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Title: How to put an end to the practice of female genital mutilation (FGM)? Panel discussion report (6 February 2008).
Author: Inter-Parliamentary Union; International Organization for Migration [IOM]; Inter-African Committee on Traditional Practices Affecting the Health of Women and Children; Switzerland. Geneva. Departement des Institutions
Source: Geneva, Switzerland, Inter-Parliamentary Union, 2009. 32 p.
Abstract: Every 10 seconds, somewhere in the world, a little girl is a victim of genital mutilation. Three million girls are excised every year. To mark the International Day of Zero Tolerance to FGM on 6 February 2008, more than 100 representatives of international organizations, civil society, media, diplomatic missions and the local authorities in Geneva gathered at The House of Parliaments to discuss ways of putting an end to this harmful practice. The IPU, the Departement des Institutions de l?Etat de Geneve (Geneva Department of Institutions), the International Organization for Migration and the Inter-African Committee on Traditional Practices decided to join forces to put an end to this human tragedy. This publication contains the experts' contributions, extracts of the debates and conclusions of the seminar. (Excerpts)
Language: English
Keywords:
DEVELOPING COUNTRIES | CRITIQUE | RECOMMENDATIONS | EVALUATION | WOMEN IN DEVELOPMENT | POLICYMAKERS | ADOLESCENTS, FEMALE | FEMALE GENITAL CUTTING | POLITICAL FACTORS | ADVOCACY | RELIGION | LEADERSHIP | SOCIAL POLICY | WOMEN'S RIGHTS | CULTURE | Economic Development | Economic Factors | Administrative Personnel | Organization and Administration | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Harmful Traditional Practices | Traditional Health Practices | Sociocultural Factors | Communication | Policy | Human Rights
Document Number: 331363

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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

Peer Reviewed

Title: Expanding access to intrauterine contraception.
Author: Allen RH; Goldberg AB; Grimes DA
Source: American Journal of Obstetrics and Gynecology. 2009 Jun 13;
Abstract: The intrauterine device is a safe, highly effective, long-lasting, yet reversible method of contraception. Expanding access to intrauterine contraception is an important measure to reduce the rate of unintended pregnancy in the United States. Clinicians should consider intrauterine contraception in appropriate candidates, including women who are nulliparous, adolescent, immediately postpartum or postabortal, and desiring emergency contraception, and as an alternative to permanent sterilization. Barriers to intrauterine contraception such as requiring cervical cancer screening before insertion, routine testing for gonorrhea and chlamydial infection in low-risk women, or scheduling insertion only during menses are unnecessary.
Language: English
Keywords:
UNITED STATES OF AMERICA | CRITIQUE | ADOLESCENTS, FEMALE | IUD | CONTRACEPTIVE AVAILABILITY | MISINFORMATION | CONTRAINDICATIONS | INSERTION | PAIN | IUD EXPULSION | NULLIPARITY | Developed Countries | North America | Americas | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Communication | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Signs and Symptoms | Diseases | Parity | Fertility Measurements | Fertility | Population Dynamics
Document Number: 341709

Title: The role of education level in the intergenerational pattern of adolescent pregnancy in Brazil.
Author: Almeida MC; Aquino EM
Source: International Perspectives on Sexual and Reproductive Health. 2009 Sep;35(3):139-146.
Abstract: Adolescent pregnancy has been associated with the early childbearing experience of the mothers of adolescents, and young people's education level is believed to be an important factor in this phenomenon. In 2002, a representative household survey collected data from 3,050 young men and women ages 20�24 in three Brazilian cities. The main measures were mother's age at first birth, daughter's age at first pregnancy, and son's age when he first impregnated a partner. Ages were dichotomized as younger than 20 and 20 or older. The distribution of respondents, by both their own and their mothers' reproductive experience, was analyzed in relation to various characteristics, and logistic regressions assessed possible associations between these variables and pregnancy experience. Thirty percent of women reported getting pregnant before age 20, and 21% of men said they were younger than 20 when they first impregnated a partner. Of these groups, 34% of women and 31% of men reported that their mothers had first given birth at the same age. Both women and men were more likely to have had an early pregnancy experience if their mother had had a child before age 20. Among women, this positive association disappeared in the final model after adjusting for their education level, whereas among men the association remained after similar adjustment.
Spanish Abstract: Contexto: El embarazo durante la adolescencia se ha asociado con la experiencia de la maternidad temprana de las madres de los y las adolescentes; y se considera el nivel educativo de la gente joven como un factor importante en este fen�meno. M�todos: En 2002, una encuesta representativa de hogares recolect� datos de 3,050 hombres y mujeres j�venes de 20-24 a�os en tres ciudades brasile�as. Las principales medidas fueron la edad de la madre de los encuestados en el momento de su primer parto, la edad de la joven en el primer embarazo y la edad del joven al embarazar por primera vez a una pareja; los grupos de edad se dividieron en menores de 20 y de 20 a�os o mayores. La distribuci�n de las personas encuestadas (tanto por su propia experiencia reproductiva como la de su madre), se analiz� en relaci�n con varias caracter�sticas, y se valor� mediante regresiones log�sticas las posibles asociaciones entre estas variables y la experiencia del embarazo. Resultados: Treinta por ciento de las j�venes reportaron haberse embarazado antes de los 20 a�os; y 21% de los hombres dijeron que eran menores de 20 a�os cuando su pareja se embaraz�. De estos grupos, 34% de las mujeres y 31% de los hombres reportaron que sus madres hab�an dado a luz por primera vez a la misma edad. Tanto las mujeres como los hombres tuvieron mayor probabilidad de experimentar un embarazo temprano si su madre hab�a tenido un hijo antes de los 20 a�os (razones de momios, 2.0 y 2.3, respectivamente). En las mujeres, esta asociaci�n positiva desapareci� en el modelo final, despu�s de ajustar por nivel de educaci�n, mientras que entre los hombres la asociaci�n permaneci� despu�s de un ajuste similar (1.8). Conclusiones: El nivel de educaci�n de las hijas e hijos parece ser un factor importante en la repetici�n de la fecundidad adolescente a trav�s de las generaciones. Se necesita esfuerzos para aumentar el acceso a la educaci�n y para alentar a la gente joven a que permanezca en la escuela.
French Abstract: Contexte: Les grossesses d'adolescentes ont �t� associ�es � l'exp�rience de la maternit� pr�coce des m�res des adolescents concern�s et le niveau d'instruction des jeunes semble jouer un r�le important. M�thodes: En 2002, une enqu�te de m�nages repr�sentative a recueilli des donn�es aupr�s de 3.050 jeunes hommes et femmes de 20 � 24 ans dans trois villes du Br�sil. Les principales mesures ont port� sur l'�ge de la m�re � la premi�re naissance, l'�ge de la fille � la premi�re grossesse et l'�ge du fils au moment de la f�condation d'une partenaire. Les �ges ont �t� dichotomis�s entre moins de 20 ans et 20 ans ou plus. La distribution des r�pondants en fonction de leur propre exp�rience g�n�sique et de celle de leur m�re a �t� analys�e selon diff�rentes caract�ristiques, tandis que les associations possibles entre ces variables et l'exp�rience d'une grossesse �taient �valu�es par r�gressions logistiques. R�sultats: Trente pour cent des femmes ont d�clar� avoir �t� enceintes avant l'�ge de 20 ans, tandis que 21% des hommes d�claraient avoir eu moins de 20 ans au moment de la f�condation de leur partenaire. De ces groupes, 34% des femmes et 31% des hommes ont d�clar� que leur m�re avait accouch� pour la premi�re fois � ce m�me �ge. Tant les femmes que les hommes sont apparus plus susceptibles d'avoir connu une grossesse pr�coce si leur m�re avait eu un enfant avant l'�ge de 20 ans (rapports de probabilit�s, 2,0 et 2,3, respectivement). C�t� f�minin, cette association positive dispara�t dans le mod�le final apr�s correction du niveau d'instruction; c�t� masculin, elle se maintient apr�s correction similaire (1,8). Conclusions: Le niveau d'instruction des filles comme des fils semble jouer un r�le important dans la r�p�tition de la f�condit� adolescente d'une g�n�ration � l'autre. Des efforts sont n�cessaires pour accro�tre l'acc�s � l'�ducation et encourager les jeunes � poursuivre leur scolarisation.
Language: English
Keywords:
BRAZIL | RESEARCH REPORT | SURVEYS | MOTHERS | ADOLESCENTS, FEMALE | ADOLESCENT PREGNANCY | AGE FACTORS | FIRST BIRTH | EDUCATIONAL STATUS | REPRODUCTIVE BEHAVIOR | FERTILITY | South America, Eastern | South America | Latin America | Americas | Developing Countries | Sampling Studies | Studies | Research Methodology | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Adolescents | Youth | Population Characteristics | Demographic Factors | Population | Population Dynamics | Pregnancy History | Fertility Measurements | Socioeconomic Status | Socioeconomic Factors | Economic Factors
Document Number: 343004

