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Individuals suffering from depression exhibit a higher rate of unintended pregnancies, which are associated with negative outcomes for both parents and children. Often, unintended pregnancies result from contraceptive mistakes. Here, we examine the relationship between depression and the consistency of contraceptive behavior, testing ambivalence as a possible mediator. The analyses were based on cross-sectional data from the second and third waves of the German Relationship and Family Panel Pairfam. A German-speaking sample without children (N = 190; 117 female, 73 male), who reported not attempting to conceive or become pregnant during the last 12 months, was analyzed in comparison with a propensity score matched sample. Ambivalence was operationalized as the difference between the ideal and realistic number of children in wave 2. Data from wave 3 were used to assess contraceptive behavior. Depressed mood in wave 2 and consistency of contraceptive behavior in wave 3 were negatively correlated. After including ambivalence in wave 2 as a mediator in the model, the direct path between depressed mood and consistency of contraceptive behavior remained significant, with no significant mediation found. For men only, we observed a significant negative association of ambivalence with the consistency of contraceptive behavior in the last 3 months. No significant relationship was found between depressed mood and ambivalence. We conclude that future research aiming to better understand the consistency of contraceptive behavior should incorporate measures of ambivalence. [ABSTRACT FROM AUTHOR]

Background: The contraceptive preferences of obstetricians and gynecologists (OB/GYNs) are thought to influence the contraceptive counseling they provide. The purpose of this study was to assess contraceptive preferences of OB/GYNs and women in the general population (WGP) in the current Spanish contraceptive scenario. Materials and Methods: Anonymous online survey of 100 OB/GYNs and 1,217 WGP aged 23?49 years. Results: WGP were younger (35.3???7.3 vs. 37.9???6.2 years, respectively) and less likely to have stable partners (64.7% vs. 84.0%) and children (49.1% vs. 62.0%) (all p??0.05). Intrauterine devices (IUDs) were more frequently used by OB/GYNs (20% vs. 5%; p?0.05), especially the levonorgestrel-releasing intrauterine devices (LNG-IUDs) (18% vs. 2.6%; p?

Abstract Background There is high global demand for new methods of male birth control (MBC). However, contemporary evidence regarding men’s method-specific attitudes and their determinants is sparse. Methods Non-sterilized cisgender men ages 18–45 with recent history of female sex partners were surveyed at a large community event in the Midwestern US. We examined variation in participants’ willingness to use MBC by method (gel, pill, injection, implant, and vas occlusion), potential side effects, and potential barriers. We estimated crude and adjusted prevalence ratios (aPRs) for associations between participant characteristics and willingness to use ≥ 1 MBC method. Results Overall, 72% of participants (n = 187; mean age, 29) were very willing to use ≥ 1 MBC method although support for individual methods ranged widely from 62% (pill) to 24% (vas occlusion). In bivariate analysis of sociodemographic and health characteristics, few demonstrated associations with MBC willingness. In a multivariable model, willingness was independently related to age (30–39 vs. 18–29 years old, aPR = 1.24, 95% CI 1.04–1.48) and having ever been tested for HIV (aPR = 1.27, 95% CI 1.07–1.51). Willingness to tolerate side effects was

BACKGROUND AND AIM: One of the key factors affecting women’s behavior with fertility issues is their health literacy, but this topic has been less addressed in the existing studies. We aimed to determine the relationship between reproductive health literacy and components of healthy fertility in women of reproductive age. MATERIALS AND METHODS: This cross-sectional study was conducted from March 2019 to September 2014 on 230 married women who were referred to comprehensive health centers in Lordegan city. Data were collected using a reproductive health literacy questionnaire, demographic and fertility information checklist, and components of healthy fertility. Data analysis was done using SPSS software, version 20. Pearson, Spearman, and independent t-tests were used as appropriate. RESULTS: The mean ± SD reproductive health literacy score in the participants was 43.80 ± 18.99 depicting an average literacy level in more than half of the women. Also, the reproductive health literacy score had a statistically significant relationship with the use of low-failure contraceptive methods (P < 0.001) and planned pregnancy (P = 0.03). However, this relationship was not significant regarding pre-pregnancy care (P = 0.88) and observing the interval between pregnancies (P = 0.57). CONCLUSION: We found a relationship between the level of reproductive health literacy and the use of family planning methods with low failure and planned pregnancy. Hence, it seems that interventions to improve reproductive health literacy are effective in reducing the occurrence of high-risk pregnancies and unwanted and unplanned pregnancies. Therefore, it is suggested that the health system consider and provide education related to reproductive health literacy as a part of healthy reproductive services.

