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Strong J. "Even when you write with a pencil there is an eraser to clean it": Examining men's conceptualisations of and involvement in emergency contraceptive use in Accra, Ghana. Soc Sci Med 2024; 344:116635. [PMID: 38324975 DOI: 10.1016/j.socscimed.2024.116635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 12/01/2023] [Accepted: 01/25/2024] [Indexed: 02/09/2024]
Abstract
Emergency contraceptive pills are an essential and unique post-coital method to avoid a pregnancy, with evidence showing the significant role men can have in procurement and decisions to use. Global Health recommendations specify that emergency contraceptive pills be used sparingly and under specific conditions. This increasingly misaligns with the myriad conceptualisations and rationales among the public for why they choose to use emergency contraceptive pills. There has been a paucity of research aiming to understanding men's involvement and how they shape women's access, choice, and autonomy. This study interrogates how emergency contraceptive pills are conceptualised by men in James Town, Ghana, and how this intersects with their motivations to be involved in its use. Mixed method data from a survey (n = 270) and in-depth interviews (n = 37) were collected between July 2020 and January 2021. The analysis examines men's framings of emergency contraceptive pills and how these shape their involvement in its use. Men's knowledge of post-coital contraceptives was high, while knowledge of the specific term 'emergency contraception' was lower. While some men understood the pills in ways that aligned to Global Health framings, many more men saw emergency contraceptive pills as another means of pregnancy prevention in line with other contraceptives. This included its conceptualisation as a contraceptive that facilitates pleasurable (condomless) and spontaneous sex. Gendered perceptions of women who use emergency contraceptive pills were bound in sexual stigma, and men indicated that emergency contraceptive pills were a directly observable form of contraception that they could pressure their partner into using. Understanding plural conceptualisations away from 'emergency' are necessary to create policies and programmes that account for men's involvement. This includes understanding how emergency contraceptive pills are located within people's sexual and reproductive lives and gendered power dynamics, to reflect the public's own rationales for and experiences using post-coital contraceptives.
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Affiliation(s)
- Joe Strong
- Department of Social Policy, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK.
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Alibrahim H, Bohsas H, Swed S, Nasif MN, Siddiq A, Msallam H, Jabban YKE, Almoshantaf MB, Jawed HA, Aswad M, Hallak N, Kasem R, Sawaf B, Elbialy I, Gabr IGM, Abazid RR, Munawar F, Ahmed AB, Elsaadouni NM, Shalaby NY, Hafez W. Emergency Contraception Knowledge, Attitudes, and Barriers Among Men: A Cross-Sectional Study. Cureus 2024; 16:e51937. [PMID: 38333452 PMCID: PMC10851918 DOI: 10.7759/cureus.51937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2024] [Indexed: 02/10/2024] Open
Abstract
Background Emergency contraception (EC) plays a pivotal role in the prevention of unintended pregnancies following unprotected sexual intercourse. Men's awareness regarding emergency contraception is pivotal for informed decision-making and for enhancing reproductive health in this context. This study investigated Syrian men's awareness and perspectives on emergency contraception to inform diverse reproductive health initiatives. Methods We conducted a cross-sectional study in Syria, from June 2022 and April 2023. Our study included male participants aged 18 years or older who held Syrian nationality and volunteered to participate. The data collection involved administering a questionnaire comprising three sections (knowledge, attitude, and barrier assessment), encompassing a total of 30 questions. Data analysis was performed using the Statistical Package for Social Sciences (SPSS) (IBM SPSS Statistics, Armonk, NY). Results Most participants were aged 18-25 (65.7%) and single (75.4%) and held a university degree (79.3%). The knowledge of emergency contraception was low (36.1%), with the Internet and social media (77.5%) being the primary sources of information. While 89% held positive attitudes toward emergency contraception, only 37.3% supported nonprescription availability. Age, income, and desire for children were associated with knowledge, attitudes, and the use of emergency contraception. Men aged 26-35 exhibited the highest positive attitude (8.11±1.83). Those desiring no children showed higher attitude scores (7.42±2.04). Income was positively associated with knowledge (adjusted odds ratio {AOR}=1.75 and confidence interval {CI}=1.02-2.99) and emergency contraception use (AOR=2.87 and CI=1.27-6.48). Conclusion This study underscores the knowledge gap regarding emergency contraception in Syrian men. Despite positive attitudes, awareness remains limited, particularly among those of childbearing age. Targeted education and improved accessibility to emergency contraception can enhance its use among men, particularly in those with low socioeconomic status and younger age groups.