Title: The influence of early sexual debut and sexual violence on adolescent pregnancy: a matched case-control study in Jamaica.
Author: Baumgartner JN; Geary CW; Tucker H; Wedderburn M
Source: International Perspectives on Sexual and Reproductive Health. 2009 Mar;35(1):21-28.
Abstract: The authors conducted structured interviews with 15- to 17-year-old females-250 who were currently pregnant and 500 sexually experienced, but never-pregnant, neighborhood-matched controls. Bivariate and multivariate analyses were used to examine associations between adolescent pregnancy and early sexual debut, sexual coercion or violence, and sexual risk-taking behaviors. Greater proportions of pregnant youth than of their never-pregnant peers reported having had first sex by age 14 (54% vs. 41%), a first sexual partner who was five or more years older (33% vs. 20%), or multiple partners (63% vs. 50%). A greater proportion of never-pregnant youth had used contraceptives at first sex (88% vs. 80%). Almost half (49%) of all young women reported ever having experienced sexual coercion or violence. Compared with controls, pregnant youth had greater odds of having had an older partner at first sex and believing contraception is a woman's responsibility (odds ratios, 1.3 and 2.1, respectively), and had lower odds of ever having experienced sexual violence and thinking that it is important to protect oneself against pregnancy (0.5 and 0.2, respectively). An interaction between early sexual debut and multiple partners was found. Having had multiple partners was associated with pregnancy only for youth with early sexual debut. Encouraging adolescents to delay sexual debut and reduce their number of sexual partners may help prevent unintended pregnancies. Experiences of sexual coercion and violence were common among both groups, highlighting the need to address gender-based violence at the community level.
Language: English
Keywords:
JAMAICA | RESEARCH REPORT | CASE STUDIES | ADOLESCENTS, FEMALE | ADOLESCENT PREGNANCY | SEXUAL ABUSE | Caribbean | Americas | Developing Countries | Studies | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Reproductive Behavior | Fertility | Population Dynamics | Crime | Social Problems | Sociocultural Factors
Document Number: 315213

Peer Reviewed

Title: Bone mineral density in a cohort of adolescents during use of norethisterone enanthate, depot-medroxyprogesterone acetate or combined oral contraceptives and after discontinuation of norethisterone enanthate.
Author: Beksinska ME; Kleinschmidt I; Smit JA; Farley TM
Source: Contraception. 2009 May;79(5):345-9.
Abstract: BACKGROUND: Depot medroxyprogesterone acetate (DMPA), norethisterone enanthate (NET-EN) and combined oral contraceptives (COCs) have been shown to have a negative effect on bone mineral density (BMD) in adolescents. The aim of this study was to investigate BMD in 15- to 19-year-old new users of DMPA, NET-EN and COCs. STUDY DESIGN: This 5-year longitudinal study followed up new users of DMPA (n=115), NET-EN (n=115) and COCs (n=116) and 144 nonuser controls. BMD was measured at the distal radius using dual-energy X-ray absorptiometry. RESULTS: BMD increased in all groups (annual percent increase: nonusers, 1.49%; DMPA, 1.39%; NET-EN, 1.03%; COCs, 0.84%) during follow-up (p<.001). There was evidence for lower BMD increases per annum in NET-EN (p=.050) and COC (p=.010) users compared to nonusers but no difference between DMPA and nonusers (p=.76). In 14 NET-EN discontinuers, an overall reduction of 0.61% per year BMD was followed upon cessation by an increase of 0.69% per year (p=.066). CONCLUSION: This study suggests that BMD increases in adolescents may be less in NET-EN and COC users; however, recovery of BMD in NET-EN users was found in the small sample of adolescents followed post-discontinuation.
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | CLINICAL RESEARCH | COHORT ANALYSIS | COMPARATIVE STUDIES | ADOLESCENTS, FEMALE | WOMEN IN DEVELOPMENT | SKELETAL EFFECTS | CONTRACEPTION TERMINATION | NORETHINDRONE ENANTHATE | DEPO-PROVERA | ORAL CONTRACEPTIVES, COMBINED | ORAL CONTRACEPTIVES, SIDE EFFECTS | CONTRACEPTIVE SAFETY | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | Studies | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | Physiology | Biology | Contraception | Family Planning | Norethindrone | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Medroxyprogesterone Acetate | Oral Contraceptives | Contraceptive Methods | Safety | Public Health | Health
Document Number: 330938

