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Borges ALV, Dias ACDS, Ale CCDS. Reproductive autonomy associated with the use of contraceptive methods among reproductive aged women. Rev Gaucha Enferm 2023; 44:e20230072. [PMID: 38055416 DOI: 10.1590/1983-1447.2023.20230072.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 07/12/2023] [Indexed: 12/08/2023] Open
Abstract
OBJECTIVE To assess the sociodemographic aspects associated with reproductive autonomy among urban women, with special regard to the relationship with the use of contraceptive methods. METHOD Cross-sectional study with 1252 women, conducted between April and June 2021, using the Brazilian version of the Reproductive Autonomy Scale. Data were analyzed using multiple linear regression. RESULTS Mean scores for the subscales were 2.5 (SD=0.3) (Decision-making), 3.8 (SD=0.3) (Absence of Coercion) and 3.6 (SD=0.4) (Communication). Compared to women who reported no use of contraceptive methods, women using barrier or behavioral methods and those using LARC had higher level of reproductive autonomy on all dimensions of the Scale (p<0.001). Other aspects associated with reproductive autonomy were education, race/ethnicity, religion, socioeconomic status and cohabitation living with a partner, depending on each subscale. CONCLUSION The type of contraceptive method used was statistically associated with reproductive autonomy in all subscales.
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Marques GCM, Ferreira SL, Dias ACDS, Pereira CODJ, Fernandes ETBS, Lacerda FKL. INTERGENERATIONAL TRANSMISSION BETWEEN QUILOMBOLA MOTHERS AND DAUGHTERS: REPRODUCTIVE AUTONOMY AND INTERVENING FACTORS. TEXTO & CONTEXTO ENFERMAGEM 2022. [DOI: 10.1590/1980-265x-tce-2020-0684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: to analyze reproductive autonomy in quilombola women and the intervening factors of intergenerational transmission between mothers and daughters. Method: a cross-sectional and analytical study developed with 160 women, mothers and daughters from quilombola communities in the municipality of Vitória da Conquista, Bahia. The National Health Survey questionnaire was used to verify sociodemographic characteristics and intervening factors; and the Reproductive Autonomy Scale was also employed. The Chi-square, Mann-Whitney and Wilcoxon tests were applied. The data were analyzed by means of simple and multiple linear regression. Results: the group of mothers presented higher frequency of women that are married or live with a partner (66.2%), who worked (51.2%) and who had higher incomes (358.00 ± 663.00). The daughters presented more years of study (10.50 ± 5.00). Reproductive autonomy and intergenerational transmission between mothers and daughters mainly occur in the Absence of coercion (ICC=0.70; p=0368) and Communication (ICC=0.69; p=0694) domains. The mother's age (β-adjusted=-0.027; p=0.039) and the daughter's skin color/race (β-adjusted=0.423; p=0.049) were intervening factors in intergenerational transmission related to Decision-making, associated with the mother's age and with the daughter's self-recognition as black-skinned. Conclusion: the daughters do not follow the same choice as their mothers, which can be understood due to greater accessibility to reproductive planning services and increased schooling levels. Intergenerational transmission among quilombolas presents important specificities for reproductive decisions and enables a better understanding of the information and qualification of the health professionals' assistance in the care provided to these women.
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Dias ACDS, Santos IND, Ruela GDA, Gurgel ADM. Semelhanças e diferenças intergeneracionais entre mães e filhas trabalhadoras rurais: características sociodemográficas e reprodutivas. ESCOLA ANNA NERY 2022. [DOI: 10.1590/2177-9465-ean-2021-0334pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo analisar as semelhanças e diferenças intergeracionais envolvendo características sociodemográficas e reprodutivas entre mães e filhas trabalhadoras rurais. Método estudo analítico e quantitativo desenvolvido em fevereiro de 2018 com 21 díades, mães e filhas trabalhadoras rurais, em idade reprodutiva cadastradas no Programa Chapéu de Palha Mulher − Pernambuco. Utilizou-se o questionário da Pesquisa Nacional de Saúde para verificar as características sociodemográficas e reprodutivas. Resultados Mães e filhas não apresentaram diferenças estatísticas para estado conjugal (p = 1,00), grau de instrução (p = 0,053), cor/raça (p = 1,00), religião (p = 1,00), idade que começou a trabalhar (p = 0,433) e horas de trabalho por semana (p = 1,00), participação em grupo de planejamento familiar (p = 0,344), uso de método contraceptivo (p = 0,065), aborto espontâneo (p = 1,00) e parto cesáreo (p = 0,459). Conclusão e implicações para a prática Os resultados sugerem que ocorreu o processo de modelação em diversos aspectos, ou seja, a mãe serviu de figura de referência para as suas filhas na tomada de atitudes e comportamentos, o que necessita maior entendimento sobre relação intergeracional, inclusive entre profissionais de saúde para melhor qualificação na assistência, a exemplo, no cuidado reprodutivo.