Most American women wanting to avoid pregnancy use contraception, yet contraceptive failures are common. Guided by the Health Belief Model (HBM), we conducted a secondary qualitative analysis of interviews with women who described experiencing a contraceptive failure (n = 69) to examine why and how this outcome occurs. We found three primary drivers of contraceptive failures (health literacy and beliefs, partners and relationships, and structural barriers), and we identified pathways through which these drivers led to contraceptive failures that resulted in pregnancy. These findings have implications for how individuals can be better supported to select their preferred contraception during clinical contraceptive discussions. [ABSTRACT FROM AUTHOR]

Introduction: Access to a full range of contraceptive services is essential for quality health care. Contraceptive provision practices of primary care providers play an important role in patients' decision-making about their reproductive health care. Understanding the multilevel factors influencing contraceptive care delivery in primary care settings is critical for advancing quality care. This study offers an in-depth examination of influences on providers' delivery of contraceptive services across multiple primary care specialties and practice settings to identify issues and strategies to improve care. Materials and Methods: Twenty-four in-depth face-to-face interviews were conducted in 2017 with primary care providers, including family physicians, gynecologists, pediatricians, and nurse practitioners from academic settings, private practices, and health centers. Interviews were transcribed and analyzed thematically. Results: Providers described a complex set of influences on their provision of contraception across multiple ecological contexts. Seven major themes emerged from the qualitative analysis, including six types of influence on provision of contraception: organizational, individual provider-related, structural and policy, individual patient-related, community, and the lack of influences or barriers. Providers also discussed the sources they access for information about evidence-based contraception counseling. Conclusions: A diverse set of providers described a complex system in which multiple concentric ecological contexts both positively and negatively influence the ways in which they provide contraceptive services to their patients. To close the gaps in contraceptive service delivery, it is important to recognize that both barriers and facilitators to patient-centered contraceptive counseling exist simultaneously across multiple ecological contexts.

The objective of this study was to examine contraception use and family planning discussions (FPD) in female people living with HIV (PLWH). A retrospective cohort study was conducted. Female PLWH were included if they were 18–44 years and received care in 2019 at an HIV clinic. 74 patients met inclusion; mean age was 35 years, 53% were white. All patients were prescribed antiretroviral therapy. 48.6% of patients had documented FPD. 64.9% of patients were using contraception; sterilization was most common (41.7%). Only five patients had a contraindication to hormonal contraception. No differences in contraception use were observed based on age, race, HIV viral load, number of visits, or past pregnancies. However, patients with documented FPD were more likely to use contraception (OR 4.55; 95% CI 1.35-15.29). Routine FPD and contraception use in female PLWH were low. Rates of sterilization were high in female PLWH. Providing quality family planning services is critical to increase contraception use and selection of the most appropriate contraception form. [ABSTRACT FROM AUTHOR]

Objective: We aimed to qualitatively describe the contraceptive experiences of individuals with medical conditions and develop an explanatory model of contraceptive decision-making in this context.Study Design: We conducted 41 interviews with pre-menopausal patients with a range of medical conditions from Michigan, United States. We identified themes through open coding and comparative analysis until we reached theoretical saturation. We analyzed the themes in the context of the Health Belief Model constructs and patient autonomy. To develop the explanatory model, we qualitatively mapped out relationships between constructs and how they informed contraceptive-decision making.Results: The model posits that contraceptive decisions are affected by the perceived impact of chronic disease on pregnancy, parenting, and contraceptive options. These perceptions were strongly affected by others, particularly health care providers (HCPs). Most worried that pregnancy could threaten their health, fetal health, or ability to parent. Active symptoms of chronic disease (e.g., pain, fatigue) amplified this perceived threat. Patients appreciated when their HCPs acknowledged, rather than dismissed, their concerns about contraceptive side effects that affected their chronic disease symptoms and management (e.g., headaches, worsening mood). Patients with medical contraindications to hormonal contraception and preferred to use coital-dependent methods (e.g., condoms) did not feel supported to do so by their HCPs. Patients who were Black, young, living on low-incomes, or considered medically "high risk" felt discriminated against by HCPs who limited or coerced their contraceptive decisions.Conclusions: This explanatory model synthesizes factors that underlie, constrain, or promote reproductive and contraceptive decisions and autonomy for individuals with medical conditions.Implications: This new explanatory model can guide the development and evaluation of interventions that support the contraceptive decisions and autonomy of individuals with medical conditions. [ABSTRACT FROM AUTHOR]

Background: Contraceptive behavior and unmet need for family planning, particularly among the tribal women of reproductive age in India, still remains a public health concern. This needs to be explored in different geographical regions. Objectives: This study aimed to ascertain the contraceptive behavior of tribal married women of 15–49 years and to assess the unmet need for family planning and its determinants. Methods: A descriptive, cross-sectional study was conducted during May 2019 to April 2020 in Barabani Block of Paschim Bardhaman District, West Bengal. A calculated sample of 530 study participants was selected from the study area by the simple random sampling. Required data on contraceptive behavior characteristics, unmet need, and correlates were collected by interviewing them with a predesigned schedule. Bivariate analysis and multivariable logistic regression were done. Data were analyzed using the SPSS software v. 20. Results: All study participants were Hindu and belonged to Santhal ethnicity; 53.4% were illiterate; 51.7% had early marriage, and 52.4% had adolescent pregnancy. Only 41.1% women were found currently using any contraceptives, another 14.5% ever used and 44.4% never used any methods. Apprehension of side effects and spouse disapproval were reported as two common reasons for never using contraceptives. The age of the women appeared as a significant predictor of current contraceptive use. Overall, unmet need for family planning was 19.4% and age of the women, socioeconomic status, and type of the family were found as significant predictors. Conclusion: Issues contributing to unsatisfactory contraceptive behavior and high unmet need for family planning need to be addressed appropriately.