Title: Perception and practice of emergency contraception among female undergraduates of the University of Ibadan, Nigeria.
Author: Bello FA; Olayemi O; Fawole AO; Ogunbode OO; Sobukunola T
Source: Journal of Reproduction and Contraception. 2009 Jun;20(2):113-121.
Abstract: The authors performed a cross-sectional questionnaire study with 383 female undergraduates in Nigeria in June 2006 to assess their perceptions about and proper use of emergency contraception (EC). One hundred and five (48.2%) of the students had been sexually exposed. Only 32 (30.5%) used regular contraception. Seventy-three (24.3%) female undergraduates were aware of EC. Only 29 (7.6%) had used EC before. Most would not use EC drugs in the future due to lack of awareness (64.8%), fear for future fertility, and fear that EC was injurious to health. Use of EC was associated with awareness of correct interval for use. The authors concluded that there was poor knowledge about EC and poor use. Most knowledge was acquired from peers and was inaccurate.
Language: English
Keywords:
NIGERIA | RESEARCH REPORT | DATA ANALYSIS | YOUTH | STUDENTS | ADOLESCENTS, FEMALE | EMERGENCY CONTRACEPTION | CONTRACEPTIVE AGENTS, POSTCOITAL | KNOWLEDGE | PEER EDUCATORS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Education | Adolescents | Contraception | Family Planning | Contraceptive Agents, Female | Contraceptive Agents | Sociocultural Factors
Document Number: 339903

Peer Reviewed

Title: Is education the link between orphanhood and HIV/HSV-2 risk among female adolescents in urban Zimbabwe?
Author: Birdthistle I; Floyd S; Nyagadza A; Mudziwapasi N; Gregson S; Glynn JR
Source: Social Science and Medicine. 2009 May;68(10):1810-1818.
Abstract: This study explored the role of education in explaining the excess sexual risk previously documented among unmarried female orphans in urban Zimbabwe. School attendance and attainment were assessed by type of orphanhood, and for their association with markers of sexual risk (HIV and/or HSV-2 infection) among 743 participants drawn from a random sample of 15- to 19-year-old girls identified in a cross-sectional survey in Highfield, Harare in 2004. Multivariable logistic regression was used to assess the role of educational status in explaining the higher prevalence of adverse sexual outcomes among unmarried orphans compared to non-orphans, adjusting for possible confounders. Double orphans had significantly lower educational attendance and attainment than non-orphans. Maternal orphans had higher odds of school drop-out, although this association disappeared when adjusted for recent mobility. Educational status was strongly associated with HIV/HSV-2 risk, but explained only a small part of double orphans' sexual risk and did not explain the HIV/HSV-2 risk of maternal and paternal orphans. High overall levels of secondary school participation and school fee assistance provided to vulnerable families may have reduced the schooling disparities between orphans and non-orphans in Highfield. However, further efforts are needed to rectify the schooling inequities that persist, while additional research is needed to identify other socioeconomic and emotional factors driving orphans' sexual risk so that prevention and support programs can meet the needs of this growing population.
Language: English
Keywords:
ZIMBABWE | URBAN AREAS | RESEARCH REPORT | SAMPLING STUDIES | ADOLESCENTS, FEMALE | ORPHANS AND VULNERABLE CHILDREN | HIV INFECTIONS | HERPES GENITALIS | EDUCATIONAL STATUS | SEX BEHAVIOR | RISK FACTORS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Geographic Factors | Population | Studies | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Family and Household | Sociocultural Factors | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Behavior | Health
Document Number: 341411

10.

Title: Patterns and trends in adolescents' contraceptive use and discontinuation in developing countries and comparisons with adult women.
Author: Blanc AK; Tsui AO; Croft TN; Trevitt JL
Source: International Perspectives On Sexual and Reproductive Health. 2009 Jun;35(2):63-71.
Abstract: Demographic and Health Survey data from more than 40 countries were used to examine the proportions of 15- to 19-year-old women who are currently married or are unmarried but sexually active; their rates of contraceptive adoption, current use, discontinuation, method switching and contraceptive failure; trends in these indicators; and comparisons with older women. In many countries, the proportion of adolescent women using contraceptives increased substantially over the last two decades. Prevalence among adolescents increased faster than among older women. Greater proportions of adolescents than of older women discontinued using a contraceptive method within a year or experienced contraceptive failure. The authors conclude that expanded demand for contraceptive supplies, services, and information can be expected to challenge the preparedness, capacity, and resources of existing family planning programs and providers.
Language: English
Keywords:
DEVELOPING COUNTRIES | RESEARCH REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | COMPARATIVE STUDIES | ADOLESCENTS, FEMALE | WOMEN | OLDER ADULTS | AGE FACTORS | CONTRACEPTIVE METHOD SWITCHING | CONTRACEPTIVE USAGE | CONTRACEPTIVE EFFECTIVENESS | FAMILY PLANNING PROGRAM EVALUATION | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Studies | Research Methodology | Adolescents | Youth | Population Characteristics | Adults | Contraception | Family Planning | Family Planning Programs
Document Number: 342143

11.

12.