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Affiliation(s)
- Hidar Alibrahim
- Department of Internal Medicine, University of Aleppo, Aleppo, SYR
| | | | - Sarya Swed
- Department of Medicine, University of Aleppo, Aleppo, SYR
| | - Mohamad Nour Nasif
- Department of Laboratory Medicine, Faculty of Medicine, University of Aleppo, Aleppo, SYR
| | | | | | | | | | - Hira A Jawed
- Department of Internal Medicine, Aga Khan Health Services, Karachi, PAK
| | - Moudar Aswad
- Faculty of Medicine, Tishreen University, Latakia, SYR
| | - Nadim Hallak
- Faculty of Medicine, Tishreen University, Latakia, SYR
| | - Razan Kasem
- Faculty of Medicine, University of Aleppo, Aleppo, SYR
| | - Bisher Sawaf
- Department of Internal Medicine, Faculty of Medicine, Syrian Private University, Damascus, SYR
| | - Ibrahim Elbialy
- Department of General Medicine, Burjeel Hospital, Abu Dhabi, ARE
| | | | - Reem Rizk Abazid
- Department of Obstetrics and Gynecology, New Medical Centre (NMC) Royal Hospital, Abu Dhabi, ARE
| | - Farida Munawar
- Department of Obstetrics and Gynecology, New Medical Centre (NMC) Royal Hospital, Abu Dhabi, ARE
| | - Azza Bakr Ahmed
- Department of Internal Medicine, Ain Shams General Hospital, Ain Shams, EGY
- Department of Internal Medicine, NMC Royal Hospital, Khalifa City, ARE
| | | | | | - Wael Hafez
- Department of Internal Medicine, National Research Centre, Cairo, EGY
- Department of Internal Medicine, New Medical Centre (NMC) Royal Hospital, Abu Dhabi, ARE
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Nguyen BT, Violette C, Li HZ, Jensen JT. Expectations for Sex without Birth Control among Young Men: Risk Factors from the USA National Survey of Reproductive and Contraceptive Knowledge. World J Mens Health 2019; 38:573-581. [PMID: 31749339 PMCID: PMC7502322 DOI: 10.5534/wjmh.190098] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 09/16/2019] [Accepted: 09/30/2019] [Indexed: 11/15/2022] Open
Abstract
Purpose Male partner engagement in family planning can influence women's contraceptive behaviors and risk of unintended pregnancy. We identified factors associated with self-reported expectations for future contraceptive use among a nationally-representative sample of young men. Materials and Methods The National Survey of Reproductive and Contraceptive Knowledge asked unmarried, sexually active men (ages, 18–29 y), who were neither involved in nor trying for a pregnancy, about their likelihood of having sex without contraception in the following three months. Demographics, social factors, and contraceptive awareness and attitudes were examined for potential associations using weighted analyses. Results Of 903 men surveyed, nearly 600 were sexually active and expected to have sex in the following 3 months; nearly half (43%) reported at least some likelihood (23% slightly, 7% very, 13% extreme likely) that they would have sex without any contraception. Factors independently associated with sex without contraception included: not completing high school, not being in school full-time, not receiving sex education, limited awareness of contraceptive methods, multiple sexual partners, and friends with unintended pregnancies. Conclusions Despite not wanting a pregnancy, many young men report they will have sex without contraception. While comprehensive sex education may increase contraceptive use, interpersonal and social factors also influence men's expected use of contraception.
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Affiliation(s)
- Brian T Nguyen
- Section of Family Planning, Department of Obstetrics and Gynecology, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.,Department of Obstetrics and Gynecology, Oregon Health & Sciences University, Portland, OR, USA.