This article reports on research aimed at defining strategies to empower Mexican women in their family planning decisions and to establish commitments and responsibilities with their partners. A systematic review was conducted, including PubMed, Redalyc and Scopus, and ten original articles from two continents and diverse populations were included. Of the studies conducted in Mexico and Latin America, none provided a proposal to implement improvements in the adoption of a family planning method among women who experience intimate partner violence. It is concluded that bioethical training and education of health personnel can contribute to ensure that the information and decision-making process by the woman or the couple is carried out in accordance with bioethics, seeking individual benefit and protection of the wellbeing of the woman and, therefore, of her family. [ABSTRACT FROM AUTHOR]

Background: Success of a programme of free-choice participation, like Family Planning Programme, can be envisaged only when focus is on the needs of the people. Although India was the first country to introduce Family Planning Programme, total fertility rate of 2.1 has not yet been achieved, highlighting that the need of limiting family after two children is not yet felt by the people of India. Therefore, the study was undertaken to assess need for limiting family and permanent methods, and factors influencing it among couples with two or more living children. Materials and Methods: A community-based cross-sectional study was conducted in rural and urban areas of Haldwani Tehsil, Uttarakhand. Multistage sampling technique was used for selection of study sample. Data were collected using a pretested questionnaire. Statistical analysis was done using Epi Info version 7.2.2.6. Results: Out of 221 women interviewed, only one-third had adopted permanent methods of contraception for limiting family, one-third were using temporary methods, and remaining were not using any contraception. Merely one-third participants were willing to adopt permanent contraception in future. Unmet need for permanent methods was higher among women of younger age, literate woman, and/or husband and joint families. It was lower in women with three or more living children in comparison with women with two children. Unfelt need for limiting the family was 8.6%. Conclusion: Acceptance of permanent methods of contraception was low with temporary methods being equally preferred for limiting family. Unfelt need for limiting still remains in the community despite promotion of small family norm.

Objective: to evaluate the content validity, criterion-related validity, and internal consistency of contraceptive use assessment instrument. Method: an instrumental, cross-sectional study was carried out. An instrument was designed with 15 items, that was submitted to expert judgement and applied to 104 young women. Content validity was assessed with descriptive statistics, criterion-related validity with inferential statistics and internal consistency with Cronbach's Alpha. Results: the instrument had a content validity index per item of 1.0, per scale greater than .80 and for universal agreement of 1.0. Criterion-related validity did not show significant differences; Cronbach’s Alpha coefficients obtained to related items ranged between .70 and .79. Conclusion: the instrument items showed to be relevant and content valid; as for contraceptive use intention dimension the instrument items indicated an acceptable internal consistency. [ABSTRACT FROM AUTHOR]

1–3 year students attending medical and preventive faculty of a medical university were our research object. Our research had many stages, and at the first one our goal was to examine and to assess basic behavioral risks for reproductive health of students attending medical and preventive faculty of a medical university. We conducted a sociological examination via questioning. 428 students were questioned as per materials collecting program which included 74 parameters; they accounted for 91.6 % out of the overall official number of students, 45.0 % male students and 40.0 % female students combined work and studies. We detected that, as per questioning results, the specific weight of students who took care of their health amounted to 79.2 % boys and 95.2 % girls. However, the students tended to have bad habits, i.e. constant alcohol intake or smoking. And although information on diseases prevention and on how to pursue healthy lifestyle was perfectly available to them, students didn't try to use it and preserve their health. All the respondents said they were against abortion. Girls were likely to adopt a complex approach when choosing a contraceptive, they resorted to hormonal agents, and, with their partners' consent, to condoms. But they often took hormonal agents without any consultations with a gynecologist or an endocrinologist. Contraceptives were rather rarely applied, and students appeared to have no knowledge on risk factors causing reproductive health deterioration. They also tended to be negligent and too self-confident when it came to reproductive health protection. A risk of abortions was very high for girls who didn't use contraceptives, and also all students ran rather high risk of catching sexual diseases. Sexual education is needed to correct contraceptive behavior; medical workers are a main source of information on reproductive health of young people in 7–10 % cases only. We need to create interactive educational programs on health protection at university level and to involve specialists from health centers and antenatal clinics to participate in them.

Objectives: Systematic reviews of contraceptive counseling interventions have shown inconsistent impact on patient outcomes. The current study assessed the effects of an evidence-informed contraceptive counseling staff training intervention on patient experience, contraceptive selection, and behavior over three months of follow-up.Study Design: We randomly assigned 10 Planned Parenthood health centers in the Southeastern US to intervention (staff received contraceptive counseling training) and control (usual counseling) groups. From December 2016-June 2017, patients completed surveys immediately post visit (n = 756) and one and three months after. We compared differences in patients' counseling experience (e.g., number of evidence-informed practices experienced, satisfaction with counseling), contraceptive selection, and behavior (e.g., method discontinuation, accurate pill use, condom use) between study groups using mixed effect models with health center specified as a random effect.Results: Seven hundred and fifty-six participants completed the baseline survey; 579 (77%) completed one or both follow-up surveys. The intervention group was more likely to report experiencing all evidence-informed counseling practices (adj. Prevalence Ratio [aPR] = 2.27, 95% CI 1.27, 4.04) with less variation in the number of practices and higher satisfaction with their counseling than the control group (p < 0.01). We found no sustained differences in contraceptive behaviors at both one- and three-month follow-up.Conclusions: We found immediate positive effects of the intervention on patients' perceptions of their counseling experience and no differences in changes in contraceptive behavior over time between the study groups.Implications: Evidence-based strategies to improve the quality of contraceptive care and subsequent outcomes, while centering patients' needs and preferences, are needed. The contraceptive counseling intervention offers a tool for increasing consistency in contraceptive counseling practices across health centers and improving patient satisfaction. [ABSTRACT FROM AUTHOR]