Peer Reviewed

Title: Rural Gambian women's reliance on health workers to deliver sulphadoxine-pyrimethamine as recommended intermittent preventive treatment for malaria in pregnancy.
Author: Brabin L; Stokes E; Dumbaya I; Owens S
Source: Malaria Journal. 2009;8:25.
Abstract: BACKGROUND: The use of most anti-malarial medications is restricted during pregnancy, but two doses of sulphadoxine-pyrimethamine are recommended after the first trimester as intermittent preventive treatment in pregnancy (IPTp). In The Gambia, only 32% of women receive two doses and very little research has been conducted on women's awareness of drug safety during pregnancy. The objective of this paper was to assess whether rural Gambian women were aware of the importance of the timing of the two-dose IPT dose schedule and its relevance to drug safety. METHODS: This was a qualitative study in which 41 interviews and 16 focus group discussions with women, adolescents, men and traditional birth attendants were conducted. A generic qualitative approach was used to generate a theory as to why women might not participate in IPTp as recommended. RESULTS: Although most women used calendar months to count their stage of pregnancy, these months did not correlate with their concept of foetal development. Foetal growth was described following Islamic tradition as water, clot, piece of meat and human being, although there was little consensus about the order or timing in which these stages occurred. Common signs and conditions of malaria were known. Women were anxious about miscarriage and recognized that some medicines should not be taken in the first trimester, but were urged by men and traditional birth attendants to attend for antenatal care in the first trimester to "start treatment." General knowledge about the purpose of pregnancy medications and when they should be taken was poor among both men and women. One important result was that women relied entirely on health workers to provide safe drugs, at the correct time. CONCLUSION: Women did not have relevant information to judge the safety and appropriate timing of pregnancy drugs, which made them over-reliant on health workers. They should be encouraged to date their own pregnancies in culturally relevant terms and to anticipate when and which medications they should receive.
Language: English
Keywords:
GAMBIA | RESEARCH REPORT | QUALITATIVE RESEARCH | PREGNANT WOMEN | MEN | TRADITIONAL BIRTH ATTENDANTS | ADOLESCENTS, FEMALE | PREGNANCY, FIRST TRIMESTER | MALARIA PREVENTION | ANTIMALARIAL DRUGS | INFORMATION | KNOWLEDGE | TREATMENT | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Population Characteristics | Demographic Factors | Population | Health Personnel | Delivery of Health Care | Health | Adolescents | Youth | Age Factors | Pregnancy | Reproduction | Malaria | Parasitic Diseases | Diseases | Sociocultural Factors | Medical Procedures | Medicine | Health Services
Document Number: 330897

13.

Title: Prenatal origins of undernutrition.
Author: Christian P
Source: Nestle Nutrition Workshop Series. Paediatric Programme. 2009;63:59-73; discussion 74-7, 259-68.
Abstract: Undernutrition continues to be high in many regions of the developing world. Birthweight, a common proxy measure of intrauterine growth, is influenced by nutritional, environmental and lifestyle factors during pregnancy and, in turn, affects immediate survival and function, and is a determinant of later life risk of chronic diseases. Maternal pre-pregnancy weight and height are independently associated with birthweight and also modify the effects of pregnancy weight gain and interventions during pregnancy on birthweight and perinatal mortality. Other prenatal factors commonly known to impact birthweight include maternal age, parity, sex, and birth interval, whereas lifestyle factors such as physical activity and maternal stress, as well as environmental toxicants have variable influences. Tobacco and other substance use and infections, specifically ascending reproductive tract infections, malaria, and HIV, can cause intrauterine growth restriction (IUGR). Few studies have examined the contribution of prenatal factors including low birthweight to childhood wasting and stunting. Studies that have examined this, with adequate adjustment for confounders, have generally found odds ratios associated with low birthweight ranging between 2 and 5. Even fewer studies have examined birth length or maternal nutritional status as risk factors. More research is needed to determine the proportion of childhood under-nutrition attributable to IUGR so that interventions can be targeted to the appropriate life stages.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | ADOLESCENTS, FEMALE | YOUTH | WOMEN | ETHNIC GROUPS | PARITY | REPRODUCTIVE AGE | MALNUTRITION | HEALTH STATUS INDEXES | INTRAUTERINE GROWTH RETARDATION | REPRODUCTIVE TRACT INFECTIONS | MALARIA | HIV INFECTIONS | INTERVENTIONS | Developed Countries | North America | Americas | Adolescents | Age Factors | Population Characteristics | Demographic Factors | Population | Cultural Background | Fertility Measurements | Fertility | Population Dynamics | Reproduction | Nutrition Disorders | Diseases | Health | Congenital Abnormalities | Neonatal Diseases and Abnormalities | Infections | Parasitic Diseases | Viral Diseases | Programs | Organization and Administration
Document Number: 341348

14.

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

15.

Peer Reviewed

Title: Adolescent Comprehension of Emergency Contraception in New York City.
Author: Cremer M; Holland E; Adams B; Klausner D; Nichols S; Scott Ram R; Alonzo TA
Source: Obstetrics and Gynecology. 2009 Apr;113(4):840-844.
Abstract: OBJECTIVE:: To estimate comprehension of the over-the-counter emergency contraception label among female adolescents aged 12 through 17 years, and to compare the results with a similar study that focused on adults. METHODS:: Surveys were administered to female adolescents in New York City in public venues such as malls, movie theaters, and parks. Participants were asked to read the emergency contraception (levonorgestrel) label before answering survey questions. Comparisons were made in SPSS version 13.0 using chi tests of independence and Fisher exact tests for sparse data. RESULTS:: One thousand eighty-five girls between the ages of 12 and 17 participated in the study. Overall, adolescents demonstrated high comprehension of the key points of emergency contraception: (1) that it is a method of preventing pregnancy 92% (confidence interval [CI] 91-94%); (2) that it has to be taken within the first 72 hours after unprotected intercourse 83% (CI 83-87%); (3) that if you are already pregnant emergency contraception will not be effective 87% (CI 85-89%); (4) that emergency contraception will not protect against human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) 95% (CI 94-96%); and (5) that emergency contraception should not be used as a method of long-term birth control 85% (CI 83-87%). CONCLUSION:: After reading the emergency contraception (levonorgestrel) label, female adolescents aged 12 to 17 understood the information necessary to use emergency contraception safely and effectively as well as their adult counterparts. LEVEL OF EVIDENCE:: III.
Language: English
Keywords:
UNITED STATES OF AMERICA | NEW YORK | RESEARCH REPORT | SURVEYS | ADOLESCENTS, FEMALE | EMERGENCY CONTRACEPTION | INFORMATION | Developed Countries | North America | Americas | Sampling Studies | Studies | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Contraception | Family Planning
Document Number: 330854

16.