| | | | - Hong Z Li
- Department of Obstetrics and Gynecology, Oregon Health & Sciences University, Portland, OR, USA
| | - Jeffrey T Jensen
- Department of Obstetrics and Gynecology, Oregon Health & Sciences University, Portland, OR, USA
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Zin NM, Ishak I, Manoharan K. Knowledge, attitude and practice towards sexually transmitted diseases amongst the inmates of women shelters homes at Klang Valley. BMC Public Health 2019; 19:639. [PMID: 31196029 PMCID: PMC6565535 DOI: 10.1186/s12889-019-6863-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background Previous studies show that there is a changing trend of sexual and reproductive behaviour among youth and this requires more attention and awareness especially on sexually transmitted diseases (STD). This study was carried out to evaluate the knowledge, attitude and practice of sexually transmitted diseases among selected inmates of women shelter homes. Methods A cross-sectional study was carried out by involving 60 participants whom aged in between 13 to 25 years old. The questionnaires were developed in ‘Bahasa Melayu’ and it has been anonymous guided questionnaires. Results The result showed that the mean age of the participants was 17.9 years old and most of the participants have completed secondary school (91.7%). Overall, the level of knowledge of participants on STDs were classified into three groups; ‘high knowledge’ (33.3%), ‘medium knowledge’ (35.0%) and ‘low knowledge’ (31.7%). The majority have heard of HIV/AIDS (95%) but with respect to other STDs was less well known. Whereas, the mean score for attitude was 23.1 out total 25. Their knowledge level was not influenced by their age (p = 0.61) and socio-economic status (p = 0.85). However, their attitude was influenced by their age (p < 0.05). Conclusion Knowledge on non-HIV STDs is still lacking and risky behaviours have been practiced. Although there were high level of knowledge and attitude among them but their practice on sexuality contradicts it especially on contraceptive use and pre-marital sex.
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Affiliation(s)
- Noraziah Mohamad Zin
- Centre of Healthy Aging and Wellness, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia.
| | - Ismarulyusda Ishak
- Centre for Health and Applied Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Kasturi Manoharan
- Centre for Health and Applied Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
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Lévesque S, Rodrigue C, Beaulieu-Prévost D, Blais M, Boislard MA, Lévy JJ. Intimate partner violence, sexual assault, and reproductive health among university women. CANADIAN JOURNAL OF HUMAN SEXUALITY 2016. [DOI: 10.3138/cjhs.251-a5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Relationships between victimization, termination of pregnancy (ToP), diagnosis of sexually transmitted infection (STI), and emergency contraceptive use were examined using data from a survey of university students in Montreal, Canada. Female students who had been sexually active in the past two years with at least one male partner were included (n=1,812). Victimization experiences were assessed, and logistic regressions were performed to predict the correlates of lifetime use of emergency contraception, ToP, and ever having been diagnosed with an STI. In this sample, 36.1% reported intimate partner violence (IPV), 8.5% reported sexual assault (SA) and 18.9% reported both SA and IPV. Factors statistically associated with emergency contraceptive use, ToP and STI diagnosis were older age, financial hardship, migratory trajectory, early sexual initiation, and dual victimization. These data indicate that the reproductive health needs of female university students experiencing victimization are unmet. Interventions should focus on victimization screening and enhancing reproductive autonomy.
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Affiliation(s)
- Sylvie Lévesque
- Sexology Department, Université du Québec à Montréal, Montréal, QC
| | - Carl Rodrigue
- Sexology Department, Université du Québec à Montréal, Montréal, QC
| | | | - Martin Blais
- Sexology Department, Université du Québec à Montréal, Montréal, QC
| | | | - Joseph J. Lévy
- Sexology Department, Université du Québec à Montréal, Montréal, QC
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McMahon JM, Volpe EM, Klostermann K, Trabold N, Xue Y. A systematic review of the psychometric properties of the Sexual Relationship Power Scale in HIV/AIDS research. ARCHIVES OF SEXUAL BEHAVIOR 2015; 44:267-94. [PMID: 25331613 PMCID: PMC4324007 DOI: 10.1007/s10508-014-0355-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Revised: 01/29/2014] [Accepted: 04/22/2014] [Indexed: 05/20/2023]
Abstract
The Sexual Relationship Power Scale (SRPS) was developed over a decade ago to address the lack of reliable and valid measures of relationship power in social, behavioral and medical research. The SRPS and its two subscales (relationship control [RC], decision-making dominance [DMD]) have been used extensively in the field of HIV prevention and sexual risk behavior. We performed a systematic review of the psychometric properties of the SRPS and subscales as reported in the HIV/AIDS literature from 2000 to 2012. A total of 54 published articles were identified, which reported reliability or construct validity estimates of the scales. Description of the psychometric properties of the SRPS and subscales is reported according to study population, and several cross-population trends were identified. In general, the SRPS and RC subscale exhibited sound psychometric properties across multiple study populations and research settings. By contrast, the DMD subscale had relatively weak psychometric properties, especially when used with specific populations and research settings. Factors that influenced the psychometric properties of the various scales and subscales included the study population, mean age of the sample, number of items retained in the scale, and modifications to the original scales. We conclude with recommendations for (1) the application and use of the SRPS and subscales, (2) reporting of psychometric properties of the scales in the literature, and (3) areas for future research.