Objective To investigate the contraceptive attitudes and contraceptive knowledge in women with unplanned pregnancy, and to explore the correlation between contraceptive attitudes and contraceptive knowledge. Methods: A total of 356 women with unplanned pregnancy were recruited and investigated by using a self-design demographic questionnaire, contraceptive attitude scale and contraceptive knowledge scale. Results: The average total score of contraceptive attitudes and contraceptive knowledge in unplanned pregnancy women respectively were(64.21±6.72)and(14.09±5.03), respectively. The total score of contraceptive attitudes scale and contraceptive knowledge was positively correlated(r=0.301, P<0.01). Conclusion: There was a positive correlation between contraceptive attitudes and contraceptive knowledge in women with unplanned pregnancy. Medical workers should pay attention on contraception knowledge level of women with unplanned pregnancy, in order to improve their contraceptive attitudes and achieve consistent contraceptive behavior. [ABSTRACT FROM AUTHOR]

This study investigated the relationship betiueen parental figure sex education and former foster alumni's contraceptive behavior. Data fom 75 women aged 18-25 from the 2011-2015 National Survey of Family Growth were analyzed. There was no association betiueen parental figure sex education and contraceptive behavior (adjusted odds ratio [aOR] = 0.26; 95% CI: 0.34--2.34, p > 0.05). Women with fewer sexual partners were less likely to use contraceptives than those who had multiple sex partners. Future research is needed to determine how the foster care system impacts partaking in high-risk sexual behaviors. [ABSTRACT FROM AUTHOR]

Background: Success of a programme of free-choice participation, like Family Planning Programme, can be envisaged only when focus is on the needs of the people. Although India was the first country to introduce Family Planning Programme, total fertility rate of 2.1 has not yet been achieved, highlighting that the need of limiting family after two children is not yet felt by the people of India. Therefore, the study was undertaken to assess need for limiting family and permanent methods, and factors influencing it among couples with two or more living children. Materials and Methods: A community-based cross-sectional study was conducted in rural and urban areas of Haldwani Tehsil, Uttarakhand. Multistage sampling technique was used for selection of study sample. Data were collected using a pretested questionnaire. Statistical analysis was done using Epi Info version 7.2.2.6. Results: Out of 221 women interviewed, only one-third had adopted permanent methods of contraception for limiting family, one-third were using temporary methods, and remaining were not using any contraception. Merely one-third participants were willing to adopt permanent contraception in future. Unmet need for permanent methods was higher among women of younger age, literate woman, and/or husband and joint families. It was lower in women with three or more living children in comparison with women with two children. Unfelt need for limiting the family was 8.6%. Conclusion: Acceptance of permanent methods of contraception was low with temporary methods being equally preferred for limiting family. Unfelt need for limiting still remains in the community despite promotion of small family norm. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the correlation between the contraceptive behavior and sexual autonomy of unmarried young people. The research was carried out among unmarried young people in Korea. The participants of this study were university students in C Province of Korea, and the study was performed in 2016. One hundred seventy four answer sheets out of two hundred respondents were analyzed except for 26 incomplete ones. The independent variables are sexual autonomy, marital communication, and contraceptive behavior for dependent variable. SPSS WIN 22.0 for statistical analysis of the data was used in this study. The participants in this study are 67 males (38.5%) and 107 females (61.5%). Regarding the proportion of age, 19.5% of participants were under 20 years old, 70.1% of participants were between 21 and 25 years old. The experience rate of sexual intercourse the young couples was 97.1%. The overall mean of the couple's sexual autonomy was upper medium level (3.99±0.69), marital communication was upper level (3.03±0.42), and relationship satisfaction was upper medium (3.86±0.55). The research participants showed a statistically significant difference in sexual autonomy (t=3.674, p<.001), and marital communication (t=3.128, p=.002). The participants using contraception showed higher sexual autonomy than the subjects not using contraception. Also, the participants using contraception showed higher marital communication ability than the subjects not using contraception. Sexual autonomy was significantly positively related with marital communication (r = .235, p=.002) and relationship satisfaction (r = .207, p=.006). Marital communication was significantly positively related with relationship satisfaction (r = .474, p<.001).According to results from logistic regression analysis, sexual autonomy (OR=2.472, CI=1.431~4.272), marital communication (OR=3.140, CI=1.182~8.341), contraceptive knowledge(OR=2.248, CI=1.134~4.455) were found to be factors significantly influenced unmarried couple's contraceptive behaviour. It is investigated that contraceptive behavior is associated with communication of young couples and sexual autonomy. Therefore, communication and sexual autonomy should be taken into account in contraception education program to increase safe sex life for unmarried couples. [ABSTRACT FROM AUTHOR]

