed

Title: Emergency contraceptive use among 5677 women seeking abortion in Shanghai, China.
Author: Meng CX; Gemzell-Danielsson K; Stephansson O; Kang JZ; Chen QF; Cheng LN
Source: Human Reproduction. 2009 Apr 9;1(1):1-7.
Abstract: BACKGROUND The increasing use of emergency contraceptive pills (ECPs) does not seem to reduce the number of induced abortions as would be expected, indicating that women use ECPs might also be a strong factor affecting their final efficacy. The study aimed to understand the attitude towards, and use of, ECPs among women seeking an abortion. METHODS A cohort study was conducted via face-to-face questionnaire interview among women seeking abortion in Shanghai, China. Logistic regression analysis and chi(2) test were performed for statistical analysis. RESULTS The response rate was 99.3%. Among all 5677 respondents aged 15-48 years, 48.8% were ECP ever-users. Compared with ever-users, ECP never-users were less likely to have used contraception during the present cycle of conception (P < 0.001). In response to the question on the main reason for non-use of contraception, ECP never-users were less likely to realize the risk of pregnancy and had less contraceptive knowledge (P < 0.001). Among 2773 ECP ever-users, 72.7% did not use ECPs to prevent the current pregnancy, mainly due to lack of awareness of pregnancy risk. Out of 757 women, 437 (57.7%) repeated unprotected sex after taking ECPs during the current pregnant cycle. A pharmacy was the preferred source to access ECPs, for the reason of convenience. CONCLUSIONS Non-use of ECPs was correlated to less knowledge on fertility and a lower rate of contraceptive use among abortion-seeking women. Women of reproductive age should have access to ECPs and receive sufficient information on their use. Health care providers and pharmacists should also be trained in contraceptive counselling, including ECPs.
Language: English
Keywords:
CHINA | RESEARCH REPORT | COHORT ANALYSIS | KAP SURVEYS | CONTRACEPTIVE PREVALENCE SURVEYS | WOMEN IN DEVELOPMENT | ABORTION | EMERGENCY CONTRACEPTION | ATTITUDES | CONTRACEPTIVE PREVALENCE | RISK ASSESSMENT | PERCEPTION | CONDOM USE | PHARMACY DISTRIBUTION | Asia, Eastern | Asia | Developing Countries | Research Methodology | Surveys | Sampling Studies | Studies | Family Planning Surveys | Family Planning | Economic Development | Economic Factors | Fertility Control, Postconception | Contraception | Psychological Factors | Behavior | Contraceptive Usage | Evaluation | Risk Reduction Behavior | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration
Document Number: 331002 Notification

26.

Peer Reviewed

Title: Does readily available emergency contraception increase women's awareness and use?
Author: Novikova N; Weisberg E; Fraser IS
Source: European Journal of Contraception and Reproductive Health Care. 2009 Feb;14(1):39-45.
Abstract: BACKGROUND: In Australia just over half of all women of reproductive age have experienced an unplanned pregnancy, many of which could have been avoided by use of emergency contraception. A dedicated emergency contraceptive pill (ECP) pack became available on prescription in Australia in 2002, and over the counter in 2004. OBJECTIVES: To determine if availability of a dedicated over the counter ECP pack in Australia increased knowledge and use of emergency contraception (EC). MATERIAL AND METHODS: Women attending three free-standing abortion clinics in Sydney answered an anonymous questionnaire on their knowledge and use of the ECP. Group 1 (208 women) was recruited prior to a dedicated ECP pack being available, group 2 (308) after it was available on prescription, and group 3 (202) after it became available over the counter. RESULTS: Women who had heard about EC were significantly younger (p < 0.005). The mean age of women who had never heard about EC was 29.8 years compared to 26.3 for women who had heard about EC. More women expressed awareness of the ECP after it became available over the counter. Women in group 2 attained a higher educational level than women in the other groups (p < 0.005). There was a significant trend to increased use of the ECP in women of higher educational level (p < 0.005). The use of EC did not increase significantly with improved availability and access. CONCLUSIONS: Among women seeking termination of pregnancy wider availability of the ECP has increased women's awareness of EC but not use.
Language: English
Keywords:
AUSTRALIA | RESEARCH REPORT | KAP SURVEYS | WOMEN | CONTRACEPTIVE USAGE | EMERGENCY CONTRACEPTION | CONTRACEPTIVE AVAILABILITY | PHARMACY DISTRIBUTION | CONTRACEPTIVE DISTRIBUTION | KNOWLEDGE | CONTRACEPTIVE PREVALENCE | AGE FACTORS | EDUCATIONAL STATUS | Developed Countries | Oceania | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Factors | Population | Contraception | Family Planning | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Sociocultural Factors | Population Characteristics | Socioeconomic Status | Socioeconomic Factors | Economic Factors
Document Number: 330346

27.