Peer Reviewed

Title: Progestogen-only contraceptive use in obese women.
Author: Curtis KM; Ravi A; Gaffield ML
Source: Contraception. 2009 Oct;80(4):346-54.
Abstract: BACKGROUND: The objective of this systematic review is to determine whether obese women who use progestogen-only contraceptives are more likely to experience weight gain or serious adverse events as compared to nonobese users. STUDY DESIGN: We searched PubMed for all articles (in all languages) published in peer-reviewed journals from database inception through October 2008, for evidence relevant to obesity and progestogen-only contraceptives. We used standard abstract forms and grading systems to summarize and assess the quality of the evidence. RESULTS: From 579 articles, we identified nine studies fitting our selection criteria. Evidence from five studies suggests that among adult women, baseline weight or body mass index is not associated with weight gain among depot medroxyprogesterone acetate (DMPA) users (Level II-2, Fair). Evidence from three studies suggests that among adolescent women, overweight or obese DMPA users may gain more weight than normal weight DMPA users or overweight/obese nonusers (Level II-2, Fair). Evidence from one small study of Norplant users showed no differences in weight gain by baseline weight (Level II-3, Poor). We did not identify studies of other progestogen-only contraceptive methods that examined weight change by baseline weight, nor did we identify studies that reported on any serious adverse events by baseline weight. CONCLUSIONS: Adolescent DMPA users who are obese may gain more weight than normal weight users. This observation was not seen in adult DMPA users or adolescent Norplant users.
Language: English
Keywords:
GLOBAL | LITERATURE REVIEW | ADULTS | ADOLESCENTS, FEMALE | CONTRACEPTIVE AGENTS, PROGESTIN | PROGESTERONE | DEPO-PROVERA | CONTRACEPTIVE IMPLANTS | CONTRACEPTIVE AGENTS, SIDE EFFECTS | OBESITY | BODY WEIGHT | Age Factors | Population Characteristics | Demographic Factors | Population | Adolescents | Youth | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Progestational Hormones | Hormones | Endocrine System | Physiology | Biology | Medroxyprogesterone Acetate | Contraceptive Methods
Document Number: 342772

17.

Title: Thrombophilic conditions in the adolescent: the gynecologic impact.
Author: Dietrich JE; Yee DL
Source: Obstetrics and Gynecology Clinics of North America. 2009 Mar;36(1):163-75.
Abstract: As Virchow's triad suggests, a fine balance exists between the vascular wall, intravascular contents, and dynamic blood flow, such that a shift in this balance predisposes to thrombosis. Although thromboembolic events (TEs) are relatively infrequent in adolescents, the morbidity and mortality associated with TEs can be significant. Over the past 15 years, TEs and inherited and acquired thrombophilic conditions underlying them have become increasingly recognized in teens at risk, with combined hormonal contraception constituting one of the most significant of these risk factors. Therefore, managing gynecologic problems in teens who have thrombophilic conditions can be challenging. It is important to have a clear understanding about safe options available to help address adolescent gynecologic concerns in this setting and to manage situations collaboratively with a hematologist.
Language: English
Keywords:
UNITED STATES OF AMERICA | RECOMMENDATIONS | ADOLESCENTS, FEMALE | GYNECOLOGY | THROMBOSIS | RISK FACTORS | HEREDITARY DISEASES | CONTRACEPTIVE AGENTS, FEMALE | ORAL CONTRACEPTIVES, COMBINED | BLOOD COAGULATION EFFECTS | SCREENING | PROGESTERONE | CONTRACEPTIVE METHODS | Developed Countries | North America | Americas | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Medicine | Health Services | Delivery of Health Care | Health | Thromboembolism | Embolism | Vascular Diseases | Diseases | Contraceptive Agents | Contraception | Family Planning | Oral Contraceptives | Hematological Effects | Hemic System | Physiology | Biology | Examinations and Diagnoses | Medical Procedures | Progestational Hormones | Hormones | Endocrine System
Document Number: 342856

18.

Peer Reviewed

Title: Adolescent access to emergency contraception: a comment on the UK context.
Author: Fallon D
Source: European Journal of Contraception and Reproductive Health Care. 2009 Apr;14(2):120-6.
Abstract: The provision of emergency contraception (EC) in the United Kingdom (UK) has been transformed over the past decade through advances in pharmacology and the implementation of governmental measures to reduce teenage pregnancy rates. This paper considers how these issues have developed in the current social and political context with specific reference to adolescent access to EC in the UK. It highlights the concerns caused by increased availability of EC and the tension between adolescent rights to confidential treatment and advice, and professional anxiety about encouraging secrecy or parental deception. It concludes that adolescents, whilst benefiting from increased access to EC may also face a series of challenges as a result.
Language: English
Keywords:
UNITED KINGDOM | RESEARCH REPORT | CLINICAL RESEARCH | ADOLESCENTS, FEMALE | EMERGENCY CONTRACEPTION | CONTRACEPTIVE AVAILABILITY | GOVERNMENT PROGRAMS | ADOLESCENT PREGNANCY | PREVENTION AND CONTROL | POLITICAL FACTORS | CONFIDENTIAL INFORMATION | FAMILY PLANNING EDUCATION | PARENTAL CONSENT | Developed Countries | Europe, Western | Europe | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Contraception | Family Planning | Programs | Organization and Administration | Reproductive Behavior | Fertility | Population Dynamics | Diseases | Sociocultural Factors | Ethics | Education
Document Number: 330933

19.

Peer Reviewed

Title: Multiple sexual partnership mediates the association between early sexual debut and sexually transmitted infection among adolescent and young adult males in Nigeria.
Author: Fatusi A; Wang W
Source: European Journal of Contraception and Reproductive Health Care. 2009 Apr;14(2):134-43.
Abstract: The study was cross-sectional analytical in design and involved 1,278 Nigerian males aged 15-24 years. Logistic regression was used in assessing the statistical relationship between early sexual debut (<16 years) and self-reported STIs (history of at least one of three symptoms-painful urination, genital discharge, and genital ulcer/sore within the past 12 months), with demographic factors, sexual behaviors, and psychosocial measures controlled for. The prevalence of self-reported symptoms was 4.2% for genital discharge, 4.1% for painful urination, and 2.0% for genital sore/ulcer. Overall, 6.8% had STI symptoms. At bivariate analysis, early sexual debut (p = 0.021), multiple partners (p < 0.001), concurrent partners (p = 0.002), and sex with casual/commercial partners (p = 0.013) were associated with STIs. At multivariate analysis, early sexual debut (odds ratio [OR] = 2.12, 95% confidence interval [CI] = 1.17-3.84) remained significantly associated with STIs. Multiple sexual partnership (OR = 2.00, 95% CI = 1.13-3.52) was also significantly associated with STIs and is a mediator of the association between early debut and STI.
Language: English
Keywords:
NIGERIA | RESEARCH REPORT | HEALTH SURVEYS | STATISTICAL REGRESSION | ADOLESCENTS, MALE | YOUTH | MULTIPLE PARTNERS | FIRST INTERCOURSE | SEXUALLY TRANSMITTED DISEASES | SIGNS AND SYMPTOMS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Health | Data Analysis | Research Methodology | Adolescents | Age Factors | Population Characteristics | Demographic Factors | Population | Sexual Partners | Sex Behavior | Behavior | Reproductive Tract Infections | Infections | Diseases
Document Number: 341447