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Affiliation(s)
- James M McMahon
- School of Nursing, University of Rochester Medical Center, 601 Elmwood Ave., Box SON, Rochester, NY, 14642, USA,
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Upadhyay UD, Dworkin SL, Weitz TA, Foster DG. Development and validation of a reproductive autonomy scale. Stud Fam Plann 2014; 45:19-41. [PMID: 24615573 DOI: 10.1111/j.1728-4465.2014.00374.x] [Citation(s) in RCA: 105] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
No validated measures are currently available to assess women's ability to achieve their reproductive intentions, also referred to as "reproductive autonomy." We developed and validated a multidimensional instrument that can measure reproductive autonomy. We generated a pool of 26 items and included them in a survey that was conducted among 1,892 women at 13 family planning and 6 abortion facilities in the United States. Fourteen items were selected through factor analysis and grouped into 3 subscales to form a Reproductive Autonomy Scale: freedom from coercion; communication; and decision-making. Construct validity was demonstrated by a mixed-effects model in which the freedom from coercion subscale and the communication subscale were inversely associated with unprotected sex in the past three months. This new Reproductive Autonomy Scale offers researchers a reliable instrument with which to assess a woman's power to control matters regarding contraceptive use, pregnancy, and childbearing, and to evaluate interventions to increase women's autonomy domestically and globally.
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Affiliation(s)
- Ushma D Upadhyay
- Assistant Professor, Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, 1330 Broadway, Suite 1100, Oakland, CA 94612.
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Volpe EM, Hardie TL, Cerulli C, Sommers MS, Morrison-Beedy D. What's age got to do with it? Partner age difference, power, intimate partner violence, and sexual risk in urban adolescents. JOURNAL OF INTERPERSONAL VIOLENCE 2013; 28:2068-87. [PMID: 23345572 PMCID: PMC3706999 DOI: 10.1177/0886260512471082] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Adolescent girls with older male main partners are at greater risk for adverse sexual health outcomes than other adolescent girls. One explanation for this finding is that low relationship power occurs with partner age difference. Using a cross-sectional, descriptive design, we investigated the effect of partner age difference between an adolescent girl and her male partner on sexual risk behavior through the mediators of sexual relationship power, and physical intimate partner violence (IPV), and psychological IPV severity. We chose Blanc's framework to guide this study as it depicts the links among demographic, social, economic, relationship, family and community characteristics, and reproductive health outcomes with gender-based relationship power and violence. Urban adolescent girls (N = 155) completed an anonymous computer-assisted self-interview survey to examine partner and relationship factors' effect on consistent condom use. Our sample had an average age of 16.1 years with a mean partner age of 17.8 years. Partners were predominantly African American (75%), non-Hispanic (74%), and low-income (81%); 24% of participants reported consistent condom use in the last 3 months. Descriptive, correlation, and multiple mediation analyses were conducted. Partner age difference was negatively associated with consistent condom use (-.4292, p < .01); however, the indirect effects through three proposed mediators (relationship power, physical IPV, or psychological IPV severity) were not statistically significant. Further studies are needed to explore alternative rationale explaining the relationship between partner age differences and sexual risk factors within adolescent sexual relationships. Nonetheless, for clinicians and researchers, these findings underscore the heightened risk associated with partner age differences and impact of relationship dynamics on sexual risk behavior.
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Affiliation(s)
- Ellen M Volpe
- School of Nursing, Buffalo, University of Buffalo, Wende Hall, Room 325, 3435 Main St. Buffalo, NY 14214, USA.