Background: The contraceptive preferences of obstetricians and gynecologists (OB/GYNs) are thought to influence the contraceptive counseling they provide. The purpose of this study was to assess contraceptive preferences of OB/GYNs and women in the general population (WGP) in the current Spanish contraceptive scenario., Materials and Methods: Anonymous online survey of 100 OB/GYNs and 1,217 WGP aged 23-49 years., Results: WGP were younger (35.3 ± 7.3 vs. 37.9 ± 6.2 years, respectively) and less likely to have stable partners (64.7% vs. 84.0%) and children (49.1% vs. 62.0%) (all p  < 0.05 vs. OB/GYNs). Seventy-nine percent versus 82%, respectively, used contraceptive methods, with condoms used most frequently by WGP (37% vs. 22% by OB/GYNs; p  < 0.05) and pills by OB/GYNs (26% vs. 21% by WGP; p  > 0.05). Intrauterine devices (IUDs) were more frequently used by OB/GYNs (20% vs. 5%; p  < 0.05), especially the levonorgestrel-releasing intrauterine devices (LNG-IUDs) (18% vs. 2.6%; p  < 0.05). The highest-rated methods were condoms among WGP and LNG-IUDs among OB/GYNs. Effectiveness was the most valued attribute of contraceptive methods for both. Reasons related to convenience were the main reason for choosing IUDs. OB/GYNs prescribed the contraceptive method in 40% of cases., Conclusions: Our study reveals differences between female OB/GYNs and WGP in contraceptive methods use and rating. The use of LNG-IUDs was much higher among OB/GYNs., Competing Interests: J.P-.C. has received honoraria for consulting, participation in advisory boards or lecturing for Bayer Hispania, MSD, Theramex, Exeltis, Gynea-Kern and Organon outside the submitted work. J.C.Q-.C. has received honoraria for consulting, participation in advisory boards or lecturing from Bayer and Gedeon Richter outside the submitted work. J.G-.A. has received honoraria for consulting, participation in advisory boards or lecturing from Bayer, Exeltis and Organon outside the submitted work. P.L-.A. has received honoraria for consulting, participation in advisory boards or lecturing from Bayer, Exeltis, Gedeon Richter, Medtronic and Organon outside the submitted work. I.P-.R. has received honoraria for consulting, participation in advisory boards or lecturing from Bayer and MSD outside the submitted work. I.C-.G. has received honoraria for consulting, participation in advisory boards or lecturing from Bayer, Gedeon Richter, MSD and Organon outside the submitted work. M.A-.G. has received honoraria for consulting, participation in advisory boards or lecturing from Bayer, Gedeon Richter and Hologyc outside the submitted work. M.H.-C. has received honoraria for consulting, participation in advisory boards or lecturing from Bayer, Gedeon Richter, MSD and Organon outside the submitted work. J.R-.T. is full-time employee of Bayer Hispania S.L. J.C-.A. has received honoraria for consulting, participation in advisory boards or lecturing from Bayer, Gedeon Richter-Preglem and Theramex outside the submitted work., (© Josep Perelló-Capo et al., 2023; Published by Mary Ann Liebert, Inc.)

Background: Fertility desires and contraceptive behavior often change over time. This study examined the influence of change in fertility desires on change in modern contraceptive use over time in three peri-urban communities in sub-Saharan Africa. Methods: This multi-site study includes baseline and follow up data from 3 sites in the Family Health and Wealth Study. Following a census in each site, a probability sample of at least 500 households was obtained. Generalized linear models were employed. Results: Modern contraceptive use increased in Ipetumodu, Nigeria (29.4 % to 36.7 %), but declined slightly in Sebeta, Ethiopia (66.9 % to 61.3 %) and Asawase, Ghana (12.6 % to 10.8 %). Across sites, at baseline and follow up, women who wanted no more children reported more contraceptive use, compared with those who wanted more children, and were more likely to shift to being contraceptive users in Ipetumodu [aOR(95 % CI):1.55 (1.07,2.26)]. Conclusions: Women's fertility desires influenced their contraceptive behavior, although there were cross-site differences. Changing contraceptive demand and program factors will be important to enable peri-urban women to frame and act on their fertility desires. [ABSTRACT FROM AUTHOR]

Background: Government Health workers play important role in awareness and acceptance of contraceptives. Hence review of their functioning is essential. In this context this study was conducted to assess the knowledge, attitude and practices regarding contraceptive services among health workers. Methodology: It is a Cross-sectional study conducted over a period of 3 months. Calculated Sample size was 150 with simple random sampling technique. Clearance from the institutional ethical committee and concerned authorities of the college had been taken for the study. Study tool was Pre-designed self administered Questionnaire, for assessing knowledge, attitude and practices regarding contraceptive services among Government Health workers from randomly selected Primary Health Centers (PHCs). Results: Of the 153 subjects, mean scores for knowledge, attitude and practices regarding contraceptive services were respectively 12.29, 9.58 and 11.27. There was no significant difference in knowledge of those under 35 yrs and those above it; but there was statistically significant difference in attitude and practices regarding contraceptive services. The knowledge and practices regarding contraceptive services regarding emergency contraception were associated with designation with ANM faring better in it. Conclusion: Although the health workers fared well in knowledge, attitude and practices regarding contraceptive services, there is room for further improvement.