20.
Title: [Chlamydia trachomatis and Neisseria gonorrhoeae among women in a family planning clinic] Infeccao por Chlamydia trachomatis e Neisseria gonorrhoeae em mulheres atendidas
Author: Fernandes AM; Daher G; Nuzzi RX; Petta CA
Source: Revista Brasileira De Ginecologia E Obstetricia. 2009 May;31(5):235-40.
Abstract: PURPOSE: to study infection prevalence by Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG), among adolescent and young women in a family planning outpatient clinic. METHODS: a total of 230 women up to 24 years old and history of up to four sexual partners have been followed-up for 48 months, with urine collection to search CT and NG, by the polymerase chain reaction method at the 1st, 12nd, 24th, 36th and 48th months. The variables studied were age group, schooling, marital status, number of gestations, abortions and children alive, age at the onset of sexual life, previous and present use of condom, previous use of intrauterine device, number of sexual partners in the previous six months and follow-up time. Bivariate analysis of variables according to positive tests for CT and NG, and multiple analyses by logistic regression were done. RESULTS: the ratio of infections by CT was 13.5% and by NG, 3%. Two women presented both tests as positive. The previous intrauterine device use was associated with positive tests for NG. CONCLUSIONS: the prevalence of infections by CT and NG was higher among the age group studied and the screening of young women must be taken into consideration in our services, to control the dissemination of sexually transmitted diseases and prevention of sequels.
Language: Portuguese
Keywords:
DEVELOPING COUNTRIES | RESEARCH REPORT | PREVALENCE | WOMEN | ADOLESCENTS, FEMALE | CHLAMYDIA | LABORATORY PROCEDURES | SEXUALLY TRANSMITTED DISEASES | Measurement | Research Methodology | Demographic Factors | Population | Adolescents | Youth | Age Factors | Population Characteristics | Reproductive Tract Infections | Infections | Diseases | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 342470

21.
Peer Reviewed

Title: Adapting a multifaceted U.S. HIV prevention education program for girls in Ghana.
Author: Fiscian VS; Obeng EK; Goldstein K; Shea JA; Turner BJ
Source: AIDS Education and Prevention. 2009;21(1):67-79.
Abstract: A U.S. HIV prevention program was adapted to address knowledge gaps and cultural pressures that increase the risk of infection in adolescent Ghanaian girls. The theory-based nine-module HIV prevention program combines didactics and games, an interactive computer program about sugar daddies, and tie-and-dye training to demonstrate an economic alternative to transactional sex. The abstinence-based study was conducted in a church-affiliated junior secondary school in Nsawam, Ghana. Of 61 subjects aged 10-14 in the prevention program, over two thirds were very worried about becoming HIV infected. A pre-post evaluation of the intervention showed significant gains in three domains: HIV knowledge (p = .001) and self efficacy to discuss HIV and sex with men (p < .001) and with boys (p < .001). Responses to items about social norms of HIV risk behavior were also somewhat improved (p = .09). Subjects rated most program features highly. Although short-term knowledge and self-efficacy to address HIV improved significantly, longer term research is needed to address cultural and economic factors placing young women at risk of HIV infection. (author's)
Language: English
Keywords:
GHANA | UNITED STATES OF AMERICA | EVALUATION REPORT | THEORETICAL MODELS | KAP SURVEYS | ADOLESCENTS, FEMALE | WOMEN IN DEVELOPMENT | SEX WORKERS | HIV PREVENTION | SEX EDUCATION | KNOWLEDGE | COMPUTER PROGRAMS AND PROGRAMMING | SELF ESTEEM | RISK BEHAVIOR | PARTNER COMMUNICATION | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Developed Countries | North America | Americas | Evaluation | Research Methodology | Surveys | Sampling Studies | Studies | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | Sex Behavior | Behavior | HIV Infections | Viral Diseases | Diseases | Education | Sociocultural Factors | Information Processing | Information | Psychological Factors | Interpersonal Relations
Document Number: 325287

22.

Peer Reviewed

Title: Adapting a multifaceted U.S. HIV prevention education program for girls in Ghana.
Author: Fiscian VS; Obeng EK; Goldstein K; Shea JA; Turner BJ
Source: AIDS Education and Prevention. 2009 Feb;21(1):67-79.
Abstract: We adapted a U.S. HIV prevention program to address knowledge gaps and cultural pressures that increase the risk of infection in adolescent Ghanaian girls. The theory-based nine-module HIV prevention program combines didactics and games, an interactive computer program about sugar daddies, and tie-and-dye training to demonstrate an economic alternative to transactional sex. The abstinence-based study was conducted in a church-affiliated junior secondary school in Nsawam, Ghana. Of 61 subjects aged 10-14 in the prevention program, over two thirds were very worried about becoming HIV infected. A pre-post evaluation of the intervention showed significant gains in three domains: HIV knowledge (p = .001) and self efficacy to discuss HIV and sex with men (p < .001) and with boys (p < .001). Responses to items about social norms of HIV risk behavior were also somewhat improved (p = .09). Subjects rated most program features highly. Although short-term knowledge and self-efficacy to address HIV improved significantly, longer term research is needed to address cultural and economic factors placing young women at risk of HIV infection.
Language: English
Keywords:
UNITED STATES OF AMERICA | GHANA | EVALUATION REPORT | THEORETICAL MODELS | ADOLESCENTS, FEMALE | SUGAR DADDIES | SEX WORKERS | FAITH-BASED ORGANIZATION | HEALTH EDUCATION | SEX EDUCATION | HIV PREVENTION | CULTURE | COMPUTER PROGRAMS AND PROGRAMMING | ABSTINENCE | BEHAVIOR CHANGE COMMUNICATION | Developed Countries | North America | Americas | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Evaluation | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Sex Behavior | Behavior | Organizations | Political Factors | Sociocultural Factors | Education | HIV Infections | Viral Diseases | Diseases | Information Processing | Information | Family Planning, Behavioral Methods | Family Planning | Communication Programs | Communication | Behavior Change
Document Number: 331081

23.