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Wong LP. An exploration of knowledge, attitudes and behaviours of young multiethnic Muslim-majority society in Malaysia in relation to reproductive and premarital sexual practices. BMC Public Health 2012; 12:865. [PMID: 23057505 PMCID: PMC3497870 DOI: 10.1186/1471-2458-12-865] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Accepted: 10/10/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The increasing trend of premarital sexual experience and unintended pregnancies in Malaysia warrants sustained and serious attention. The sensitivities of sex-related issues in a Muslim-majority country create various types of barriers to sexual and reproductive health information, support and practices. This study aims to gain understanding of knowledge, attitudes and behaviours of young women in Malaysia concerning reproductive, contraception and premarital sexual practices. METHODS A cross-sectional study was performed, using an anonymous self-administered questionnaire carried out among 1695 female university students in a public university in Malaysia. RESULTS Respondents had low scores for knowledge of reproduction and pregnancy (median=4, of maximum score 10), contraceptive uses (median=6, of maximum score 16) and contraceptive availability (median=3, of maximum score 13). The majority of women surveyed do not have liberal values in relation to premarital sexual behaviour (median=37, of maximum 40); higher scores on this scale corresponded to opposing premarital sex. The multivariate analyses showed that ethnic group was the strongest correlate of knowledge and attitude scores; being of Malay Muslim ethnicity was associated significantly with lower knowledge scores and premarital sex permissiveness. Other significant correlates were year of study, maternal occupational groups, level of religious faith, dating status and urban-rural localities. Level of premarital sex permissiveness was inversely correlated with reproduction and pregnancy knowledge score, and contraceptive knowledge scores. CONCLUSION Reproductive health knowledge and attitudes were intricately linked to religious values and cultural norms differences surrounding sexual issues.
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Affiliation(s)
- Li Ping Wong
- Centre of Population Health, Department of Social and Preventive Medicine, University of Malaya, Kuala Lumpur, Malaysia.
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Marcell AV, Waks AB, Rutkow L, McKenna R, Rompalo A, Hogan MT. What do we know about males and emergency contraception? A synthesis of the literature. PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2012; 44:184-193. [PMID: 22958663 DOI: 10.1363/4418412] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
CONTEXT Unintended pregnancy rates are high in the United States. It is important to know whether improving males' access to emergency contraceptive pills may help prevent unintended pregnancy, especially in cases of -condom failure. METHODS A search of the PubMed, PsycINFO and Cumulative Index of Nursing and Allied Health Literature databases was conducted to identify studies published from January 1980 to April 2011 concerning males and emergency contraception. Forty-three studies met the specified criteria and examined relevant knowledge, attitudes, beliefs, intentions or behaviors, from the perspectives of males, clinicians or pharmacists. RESULTS The proportion of males who were familiar with emergency contraception ranged from 38% among teenagers to 65-100% among adults. Small proportions reported that they and their partner had used or discussed using emergency contraceptive pills (13-30%) or that they themselves had ever purchased them (11%). Most providers (77-85%) reported general knowledge about emergency contraceptives, but the proportions who knew the time frame within which the pills can be prescribed were smaller (28-63%). Most males approved of emergency contraceptive use following contraceptive failure (74-82%) or unprotected sex (59-65%), or in cases of rape (85-91%), but both pharmacists and college students reported concerns that females might feel pressured to use the method. No study examined clinicians' attitudes and behaviors (e.g., counseling or advance provision) regarding males and emergency contraception. CONCLUSIONS Studies are needed to determine whether male involvement in emergency contraception can reduce rates of unintended pregnancy and to assess health professionals' ability to counsel males about the method.
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Affiliation(s)
- Arik V Marcell
- Department of Pediatrics, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Warren JT, Harvey SM, Bovbjerg ML. Characteristics related to effective contraceptive use among a sample of nonurban Latinos. PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2011; 43:255-262. [PMID: 22151513 DOI: 10.1363/4325511] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
CONTEXT A better understanding of effective contraceptive use among Latinos is needed to reduce their high rate of unintended pregnancy. Most research has focused on urban Latinas and has overlooked the relationship context of effective contraceptive use. METHODS Interviews were conducted among a sample of 450 Latino women and men aged 18-25 in sexual relationships, who were recruited from community sites in four rural Oregon counties in 2006. Bivariate and multinomial logistic regression analyses were used to examine the associations between effective contraceptive use and -individual, cultural and relationship characteristics. RESULTS Half of participants reported effective contraceptive use in their primary relationships: Thirty-six percent consistently used a female method, and 15% consistently used condoms. Acculturation and confidence in one's -ability to practice contraception with a primary partner were associated with female method use rather than no effective use (risk ratios, 0.7 and 1.7, respectively). Participation in sexual decision making was positively associated with condom use rather than no effective method use (2.2) or female method use (1.9); partner involvement in birth control was positively associated with condom use rather than female method use (1.8). CONCLUSIONS Variations in effective contraceptive use among nonurban Latinos appear related to relationship characteristics and dynamics. Contraceptive counseling and unintended pregnancy prevention programs that are tailored to reflect relationship contexts and to include male partners where appropriate could improve the quality and cultural relevance of services among nonurban Latinos.