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Dias ACDS, Triaca LM, Santos IND, Santos RCD, Gusmão MEN, Lacerda FKL. Association between rural workers’ sociodemographic and reproductive characteristics and their reproductive autonomy. Rev Bras Enferm 2022; 75Suppl 2:e20210878. [DOI: 10.1590/0034-7167-2021-0878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 06/24/2022] [Indexed: 11/07/2022] Open
Abstract
ABSTRACT Objectives: to verify the association between sociodemographic and reproductive characteristics with rural workers’ reproductive autonomy. Methods: a cross-sectional study, with a sample of 346 women and application of the Reproductive Autonomy Scale. Multinomial regression was performed to analyze associations between independent variables and outcomes. Results: in the analysis of subscales “Decision-making”, “My sexual partner or someone else such as a parent”, “Both me and my partner” and “Me”, women experienced greater reproductive autonomy in relation to their partners. For outcomes “Decision about which method to use”, “When to have a baby” or “About unplanned pregnancy”, the highest prevalence was for category “Me”, with statistically significant associations. Conclusions: the sociodemographic and reproductive characteristics among the most vulnerable women, in terms of the social, economic and cultural context in which they are inserted, may be associated with greater difficulties in exercising reproductive autonomy.
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Dias ACDS, Santos IND, Ruela GDA, Gurgel ADM. Intergenerational similarities and differences between rural working mothers and daughters: socio-demographic and reproductive characteristics. ESCOLA ANNA NERY 2022. [DOI: 10.1590/2177-9465-ean-2021-0334en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective To analyze similarities and differences involving socio-demographic and reproductive characteristics between rural working mothers and daughters. Method An analytical and quantitative study was developed in February 2018 with 21 dyads, rural working mothers and daughters, of reproductive age registered in the Chapéu de Palha Mulher Program in Pernambuco State, Brazil. The National Health Survey questionnaire was adopted to verify socio-demographic and reproductive characteristics. Results Mothers and daughters did not show statistical differences for marital status (p = 1.00), education level (p = 0.053), skin color/race (p = 1.00), religion (p = 1.00), age when started working (p = 0.433) and working hours per week (p = 1.00), participation in a family planning group (p = 0.344), use of contraceptive methods (p = 0.065), miscarriage (p = 1.00), and cesarean childbirth (p = 0.459). Conclusion and implications for practice The results suggest that the modeling process took place in numerous aspects, meaning these mothers fulfilled a reference role for their daughters in decision-making and behaviors. It requires a greater understanding of intergenerational relationships, especially amongst health professionals, for them to provide a better qualification in assistance, such as in reproductive care.
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Dias ACDS, Triaca LM, Santos IND, Santos RCD, Gusmão MEN, Lacerda FKL. Associação entre as características sociodemográficas e reprodutivas com a autonomia reprodutiva das trabalhadoras rurais. Rev Bras Enferm 2022. [DOI: 10.1590/0034-7167-2021-0878pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
RESUMO Objetivos: verificar a associação entre as características sociodemográficas e reprodutivas com a autonomia reprodutiva das trabalhadoras rurais. Métodos: estudo transversal, com amostra de 346 mulheres e aplicação da Escala de Autonomia Reprodutiva. Foi realizada regressão multinomial para análises de associações entre as variáveis independentes e desfechos. Resultados: na análise das subescalas “Tomada de decisão”, “Meu parceiro sexual ou alguém da família tem mais a dizer”, “Eu e meu parceiro sexual” e “Eu decido”, as mulheres experimentaram maior autonomia reprodutiva em relação aos parceiros. Para os desfechos “Decisão sobre qual método utilizar”, “Quando ter um bebê” ou “Sobre gravidez não planejada”, as maiores prevalências foram para a categoria “Eu decido”, com associações estatisticamente significante. Conclusões: as características sociodemográficas e reprodutivas entre mulheres mais vulneráveis, tratando-se do contexto social, econômico e cultural que estão inseridas, podem estar associadas a maiores dificuldades para exercerem a autonomia reprodutiva.