Title: Comparison of Sexual Partnership Characteristics and Associations with Inconsistent Condom Use among a Sample of Adolescents and Adult Women Diagnosed with Chlamydia trachomatis.
Author: Foulkes HB; Pettigrew MM; Livingston KA; Niccolai LM
Source: Journal of Women's Health. 2009;18(3):393-399.
Abstract: Abstract Background: This analysis compared characteristics of female adolescent and adult sexual partnerships and related these characteristics to inconsistent condom use. Methods: Data are from a study of 126 women with prevalent chlamydia infections who reported information about 172 sexual partnerships in the previous 3 months. Characteristics of sexual partnerships included type of partner (main vs. other), duration of sexual relationship (<3 months vs. >/=3 months), partner age difference (<2 years older vs. >/=2 years older), and two scale measures: overlap of social networks (a measure based on how well the participant knew her partner's friends, for example) and intimacy. Results: Compared with adult partnerships, adolescent partnerships were of shorter duration and had less social overlap but were more likely to be classified by the participants as main partnerships. Among adolescents, longer partnership duration was not associated with higher intimacy, yet higher intimacy was significantly correlated with inconsistent condom use. Conclusions: These differences suggest that adolescent females perceive and characterize their sexual relationships differently from adults. This, in turn, may have implications for risk of sexually transmitted infections (STIs). Prevention efforts for adolescents, including interventions and counseling, should consider the nature of their sexual partnerships.
Language: English
Keywords:
CONNECTICUT | RESEARCH REPORT | KAP SURVEYS | COMPARATIVE STUDIES | CONTRACEPTIVE PREVALENCE SURVEYS | SEXUAL PARTNERS | ADOLESCENTS, FEMALE | WOMEN | SOCIAL NETWORKS | CONDOM USE | CHLAMYDIA | AGE FACTORS | TIME FACTORS | PERCEPTION | SEX BEHAVIOR | Developed Countries | United States of America | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Family Planning Surveys | Family Planning | Behavior | Adolescents | Youth | Population Characteristics | Demographic Factors | Population | Friends and Relatives | Family and Household | Sociocultural Factors | Risk Reduction Behavior | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Population Dynamics | Psychological Factors
Document Number: 330416

24.

25.

Title: Contraceptive attitudes among inner-city African American female adolescents: Barriers to effective hormonal contraceptive use.
Author: Gilliam ML; Davis SD; Neustadt AB; Levey EJ
Source: Journal of Pediatric and Adolescent Gynecology. 2009 Apr;22(2):97-104.
Abstract: STUDY OBJECTIVE: To better understand the contraceptive attitudes of low-income, inner-city African American female adolescents. DESIGN: We conducted four focus group sessions with African American female adolescents. SETTING: An urban, community health clinic serving low-income patients on Chicago's south side. PARTICIPANTS: African American female adolescents (n = 15) between 14 and 19 years of age. INTERVENTIONS: Focus group sessions lasting approximately 90 minutes in length were conducted using a pre-determined script with set probes and open-ended questions. MAIN OUTCOME MEASURES: Qualitative analysis was conducted to identify major themes related to adolescents' contraceptive attitudes. RESULTS: Six themes related to the contraceptive attitudes of these adolescents emerged: Concerns About Hormones, Concerns About Privacy, Concerns About Compliance, Limited Awareness of New Methods of Hormonal Contraception (HC), Preference for Condoms, and Acceptability of Emergency Contraception (EC). Overall, adolescents in these sessions expressed skepticism and unwillingness to use continuous methods of HC. For some adolescents, concerns about hormones, privacy, and compliance outweighed their concerns about pregnancy. CONCLUSION: Concerns about perceived side effects and long-term health risks associated HC and privacy in obtaining contraception and reproductive health care, as well as concerns about ability to comply with daily and weekly HC regimens are common among African American female adolescents and may deter consistent HC use. Although condoms and EC appear to be highly acceptable among this group, adolescents also report a number of barriers to their consistent use. Efforts to reduce early, unintended pregnancy among African American youth should focus on addressing adolescents' HC-related concerns, improving access to EC, and helping female adolescents effectively negotiate condom use.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | FOCUS GROUPS | BLACKS | LOW INCOME POPULATION | ADOLESCENTS, FEMALE | URBAN POPULATION | ATTITUDES | CONTRACEPTIVE SAFETY | PRIVACY | CONTRACEPTION CONTINUATION | CONDOM USE | CONTRACEPTIVE METHODS | KNOWLEDGE | EMERGENCY CONTRACEPTION | Developed Countries | North America | Americas | Data Collection | Research Methodology | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Adolescents | Youth | Age Factors | Psychological Factors | Behavior | Safety | Public Health | Health | Contraceptive Usage | Contraception | Family Planning | Risk Reduction Behavior | Sociocultural Factors
Document Number: 330953

26.

Title: Extended cycling or continuous use of hormonal contraceptives for female adolescents.
Author: Gold MA; Duffy K
Source: Current Opinion In Obstetrics and Gynecology. 2009 Jun 12;
Abstract: PURPOSE OF REVIEW: The purpose of this review is to present the most recent data on extended cycling and continuous use of hormonal contraception for female adolescents. RECENT FINDINGS: Since 2003, several new products have been US Food and Drug Administration approved to provide extended cycling or continuous use of hormonal contraception. Clinical trials have been conducted with adult women of 18 years and older and not with adolescents under age of 18 years. Studies find successful menstrual suppression using extended cycling and continuous-use regimens that are safe and effective without negative effects on the endometrium or hemostasis. Extended cycling and continuous use improves menstrual symptoms attributed to the hormone-free interval in traditional cyclic regimens. Adolescent health providers report prescribing extended cycles of contraception with increasing frequency to adolescents. It is unknown how well female adolescents tolerate breakthrough bleeding, but data suggest that bleeding is the main reason for discontinuing. Supplementation with intermittent estrogen or instituting a 4-day hormone-free interval in response to persistent bleeding may decrease this side effect; adolescents should be counseled about these options. SUMMARY: Extended cycling or continuous use of hormonal contraception offers adolescents an opportunity to decrease, delay or suppress monthly menstruation for health or personal reasons.
Language: English
Keywords:
UNITED STATES OF AMERICA | CRITIQUE | ADOLESCENTS, FEMALE | CONTRACEPTIVE METHODS | HORMONES | ADMINISTRATION AND DOSAGE | MENSTRUATION | PRODUCT APPROVAL | USFDA | COUNSELING | CONTRACEPTIVE SAFETY | CONTRACEPTIVE AGENTS, SIDE EFFECTS | Developed Countries | North America | Americas | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Contraception | Family Planning | Endocrine System | Physiology | Biology | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Reproduction | Legislation | Political Factors | Sociocultural Factors | USPHS | Government Agencies | Organizations | Clinic Activities | Program Activities | Programs | Organization and Administration | Safety | Public Health | Contraceptive Agents
Document Number: 341708

27.