Abstract: Objective: To investigate whether mental illness and substance use disorder (SUD) are associated with having a prescription contraceptive method among women veterans. Study design: We conducted a retrospective analysis of National Veterans Administration (VA) administrative and clinical data for women veterans aged 18–45 years who made at least one primary care visit in 2008. We assessed associations between mental illness (depression, posttraumatic stress disorder, anxiety, bipolar disorder, schizophrenia and adjustment disorder) and SUD (drug/alcohol use disorder) with having a prescription contraceptive method from VA (pill, patch, ring, injection, implant and intrauterine device) using multivariable logistic regression with random effects for VA facility, adjusting for confounders. Results: Among 94,115 reproductive aged women, 36.5% had mental illness only, 0.6% had SUD only, 5.3% had both mental illness and SUD and 57.7% had neither diagnosis. In these groups, 22.1%, 14.6%, 18.2% and 17.7% (p<0.001), respectively, had documentation in 2008 of prescription contraception. After adjusting for potential confounders, women with mental illness only were as likely as women with neither diagnosis to have a prescription method and were more likely to use a highly effective prescription method (implant or intrauterine device) if using contraception [adjusted odds ratio (aOR) 1.17, 95% confidence interval (CI) = 1.08–1.27]. Women with SUD (with or without mental illness) were significantly less likely to have a prescription method than women with neither diagnosis (aOR 0.73, 95% CI = 0.57–0.95 and aOR 0.79, 95% CI = 0.73–0.86, respectively). Conclusion: Women veterans with SUD are less likely to have prescription contraception compared to other women, which may increase their risk of unintended pregnancy. [Copyright &y& Elsevier]

The last two decades of socioeconomic transition, started in Romania with the fall of the authoritarian communist regime and with the end of the centrally planned economy at the end of 1989, have been decades of important demographic changes, as well. This study tries to overview the onset of the Second Demographic Transition in the country, using The Netherlands as benchmark. We found that most of the “threshold levels” were surpassed in the period 1990-1996, even if some evolutions were onset much earlier and interrupted by the pro-natalist policies during the so-called “golden age” of communist times. Passed thresholds levels concern especially fall and long-lasting low fertility, postponement of childbearing and marriage (more marriage than childbearing), drop in marriage rates. However, a few other threshold levels have not yet been surpassed: marriage is still stable, ultimate celibacy is still rare, and modern contraception yet is not a current practice.

Elaborou-se revisão crítica da literatura sobre os fatores associados ao não uso de anticoncepcionais, na adolescência. Procurou-se integrar resultados de pesquisa, tanto no sentido de uma maior compreensão da vulnerabilidade do adolescente para problemas como a gravidez indesejada e a AIDS, quanto para o desenvolvimento de uma educação sexual mais efetiva e realista para esta faixa etária.The literature concerning the major correlates of the non-utilization contraceptives in adolescence is critically reviewed. Research findings are analyzed and discussed in terms of their contribution not only to a deeper understanding of adolescents' risk-taking sexual behavior, but also to the implementation of more effective and realistic sexual education for this age-group.

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Abstract: Background: We prospectively examined the influence of young women’s depression and stress symptoms on their weekly consistency of contraceptive method use. Study Design: Women ages 18-20 years (n=689) participating in a longitudinal cohort study completed weekly journals assessing reproductive, relationship and health characteristics. We used data through 12 months of follow-up (n=8877 journals) to examine relationships between baseline depression (CES-D) and stress (PSS-10) symptoms and consistency of contraceptive methods use with sexual activity each week. We analyzed data with random effects multivarible logistic regression. Results: Consistent contraceptive use (72% of weeks) was 10–15 percentage points lower among women with moderate/severe baseline depression and stress symptoms than those without symptoms (p<.001). Controlling for covariates, women with depression and stress symptoms had 47% and 69% reduced odds of contraceptive consistency each week than those without symptoms, respectively (OR 0.53, CI 0.31–0.91 and OR 0.31, CI 0.18–0.52). Stress predicted inconsistent use of oral contraceptives (OR 0.27, CI 0.12–0.58), condoms (OR 0.40, CI 0.23–0.69) and withdrawal (OR 0.12, CI 0.03–0.50). Conclusion: Women with depression and stress symptoms appear to be at increased risk for user-related contraceptive failures, especially for the most commonly used methods. Implications: Our study has shown that young women with elevated depression and stress symptoms appear to be at risk for inconsistent contraceptive use patterns, especially for the most common methods that require greater user effort and diligence. Based upon these findings, clinicians should consider women’s psychological and emotional status when helping patients with contraceptive decision-making and management. User-dependent contraceptive method efficacy is important to address in education and counseling sessions, and women with stress or depression may be ideal candidates for long-acting reversible methods, which offer highly effective options with less user-related burden. Ongoing research will provide a greater understanding of how young women’s dynamic mental health symptoms impact family planning behaviors and outcomes over time. [Copyright &y& Elsevier]