Peer Reviewed

Title: Trends in family planning in Russia, 1994-2003.
Author: Perlman F; McKee M
Source: Perspectives on Sexual and Reproductive Health. 2009 Mar;41(1):40-50.
Abstract: CONTEXT: Although Russian women have adequate knowledge of modern contraceptives, their level of use of these methods has been low, and abortion rates remain relatively high. METHODS: In 1994-2003, sexually active women aged 18-49 were interviewed about their contraceptive use as part of the Russia Longitudinal Monitoring Survey. Trends in contraceptive use were examined. Multivariate analyses were conducted to identify characteristics associated with reliable contraceptive use (IUD use or consistent oral contraceptive use) in 1994 and 2003. RESULTS: In each year, about 25% of sexually active women had used no contraceptive method in the past month, and 20% had used traditional methods. Prevalence of barrier method use increased from 9% to 21% between 1994 and 2003, while that of IUD use declined from 34% to 21%. These changes were especially pronounced in Moscow and St. Petersburg, and among younger women. Common reasons for nonuse were irregular sexual relations (cited by 29% of nonusers in 2003), desire for pregnancy (22%), perceived inability to get pregnant (15%), feeling that contraceptives are uncomfortable or unpleasant (15%), health problems (11%) and the availability of abortion (6%). In 1994 and 2003, the odds of reliable contraceptive use were elevated among women with at least a secondary education (odds ratios, 1.5-1.7), and were reduced among smokers (0.6-0.7). CONCLUSIONS: Modern, effective contraceptive use has not increased among sexually active Russian women. Growing use of barrier contraceptives may reflect HIV awareness. Obstacles to effective contraceptive use, such as attitudes and health service factors, need further clarification.
Language: English
Keywords:
RUSSIA | RESEARCH REPORT | LONGITUDINAL STUDIES | CONTRACEPTIVE PREVALENCE SURVEYS | KAP SURVEYS | MULTIVARIATE ANALYSIS | WOMEN | CONTRACEPTIVE PREVALENCE | CONTRACEPTIVE USAGE | IUD | ORAL CONTRACEPTIVES | FAMILY PLANNING PERSONNEL EVALUATION | BARRIER METHODS | AGE FACTORS | Developing Countries | Asia, Northern | Asia | Studies | Research Methodology | Family Planning Surveys | Family Planning | Surveys | Sampling Studies | Data Analysis | Demographic Factors | Population | Contraception | Contraceptive Methods | Family Planning Personnel | Family Planning Programs | Population Characteristics
Document Number: 330704

28.

Peer Reviewed

Title: Condom use in the year following a sexually transmitted disease clinic visit.
Author: Peterman TA; Tian LH; Warner L; Satterwhite CL; Metcalf CA; Malotte KC; Paul SM; Douglas JM Jr
Author: RESPECT-2 Study Group
Source: International Journal of STD and AIDS. 2009 Jan;20(1):9-13.
Abstract: Consistent condom use can prevent sexually transmitted infections (STIs), but few studies have measured how the prevalence of consistent use changes over time. We measured the prevalence and correlates of consistent condom use over the course of a year. We did a secondary analysis of data from an HIV prevention trial in three sexually transmitted disease clinics. We assessed condom use during four three-month intervals for subjects and across their partnerships using unconditional logistic regression. Condom use was also assessed for subjects during all three-month intervals combined. The 2125 subjects reported on 5364 three-month intervals including 7249 partnership intervals. Condoms were always used by 24.1% of subjects and 33.2% of partnerships during a three-month interval. Over the year, 82% used condoms at least once but only 5.1% always used condoms. Always use of condom was more likely for subjects who had sex only once (66.5%) compared with >30 times (6.4%); one-time partnerships (64.1%) compared with main partnerships (22.2%); and in new partnerships (44.0%) compared with partnerships that were not new (24.5%). Although consistent condom use may prevent STIs, condoms were rarely used consistently during the year of follow-up.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | KAP SURVEYS | CONTRACEPTIVE PREVALENCE SURVEYS | STATISTICAL REGRESSION | COHORT ANALYSIS | CLINIC VISITS | CONDOM USE | SEXUALLY TRANSMITTED DISEASE PREVENTION | CONTRACEPTIVE PREVALENCE | TIME FACTORS | COITAL FREQUENCY | HIV PREVENTION | Developed Countries | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Family Planning Surveys | Family Planning | Data Analysis | Service Statistics | Program Activities | Programs | Organization and Administration | Risk Reduction Behavior | Behavior | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Contraceptive Usage | Contraception | Population Dynamics | Demographic Factors | Population | Sex Behavior | HIV Infections | Viral Diseases
Document Number: 330716

29.