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Affiliation(s)
- Jocelyn T Warren
- Department of Public Health, Oregon State University, Corvallis, Oregon, USA.
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Sexual, relationship, contraceptive and personal factors influencing emergency contraception use: a qualitative study. Contraception 2011; 84:266-72. [DOI: 10.1016/j.contraception.2011.01.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2010] [Revised: 01/02/2011] [Accepted: 01/07/2011] [Indexed: 11/23/2022]
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Beaulieu R, Kools SM, Kennedy HP, Humphreys J. Young adult couples' decision making regarding emergency contraceptive pills. J Nurs Scholarsh 2011; 43:41-8. [PMID: 21342423 DOI: 10.1111/j.1547-5069.2010.01381.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE Unintended pregnancy is a significant public health problem among young people worldwide. The purpose of this study was to explore and better understand the reasons for the apparent underuse of emergency contraceptive pills (ECP) in young people in coupled relationships. THEORETICAL RATIONAL: In postmodern explications of grounded theory, social construction of realities and the influence of subjectivities on the meanings of experiences lead to the development of partial truths that may change with time, context, and situation. METHODS Grounded theory methods guided semi-structured face-to-face interviews and data analysis. Twenty-two couples aged 18 to 25 years old were recruited through public notices. FINDINGS Four salient and interrelated conditions were constructed to help explain the complexities involved in young couples decision making regarding ECP use: (a) the shifting locus of responsibility for contraceptive decision making: in a perfect world versus biological reality; (b) relationship power: control-vulnerability continuum; (c) a woman's autonomy over her own body; and (d) conflicting views on ECP. CONCLUSIONS Healthcare professionals whose practice includes young people need to be aware of possible couple dynamics when discussing contraception. Clients in supportive relationships should be encouraged to engage in open communication with their partners about their contraception needs, including possible ECP use. CLINICAL RELEVANCE The results of this study contribute to the body of knowledge with regard to decision making related to ECP use in young adults.
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Nguyen BT, Zaller N. Male Access to Over-the-Counter Emergency Contraception. Womens Health Issues 2009; 19:365-72. [DOI: 10.1016/j.whi.2009.07.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2009] [Revised: 07/16/2009] [Accepted: 07/16/2009] [Indexed: 12/20/2022]
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Araújo MSPD, Costa LOBF. Comportamento sexual e contracepção de emergência entre adolescentes de escolas públicas de Pernambuco, Brasil. CAD SAUDE PUBLICA 2009; 25:551-62. [DOI: 10.1590/s0102-311x2009000300010] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2008] [Accepted: 08/25/2008] [Indexed: 11/22/2022] Open
Abstract
O objetivo deste estudo foi investigar o conhecimento e o uso do contraceptivo de emergência em 4.210 adolescentes (14-19 anos) da rede pública estadual de Pernambuco, Brasil. As informações foram coletadas pelo questionário Global School-Based Student Health Survey, previamente validado. Foi investigado o conhecimento, a freqüência e forma de uso do contraceptivo de emergência. As variáveis independentes foram divididas em sócio-demográficas e relacionadas ao comportamento sexual. A maioria dos adolescentes relatou conhecer e já ter recebido informações sobre o método, entretanto dentre os que já utilizaram apenas 22,1% o fez de forma correta. A análise ajustada de regressão evidenciou uma maior chance de conhecer o método entre as moças (OR = 5,03; IC95%: 1,72-14,69) e entre aqueles que já tiveram relação sexual (OR = 1,52; IC95%: 1,34-1,75), enquanto os residentes do interior possuem 68% menos chance. Em relação ao uso, os residentes do interior apresentam 1,68 (OR; IC95%: 1,09-2,25) mais chance de uso incorreto, enquanto as moças apresentam 71% menos chance. São necessárias ações de educação sexual e reprodutiva, sobretudo entre os rapazes e adolescentes do interior.