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Gutin SA, Harper GW, Moshashane N, Ramontshonyana K, Stephenson R, Shade SB, Harries J, Mmeje O, Ramogola-Masire D, Morroni C. Relationship, partner factors and stigma are associated with safer conception information, motivation, and behavioral skills among women living with HIV in Botswana. BMC Public Health 2021; 21:2231. [PMID: 34879845 PMCID: PMC8653588 DOI: 10.1186/s12889-021-12268-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 11/16/2021] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND A significant proportion (20-59%) of people living with HIV in sub-Saharan Africa desire childbearing, are of reproductive age, and are in sero-different relationships (~50%). Thus it is plausible that some portion of new HIV transmissions are due to attempts to become pregnant. Safer conception (SC) methods that effectively reduce the risk of HIV transmission exist and can be made available in resource-constrained settings. Few studies in the region, and none in Botswana, have quantitatively examined the correlates of information, motivation, and behavioral skills for SC uptake. METHODS We surveyed 356 women living with HIV from 6/2018 to 12/2018 at six public-sector health clinics in Gaborone, Botswana. Participants were 18-40 years old, not pregnant, and desired future children or were unsure about their childbearing plans. We examined correlates of SC information, motivation, and behavioral skills using nested linear regression models, adjusting for socio-demographic, interpersonal, and structural variables. RESULTS Knowledge of SC methods varied widely. While some SC methods were well known (medical male circumcision by 83%, antiretroviral therapy for viral suppression by 64%), most other methods were known by less than 40% of participants. Our final models reveal that stigma as well as relationship and partner factors affect SC information, motivation, and behavioral skills. Both internalized childbearing stigma (ß=-0.50, 95%CI:-0.17, -0.02) and perceived community childbearing stigma were negatively associated with SC information (ß=-0.09, 95%CI:-0.80, -0.21). Anticipated (ß=-0.06, 95%CI:-0.12, -0.003) and internalized stigma (ß=-0.27, 95%CI:-0.44; -0.10) were associated with decreased SC motivation, while perceived community childbearing stigma was associated with increased SC motivation (ß=0.07, 95%CI:0.02, 0.11). Finally, internalized childbearing stigma was associated with decreased SC behavioral skills (ß=-0.80, 95%CI: -1.12, -0.47) while SC information (ß=0.24, 95%CI:0.12, 0.36), motivation (ß=0.36, 95%CI:0.15, 0.58), and perceived partner willingness to use SC (ß=0.47, 95%CI:0.36, 0.57) were positively associated with behavioral skills CONCLUSIONS: Low SC method-specific information levels are concerning since almost half (47%) of the study participants reported they were in sero-different relationships and desired more children. Findings highlight the importance of addressing HIV stigma and partner dynamics in interventions to improve SC information, motivation, and behavioral skills.
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Affiliation(s)
- Sarah A Gutin
- Center for AIDS Prevention Studies, Division of Prevention Science, University of California, San Francisco, 550 16th Street, 3rd Floor, 94143, San Francisco, CA, USA.
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, MI, 48109, Ann Arbor, USA.
- Women's Health Research Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, 7925, Observatory, Cape Town, South Africa.
| | - Gary W Harper
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, MI, 48109, Ann Arbor, USA
| | - Neo Moshashane
- Botswana Harvard AIDS Institute Partnership Princess Marina Hospital, Private Bag BO 320, Gaborone, Botswana
| | - Kehumile Ramontshonyana
- Botswana Harvard AIDS Institute Partnership Princess Marina Hospital, Private Bag BO 320, Gaborone, Botswana
| | - Rob Stephenson
- Department of Systems, Population and Leadership, School of Nursing, University of Michigan, MI, Ann Arbor, USA
- The Center for Sexuality and Health Disparities, School of Nursing, University of Michigan, Ann Arbor, MI, USA
| | - Starley B Shade
- Department of Epidemiology & Biostatistics School of Medicine, University of California, San Francisco, CA, San Francisco, USA
| | - Jane Harries
- Women's Health Research Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, 7925, Observatory, Cape Town, South Africa
| | - Okeoma Mmeje
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, MI, 48109, Ann Arbor, USA
- Department of Obstetrics and Gynecology, University of Michigan Medical School, MI, Ann Arbor, USA
| | - Doreen Ramogola-Masire
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | - Chelsea Morroni
- Women's Health Research Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, 7925, Observatory, Cape Town, South Africa
- Botswana Harvard AIDS Institute Partnership Princess Marina Hospital, Private Bag BO 320, Gaborone, Botswana
- MRC Centre for Reproductive Health, University of Edinburgh, 47 Little France Crescent, EH16 4TJ, Edinburgh, United Kingdom
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Dias ACDS, Ferreira SL, Gusmão MEN, Marques GCM. INFLUENCE OF THE SOCIODEMOGRAPHIC AND REPRODUCTIVE CHARACTERISTICS ON REPRODUCTIVE AUTONOMY AMONG WOMEN. TEXTO & CONTEXTO ENFERMAGEM 2021. [DOI: 10.1590/1980-265x-tce-2020-0103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
ABSTRACT Objective to analyze the influence of the sociodemographic and reproductive characteristics on reproductive autonomy among women through the subscales of the Reproductive Autonomy Scale. Method an analytical and cross-sectional study with a stratified sample composed of 346 female rural workers registered in Chapéu de Palha Mulher Program in Pernambuco. Data collection occurred in the month of February 19th and February 23rd, 2018. The National Health Survey questionnaire and the Reproductive Autonomy Scale were used. The data were analyzed using simple and multiple linear regression analyses. Results the women presented high reproductive autonomy with the lowest autonomy being observed in relation to the “Communication” construct. Marital status, education level, skin color/race, participation in a family planning group, and having already being pregnant are significant variables for total reproductive autonomy. Conclusion the full reproductive autonomy of rural women can be influenced by sociodemographic and reproductive variables. One of the ways to increase reproductive autonomy among the women in this study would be through an intervention aimed at health education on sexual and reproductive rights and power and gender relations so that women can be guided, obtain more information on these topics, and correlate them with reproductive autonomy.
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