Peer Reviewed

Title: Sexual activity and contraceptive use among secondary-school students in Slovenia.
Author: Pinter B; Verdenik I; Grebenc M; Ceh F
Source: European Journal of Contraception and Reproductive Health Care. 2009 Apr;14(2):127-33.
Abstract: OBJECTIVES: To evaluate sexual activity and contraceptive use among secondary-school students in Slovenia. METHODS: A representative sample of 1095 third grade secondary-school students in Slovenia in 2004 was assessed by means of a self-administered questionnaire. RESULTS: The average age of the students was 17.4 +/- 0.7 years. Most students had experienced being in love (92%), dating (82%), kissing (87%), caressing (78%) and petting (61%). One half (53%) of them had already had coitus. Homosexual contacts had occurred among 2% of the boys and 11% of the girls. The main reason for the first sexual intercourse was love (44%) but it occurred by chance in 27% of the cases. Contraceptive methods used foremost at first intercourse were the condom (75%) and the pill (7%). Contraceptive methods resorted to on the occasion of the last intercourse were the condom (50%), the pill (32%), a double method whereby a condom is used in addition to the pill (4%), withdrawal (4%), periodic abstinence (1%), emergency contraception (1%), and other methods (1%); no contraceptive measures at all were applied in 7% of the encounters. CONCLUSIONS: At the age of 17 about one half of secondary-school students in Slovenia have already had sexual intercourse. Most students resort to effective contraception, but the double method is underused.
Language: English
Keywords:
SLOVENIA | RESEARCH REPORT | KAP SURVEYS | STUDENTS | HOMOSEXUALS | SECONDARY SCHOOLS | CONTRACEPTIVE PREVALENCE | SEX BEHAVIOR | RISK BEHAVIOR | LOVE | INTERPERSONAL RELATIONS | SEXUAL INTERCOURSE | SEX FACTORS | FIRST INTERCOURSE | CONDOM USE | Developing Countries | Europe, Central | Europe | Surveys | Sampling Studies | Studies | Research Methodology | Education | Behavior | Schools | Contraceptive Usage | Contraception | Family Planning | Emotions | Psychological Factors | Reproduction | Population Characteristics | Demographic Factors | Population | Risk Reduction Behavior
Document Number: 330934

30.

Title: Making family planning accessible in resource-poor settings.
Author: Prata N
Source: Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences. 2009 Oct 27;364(1532):3093-9.
Abstract: It is imperative to make family planning more accessible in low resource settings. The poorest couples have the highest fertility, the lowest contraceptive use and the highest unmet need for contraception. It is also in the low resource settings where maternal and child mortality is the highest. Family planning can contribute to improvements in maternal and child health, especially in low resource settings where overall access to health services is limited. Four critical steps should be taken to increase access to family planning in resource-poor settings: (i) increase knowledge about the safety of family planning methods; (ii) ensure contraception is genuinely affordable to the poorest families; (iii) ensure supply of contraceptives by making family planning a permanent line item in healthcare system's budgets and (iv) take immediate action to remove barriers hindering access to family planning methods. In Africa, there are more women with an unmet need for family planning than women currently using modern methods. Making family planning accessible in low resource settings will help decrease the existing inequities in achieving desired fertility at individual and country level. In addition, it could help slow population growth within a human rights framework. The United Nations Population Division projections for the year 2050 vary between a high of 10.6 and a low of 7.4 billion. Given that most of the growth is expected to come from today's resource-poor settings, easy access to family planning could make a difference of billions in the world in 2050.
Language: English
Keywords:
DEVELOPING COUNTRIES | CRITIQUE | FAMILY PLANNING PROGRAMS | PROGRAM ACCESSIBILITY | NEEDS | OBSTACLES | POVERTY | INEQUALITIES | CONTRACEPTIVE PREVALENCE | CONTRACEPTIVE AVAILABILITY | POPULATION GROWTH | MATERNAL MORTALITY | Family Planning | Program Evaluation | Programs | Organization and Administration | Economic Factors |