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Serra-Torres A, Montaner-Amorós M, Sitjar-Martínez de Sas S, Sisó-Almirall A, Espanyol-Navarro M, Devant-Altimir M. [Emergency contraception: evaluation of women's understanding of it, a requisite for the effectiveness of the treatment]. Aten Primaria 2007; 39:87-92. [PMID: 17306170 PMCID: PMC7664514 DOI: 10.1157/13098676] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To evaluate how much women who attend primary care consultations understand about the correct use of emergency ("morning after") contraception (EC), their information requirements and their views about free EC prescription. DESIGN Cross-sectional study, using a questionnaire. SETTING Les Corts Primary Care Centre, Barcelona, Spain. PARTICIPANTS A total of 130 women aged 15 to 45 years old who attended primary care consultations in May and June, 2005, were included. One-hundred and twenty-four of them (95.4%) agreed to the questionnaire. MAIN MEASUREMENTS We tested knowledge of EC, and we drew up a questionnaire to evaluate understanding. This had 4 multiple-choice questions, as well as socio-demographic data, contraception background, how they preferred to obtain EC, and their information requirements. RESULTS We found a lack of knowledge about several aspects of EC use: in particular, 33% of the women thought that EC eliminated completely the risk of pregnancy. We only found differences for better knowledge of EC in women who had used it before (3.03; 95% CI, 2.29-3.77) versus those who had never used it (2.47; 95% CI, 1.54-3.4; P=.028. Free prescription of EC in health centres was approved of by 75.8%, while 83.1% said they needed more information. Their preferred method to obtain this information was by leaflet. CONCLUSIONS Women who attend primary health care clinics have a need for information on EC. Their lack of knowledge could limit the effectiveness of treatment. A brief explanation and handing out a leaflet could solve this problem.
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Affiliation(s)
| | | | | | - Antoni Sisó-Almirall
- Correspondencia: Dr. A. Sisó-Almirall. Mejía Lequerica, s/n. 08028 Barcelona. España.
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Cunnane MS, Dickson G, Cook RL. Women's experiences with emergency contraception in an internal medicine practice. J Womens Health (Larchmt) 2007; 15:1080-9. [PMID: 17125427 DOI: 10.1089/jwh.2006.15.1080] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Emergency contraceptive pills (ECPs) are effective for preventing unintended pregnancy. Whether patients in primary care settings receive physician counseling regarding ECPs has not been evaluated. METHODS We conducted a cross-sectional telephone survey of reproductive-age women who sought care at a university-based general internal medicine clinic regarding receipt of physician counseling about ECPs, knowledge and experiences with ECPs, and attitudes toward using ECPs. RESULTS One hundred forty-nine women aged 18-45 completed the survey. Eighty percent of respondents (n = 119) were at risk for unintended pregnancy. Although all women in the sample had seen an internist in the previous 12 months, only 10% had received physician counseling about ECPs. There was little difference in the proportion of women who received counseling about ECPs comparing those who received care from an obstetrician/gynecologist and an internist with women who received care from an internist alone (13% vs. 8%, p = 0.529). Receipt of ECP counseling was not associated with the consistency of current contraceptive use. No women who were married or over the age of 40 were counseled about ECPs. The majority of participants (92%) had heard of ECPs, although most (54%) had learned about them through the media. Fifty-four percent of women would be likely to use ECPs to prevent unintended pregnancy. CONCLUSIONS Only a fraction of women seeing internists for their primary care are receiving counseling about ECPs, irrespective of receiving care from an obstetrician/gynecologist. As primary care physicians, internists should determine risk for unintended pregnancy, assess patients' knowledge and attitudes toward ECPs, and provide counseling about this effective therapy.