Peer Reviewed

Title: Lack of utility of risk score and gynecological examination for screening for sexually transmitted infections in sexually active adolescents.
Author: Guimaraes EM; Guimaraes MD; Vieira MA; Bontempo NM; Seixas MS; Garcia MS; Daud LE; Cortes RL; Alves Mde F
Source: BMC Medicine. 2009;7:8.
Abstract: BACKGROUND: Sexually transmitted infections constitute the main health risk among adolescents. In developing countries the diagnosis and treatment of cervical infections is based on the syndromic approach. In this study we estimated the prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae among female adolescents from a Health Sector of the city of Goiania, Brazil, and validated cervicitis diagnosis using World Health Organization/Ministry of Health risk score and gynecological examination. METHODS: A cross-sectional community-based sample of 914 15- to 19-year-old female teenagers was randomly selected and referred to the local Family Health Program. Of these, 472 (51.6%) were sexually active and gynecological examinations were carried out for 427. Endocervical samples were collected to perform the polymerase chain reaction for C. trachomatis and N. gonorrhoeae. Performance of risk score, the presence of mucopurulent discharge, friability, ectopia and pain during cervical maneuver were compared with the presence of C. trachomatis or N. gonorrhoeae or both. RESULTS: The prevalence of C. trachomatis and N. gonorrhoeae was 14.5% and 2.1%, respectively. The risk score had a specificity of 31.9% (95% confidence interval, 21.2 to 44.2) and a positive predictive value of 20.8% (95% confidence interval, 13.5 to 29.7). Friability was the component of the gynecological examination that presented the best performance with a sensitivity of 43.5%, specificity of 81.0%, and 30.6% of positive predictive value. CONCLUSION: The prevalence of infection by C. trachomatis and N. gonorrhoeae was high among these sexually active adolescents. The syndromic approach is clearly inadequate for screening and treating these infections in this population. Therefore, the implantation of other strategies to control these infections among adolescents is urgently required.
Language: English
Keywords:
BRAZIL | RESEARCH REPORT | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | CROSS SECTIONAL ANALYSIS | ADOLESCENTS, FEMALE | URBAN POPULATION | RISK ASSESSMENT | SEX BEHAVIOR | GYNECOLOGY | CERVICAL EFFECTS | PREVALENCE | CHLAMYDIA | GONORRHEA | SIGNS AND SYMPTOMS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Evaluation | Behavior | Medicine | Health Services | Delivery of Health Care | Health | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Measurement | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases
Document Number: 331079

28.

Title: Bone Accretion in Adolescents Using the Combined Estrogen and Progestin Transdermal Contraceptive Method Ortho Evra: A Pilot Study.
Author: Harel Z; Riggs S; Vaz R; Flanagan P; Harel D; Machan JT
Source: Journal of Pediatric and Adolescent Gynecology. 2009 Jul 30;
Abstract: OBJECTIVE: To date, there are no data regarding the effect of the transdermal combined estrogen and progestin contraceptive Ortho Evra on bone mineral content (BMC) and bone mineral density (BMD). We examined the effects of transdermally delivered ethinyl estradiol and norelgestromin on whole body (WB) BMC and BMD of the hip and lumbar spine (LS) of adolescent girls. METHODS: In a matched case-control study, girls (n=5) who applied Ortho Evra for days 1-21 followed by days 22-28 free of medication for 13 cycles (about 12 months) were compared with 5 age- and ethnicity-matched control girls. Evaluations of calcium intake; bone-protective physical activity; bone densitometry (DXA, QDR 4500A, Hologic); bone formation markers serum osteocalcin (OC) and bone-specific alkaline phosphatase (BAP); bone resorption marker urinary N-telopeptide (uNTX); insulin growth factor-1 (IGF-1); and sex hormone binding globulin (SHBG) were carried out at initiation, 6 months, and 12 months. Changes from baseline were compared using mixed models, adjusting for follow-up comparisons using the Holm Test (sequential Bonferroni). RESULTS: There were no significant differences (SD) between groups at baseline in age, gynecologic age, WBBMC, hip BMD, and LSBMD. Girls on Ortho Evra did not change significantly in WBBMC (12-month mean increase 0.2% +/- 0.8%), whereas controls did (3.9% +/- 1.8%, P Language: English
Keywords:
UNITED STATES OF AMERICA | RHODE ISLAND | RESEARCH REPORT | CONTROL GROUPS | ADOLESCENTS, FEMALE | CONTRACEPTIVE AGENTS, ESTROGEN | LOW-DOSE PROGESTINS | BIODEGRADABLE DELIVERY SYSTEMS | ETHINYL ESTRADIOL | CONTRACEPTIVE AGENTS, SIDE EFFECTS | SKELETAL EFFECTS | BODY WEIGHT | Developed Countries | North America | Americas | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Methods | Physiology | Biology
Document Number: 342419

29.

Title: The effects of hormonal contraceptives on bone turnover markers and bone health.
Author: Herrmann M; Seibel MJ
Source: Clinical Endocrinology. 2009 Sep 9;
Abstract: Abstract Sex hormones are important regulators of bone metabolism. As hormonal contraceptives contain either estrogens or progestins, or a combination thereof, it is conceivable that these widely used agents have an effect on bone metabolism and bone health. The main users of hormonal contraceptives, adolescent girls and young women, are still building bone and accruing bone mass and may therefore be particularly susceptible to the effects of hormonal contraceptives on bone. Despite these concerns, the effects of hormonal contraceptives on bone health are still poorly understood. As biochemical markers of bone turnover have been proven useful tools in the assessment and monitoring of bone metabolism, we reviewed the effects of combined and gestagen-only hormonal contraceptives on bone turnover markers and related effects on bone mineral density and fracture risk in premenopausal women, as documented in the literature until January 2009.
Language: English
Keywords:
AUSTRALIA | RESEARCH REPORT | LITERATURE REVIEW | WOMEN | ADOLESCENTS, FEMALE | SKELETAL EFFECTS | ORAL CONTRACEPTIVES | ORAL CONTRACEPTIVES, COMBINED | Oceania | Developed Countries |