Abstract: Purpose: We prospectively examined the influence of young women's depression and psychological stress symptoms on their weekly contraceptive method use. Methods: We examined data from 689 women ages 18–20 years participating in a longitudinal cohort study. Women completed 8,877 weekly journals over the first year, which assessed reproductive, relationship, and health information. We focused on baseline depression (Center for Epidemiologic Studies-Depression Scale) and stress (Perceived Stress Scale) symptoms and weekly contraceptive method use. Analyses used multivariate random effects and multinomial logistic regression. Results: Approximately one quarter of women exhibited moderate/severe depression (27%) and stress (25%) symptoms at baseline. Contraception was not used in 10% of weekly journals, whereas coital and noncoital methods were used in 42% and 48% of weeks, respectively. In adjusted models, women with moderate/severe stress symptoms had more than twice the odds of contraception nonuse than women without stress (odds ratio [OR] 2.23, confidence interval [CI] 1.02–4.89, p = .04). Additionally, women with moderate/severe depression (RR .52, CI .40–.68, p < .001) and stress (relative risk [RR] .75, CI .58–.96, p = .02) symptoms had lower relative risks of using long-acting methods than oral contraceptives (OCs; reference category). Women with stress symptoms also had higher relative risks of using condoms (RR 1.17, CI 1.00–1.34, p = .02) and withdrawal (RR 1.29, CI 1.10–1.51, p = .001) than OCs. The relative risk of dual versus single method use was also lower for women with stress symptoms. Conclusion: Women's psychological symptoms predicted their weekly contraceptive nonuse and use of less effective methods. Further research can determine the influence of dynamic psychological symptoms on contraceptive choices and failures over time. [Copyright &y& Elsevier]

We examine the relationship characteristics associated with contraceptive method choice within young people's nonmarital sexual relationships, using data from retrospective relationship histories available in the third wave (2001-2002) of the National Longitudinal Study of Adolescent Health. Data-reduction techniques produce a detailed multidimensional characterization of relationship commitment for nonmarital sexual relationships. We then use multilevel analysis to estimate associations between two key relationship characteristics-relationship commitment and couple heterogamy-and the type of contraceptive method used at last sexual intercourse within each relationship. Results indicate that for a given individual, contraceptive method choice varies across relationships as a function of these characteristics, even after we account for important individual and family characteristics and prior relationship experiences. [ABSTRACT FROM AUTHOR]

Objective: Poor oral contraceptive (OC) knowledge may contribute to premature OC discontinuation and unintended pregnancy. Yet, to understand relationships between OC knowledge and contraceptive behavior, knowledge must be adequately measured. This review evaluates the findings and methodological limitations of research in which OC knowledge has been measured. Methods: We performed a systematic review of primary research from January 1965 to January 2009. Studies were audited for study characteristics, purpose for measuring OC knowledge, key findings and measurement properties including administration method, knowledge domains, reliability, validity, health literacy and cultural sensitivity. Results: We reviewed 21 studies: 18 cohort studies, including one psychometric evaluation, and three randomized trials. Results on OC knowledge outcomes were variable. Measures were largely self-administered survey (n =15) and lacked assessment of all OC knowledge domains. Information on measures’ characteristics, reliability, validity, health literacy and cultural sensitivity was limited. Conclusion: Existing OC knowledge measures lack critical psychometric elements, leading to inconsistent and unreliable findings. Practice implications: Poor OC knowledge measurement precludes identifying counseling needs and developing interventions for contraceptive behavior change. Future research considerations include: measurement information in publications, psychometric evaluations, formal reliability/validity techniques, and attention to all OC knowledge domains, health literacy and cultural sensitivity. [Copyright &y& Elsevier]

The last two decades of socioeconomic transition, started in Romania with the fall of the authoritarian communist regime and with the end of the centrally planned economy at the end of 1989, have been decades of important demographic changes, as well. This study tries to overview the onset of the Second Demographic Transition in the country, using the Netherlands as benchmark. We found that most of the „threshold levels“ were surpassed in the period 1990-1996, even if some evolutions were onset much earlier and interrupted by the pro-natalist policies during the so-called „golden age“ of communist times. Passed thresholds levels concern especially fall and long-lasting low fertility, postponement of childbearing and marriage (more marriage than childbearing), drop in marriage rates. However, a few other threshold levels have not yet been surpassed: marriage is still stable, ultimate celibacy is still rare, and modern contraception yet is not a current practice. [ABSTRACT FROM AUTHOR]

Family planning is hailed as one of the great public health achievements of the last century, and worldwide acceptance has risen to three-fifths of exposed couples. In many countries, however, uptake of modern contraception is constrained by limited access and weak service delivery, and the burden of unintended pregnancy is still large. This review focuses on family planning's efficacy in preventing unintended pregnancies and their health burden. The authors first describe an epidemiologic framework for reproductive behavior and pregnancy intendedness and use it to guide the review of 21 recent, individual-level studies of pregnancy intentions, health outcomes, and contraception. They then review population-level studies of family planning's relation to reproductive, maternal, and newborn health benefits. Family planning is documented to prevent mother-child transmission of human immunodeficiency virus, contribute to birth spacing, lower infant mortality risk, and reduce the number of abortions, especially unsafe ones. It is also shown to significantly lower maternal mortality and maternal morbidity associated with unintended pregnancy. Still, a new generation of research is needed to investigate the modest correlation between unintended pregnancy and contraceptive use rates to derive the full health benefits of a proven and cost-effective reproductive technology. [ABSTRACT FROM PUBLISHER]