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Affiliation(s)
- Megan S Cunnane
- Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
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Sarkar NN. Emergency contraception: a contraceptive intervention approaching target despite controversy and opposition. J Public Health (Oxf) 2006. [DOI: 10.1007/s10389-006-0036-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Harper CC, Cheong M, Rocca CH, Darney PD, Raine TR. The Effect of Increased Access to Emergency Contraception Among Young Adolescents. Obstet Gynecol 2005; 106:483-91. [PMID: 16135577 DOI: 10.1097/01.aog.0000174000.37962.a1] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The United States Food and Drug Administration cited an absence of data on young adolescents as the reason the emergency contraceptive, Plan B, could not be moved over-the-counter. This study analyzed data on young adolescents with increased access to emergency contraception. METHODS We conducted an age-stratified analysis with previously published data from a randomized, controlled trial of Plan B with a sample size of 2,117, including 964 adolescents, 90 of whom were aged younger than 16 years. Participants were randomly assigned to nonprescription pharmacy access, advance provision of 3 packs, or clinic access (control). We measured contraceptive and sexual risk behaviors at baseline and 6-month follow-up and tested for pregnancy and sexually transmitted infections. We used contingency table and logistic regression analysis to measure the effect of the intervention on risk behaviors in young adolescents (< 16 years), compared with middle adolescents (16-17 years), older adolescents (18-19 years), and adults (20-24 years). RESULTS Adolescents aged younger than 16 years behaved no differently in response to increased access to emergency contraception (EC) from the other age groups. As with adults, EC use was greater among adolescents in advance provision than in clinic access (44% compared with 29%; P < or = .001), and other behaviors were unchanged by study arm, including unprotected intercourse, condom use, sexually transmitted infection acquisition, or pregnancy. Additionally, adolescents with increased access to EC did not become more vulnerable to unwanted sexual activity. CONCLUSION Young adolescents with improved access to EC used the method more frequently when needed, but did not compromise their use of routine contraception nor increase their sexual risk behavior. LEVEL OF EVIDENCE I.
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Affiliation(s)
- Cynthia C Harper
- Center for Reproductive Health Research and Policy, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California, USA.
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Abstract
PURPOSE OF REVIEW The purpose of this review is to inform the reader of new information published since early 2003 about emergency contraception, with a particular focus on issues of access. RECENT FINDINGS Research continues to document low but increasing levels of knowledge about emergency contraception, increasing use, and more positive attitudes towards emergency contraception by both patients and healthcare providers. Additional information is available about efficacy and mechanisms of action. More reports of side-effects have been published, as have studies relating to the impact of emergency contraception on sexual and contracepting behaviors. Advance provision, provision by pharmacists, and over-the-counter status have been studied as ways to improve access to emergency contraception. SUMMARY Knowledge about the efficacy, safety, types and use of emergency contraception continues to increase. Although patients have greater awareness of and more access to emergency contraception, there are still numerous barriers to its use even in countries where it is available over the counter. Healthcare providers must continue to educate themselves and their patients about emergency contraception even when it becomes available over the counter. In countries where emergency contraception is only available by prescription, providers should offer an advance prescription or supply (where available), and use newer dosing regimens for levonorgestrel-only emergency contraception to increase adherence and efficacy. Developing collaborative practice agreements with pharmacists to increase access is also recommended. Patients should be counseled to seek follow-up if no menses occurs within 3 weeks of taking emergency contraception or if symptoms such as lower abdominal pain occur after the use of emergency contraception.
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Affiliation(s)
- Lee Ann E Conard
- Department of Pediatrics, West Virginia University School of Medicine, Morgantown, West Virginia 26506, USA.
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Foster DG, Harper CC, Bley JJ, Mikanda JJ, Induni M, Saviano EC, Stewart FH. Knowledge of emergency contraception among women aged 18 to 44 in California. Am J Obstet Gynecol 2004; 191:150-6. [PMID: 15295356 DOI: 10.1016/j.ajog.2004.01.004] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The State of California has taken several steps to make emergency contraceptives (ECs) available to women in the state. By using data from the 1999-2001 California Women's Health Survey, we estimated the knowledge of emergency contraception among adult women of reproductive age at risk of pregnancy (n=6209). STUDY DESIGN This study is based on 3 years of data (1999-2001) from the California Women's Health Survey (CWHS), an annual population-based survey of more than 4000 randomly selected adult women (aged 18 years and older) in California. A total of 6198 women aged 18 to 44 responded to the 2 emergency contraception questions: "To the best of your knowledge, if a woman has unprotected sex is there anything she can do in the 3 days after intercourse that will prevent pregnancy?" and "What can she do?" RESULTS We find that 38% of California women were able to correctly identify emergency contraception. Most importantly, the women who are most likely to need emergency contraception-those who are at risk of an unintended pregnancy but not using any method of contraception-have among the lowest levels of knowledge (only 29% identified a method of ECs). CONCLUSION Results show that family planning providers may be reaching their clients, but broader outreach to the public has not yet achieved sufficiently high information levels among women in greatest need of the method.
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Affiliation(s)
- Diana G Foster
- Center for Reproductive Health Research and Policy, University of California, San Francisco 94143-1744, USA.
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