Purpose: To explore the relative contribution of intrapersonal factors (demographic data, sexual history, and self-efficacy for contraception) and partner factors (perceptions of support from sexual partners for contraception, and relationship power) to contraceptive behaviors among sexually active female adolescents in Taiwan. Design: A cross-sectional design. Female adolescents who have had a steady male sexual partner in the past 3 months ( N= 375) were recruited as participants. Methods: Questionnaires including demographic data, sexual history, contraceptive behavior, self-efficacy for contraception, perceptions of support from sexual partner for contraception, and perceptions of relationship power were submitted anonymously for this study. Findings: Participants who had their first sexual experience at less than 14 years of age and were from one-parent families had the least comprehensive contraceptive behavior than did other participants. Number of steady sexual partners was significantly negatively correlated with contraceptive behavior. Self-efficacy, perceptions of support from sexual partner for contraception, and relationship power all were positively correlated with contraceptive behavior. The important explanatory variables of contraceptive behavior were self-efficacy, age of first sexual intercourse, intervals between sexual intercourse, and perceptions of support from sexual partner for contraception. These accounted for 39.1% of variance in contraceptive behavior. Conclusions: Intrapersonal factors (self-efficacy, age of first sexual intercourse, and intervals between sexual intercourse) were more important than were partner factors (perceptions of support from sexual partners for contraception and relationship power) in influencing contraceptive behavior among sexually active female adolescents in Taiwan. Clinical Relevance: Intervention to increase contraceptive behavior among female adolescents should be focused more on intrapersonal factors than on partner factors. [ABSTRACT FROM AUTHOR]

This article examines the sociocognitive processes contributing to intention to use contraception and willingness to engage in unsafe sex, using extended versions of the theory of planned behavior (TPB) and the Prototype/Willingness model (Gibbons & Gerrard, 1995, 1997). Data were obtained from a questionnaire delivered to all the pupils in ninth grade (N = 196) at three schools in Oslo. Hierarchical multiple regression analysis was used to predict intention and willingness. The results showed that subjective norm was the most important predictor of intentions for girls, whereas moral norm was most important for boys' intentions and willingness. Prototypes were the most important predictor for girls' willingness. Implications of the findings are discussed. [ABSTRACT FROM AUTHOR]

Abstract: This paper reviews 83 studies that measure the impact of curriculum-based sex and HIV education programs on sexual behavior and mediating factors among youth under 25 years anywhere in the world. Two thirds of the programs significantly improved one or more sexual behaviors. The evidence is strong that programs do not hasten or increase sexual behavior but, instead, some programs delay or decrease sexual behaviors or increase condom or contraceptive use. Effective curricula commonly incorporated 17 characteristics that describe the curricula development; the goals, objectives, and teaching strategies of the curricula themselves; and their implementation. Programs were effective across a wide variety of countries, cultures, and groups of youth. Replications of studies also indicate that programs remain effective when implemented by others in different communities, provided all the activities are implemented as intended in similar settings. [Copyright &y& Elsevier]

Objective There might be a difference between non-working and working women in their perception of rights and privileges which may influence their contraceptive behavior. The purpose of this study was to examine contraceptive behavior among non-working and working women in Bangladesh determining associated factors.Method Analysis was based on data from the 1999–2000 Bangladesh Demographic and Health Survey which employs nationally representative sample.Results The prevalence of current contraceptive use (any method) was 58.2% among non-working women and 65.5% among working women. Both rates are still low for the country. Some factors, such as discussed family planning with husband, husband approves family planning, desire for more children, and husband lives together, were influential determinants of lower contraceptive prevalence among the non-working women.Conclusion The results indicate a necessity for social activities promoting husband–wife communication and women's participation in employment to enhance the use of contraceptives among Bangladeshi women, especially non-working women. [ABSTRACT FROM AUTHOR]

To better understand the differences between pregnant adolescents and parenting adolescents, we examined substance use, contraceptive behavior, and parenting knowledge among 91 first-time pregnant and parenting adolescents enrolled in an adolescent parenting case management program. After one year of program participation, pre- and post-test comparisons indicated improvements in contraception use and parenting knowledge, and increases in reported use of cigarettes, alcohol and other drugs among both groups. Adolescents who entered the program while pregnant experienced greater benefit than adolescents who entered the program already parenting. We discuss several implications for practitioners at both the programmatic and direct practice level who work with young women during pregnancy and as they transition to early parenthood. [ABSTRACT FROM AUTHOR]

To evaluate the association between knowledge about, or experience with, emergency contraception (EC), and condom use among school-attending adolescents in the state of Morelos, Mexico.We analyzed data from anonymously self-administered questionnaires (n = 10,918), from a cluster-randomized controlled trial among first year students from 40 (75%) public high schools in Morelos, Mexico. The survey included specific questions about EC knowledge and experience as well as questions about perceived ability to negotiate and condition sexual relations on condom use; and condom use at first and last sexual intercourse.Overall, 61% (6384) of students had heard of EC, and 36% (1964) of girls and 39% (1997) of boys had correct knowledge about EC. Correct knowledge was based upon knowing that EC is pills taken up to 3 days after unprotected sex to prevent pregnancy. Of 1695 (15.6%) reporting lifetime sexual activity, 16.4 % (275) reported they had tried to obtain EC and almost of all them (263) reported having used EC. The probability of a student reporting he/she is capable of interrupting sexual intercourse to use a condom was significantly higher for those who had correct EC knowledge, and a history of EC use was strongly correlated with condom use at last sexual intercourse.Experience with emergency contraception has no adverse effects on condom use, but rather is associated with an increased probability of condom use and an increased perceived capacity to negotiate condom use. Despite concern that information about, and access to EC may encourage sexual risk taking, our results suggest the reverse is true. These data support the position that there is no justification to withhold EC information or access from adolescents. [Copyright &y& Elsevier]