Contraceptive Responsibility among Male University Students

Abstract

This paper assesses the male contribution to contraceptive mismanagement and unwanted pregnancy. The subjects were 109 students at the University of Melbourne. A high incidence of risk-taking was reported, and almost one-fifth of the sexually experienced men stated that they had been involved in an unwanted pregnancy. A small group of these reported more than one such incident. The underlying reasons for poor contraceptive technique seemed to be related to two beliefs: that contraception is a female responsibility, and that sexual intercourse should be entirely spontaneous and unplanned.     

Web-based survey 'Contraception and attitudes to sexual behaviour' completed by women accessing a UK menopause website

Background and methodology Sociodemographic trends mean increasing numbers of new relationships in later life. These trends may not only have health consequences for women and health services but also impact on the targeting of sexual health messages. This study aimed to examine attitudes and knowledge surrounding contraception, sexual health and unwanted pregnancy among those accessing the website www.menopausematters.co.uk. A voluntary online survey was completed. RESULTS: Survey was completed by 550 respondents. Three hundred and sixty-six women, 94% of whom self-classified as pre- or perimenopausal, had been sexually active with a male partner in the previous four weeks. Commonest contraceptive methods used by perimenopausal and postmenopausal women were condoms, combined oral contraceptive pill (COCP) and male sterilization. Up to 42% of women surveyed were unhappy with their contraception. A total of 27% premenopausal, 32% perimenopausal women and 40% postmenopausal used no contraception. One-third of women were unhappy about this and 19 unplanned pregnancies had occurred. The majority of women were informed regarding COCP use over 35 years, hormone replacement therapy, emergency contraception and ceasing contraception. The majority of women were unaware that more terminations of pregnancy are performed in women over 40 than any other age group per total pregnancies.Almost a third of women were unaware that chlamydia incidence is increasing in older women. Most would use condoms in new relationship. Discussion and conclusions Women accessing www.menopausematters.co.uk are well informed about contraception and sexual health. The majority of those accessing the site are sexually active, but many use no contraception, or are unhappy with their chosen method, leaving them vulnerable to unwanted pregnancy or sexually transmitted infection.     

An analysis of college students' anonymous questions about human sexuality

This study analyzed the frequency and type of questions about sex and sexuality that were anonymously submitted by college undergraduates enrolled in personal health education courses at three universities. More than 1,300 queries were submitted by 626 students (249 men and 377 women) from an original pool of 644 possible subjects. Questions asked most often fell into six general categories: sexual arousal/response, general anatomy/physiology, contraception, dating/relationships, pregnancy/fertility, and sexually transmitted diseases. Queries concerning sexual arousal/response accounted for just over 30% of the questions from men and 25% of the questions from women. Women asked nearly twice as many questions about pregnancy and contraception as men did, and men asked far more about general anatomy/physiology and sexually transmitted diseases than women did. Chi-square analysis identified a significant association (p less than .001) between the sex of the questioner and the categories of sexual arousal/response and pregnancy/fertility. Physicians, psychologists, nurses, counselors, and educators should be aware that a considerable degree of sexual uncertainty still exists among college undergraduates. The authors concluded that the anonymous-submission technique was an effective means of enhancing the learning process and meeting student needs in sexuality education.     

Guilt: A Factor in Sexual Satisfaction*

As individuals begin to engage in sexual activities, they must contend with the interaction of their current behaviors with any prior learning related to sexual guilt. While guilt feelings associated with participation in masturbation, petting, and sexual intercourse have decreased in recent years, especially among females, few studies have considered the role of guilt in sexual satisfaction among adolescent/young adults. In order to examine the relationship of guilt to psychological and physiological sexual satisfaction, a survey research design was employed utilizing the responses of coitally active male and female never-married students from a state university. Findings indicate that feelings of guilt about various sexual activities do affect sexual satisfaction with differential influences for males and females.     

Sexual Intercourse and Pregnancy Among African American Girls in High‐Poverty Neighborhoods: The Role of Family and Perceived Community Environment

Data are used from a random sample of African American families in impoverished Chicago neighborhoods to address two questions: How well do modeling, supervision, and marital transition hypotheses explain the relationship between family structure and early sexual debut and pregnancy for disadvantaged Black female adolescents? Do higher levels of social support from parents and neighborhood adults decrease the risk of sexual activity for youth in poor communities? Support for each hypothesis is contingent upon the family transition experienced and specific sexual outcome examined. Living in any type of married household reduces the risk of sexual debut and pregnancy. Stronger parent‐child relationships are associated with delayed sexual onset, whereas the risk of pregnancy is reduced when adolescents report more working adults in their social networks.     

What Pediatric Subspecialists Need to Know About Sexual and Reproductive Health: A Review of the American Board of Pediatrics Content Outlines for Subspecialty Certifying Examinations

ABSTRACT

Many adolescents with complex medical conditions regard their subspecialty providers as an important source of clinical information including sexual and reproductive health information related to their medical condition. Thus, training for pediatric subspecialty providers should include clinically relevant sexual and reproductive content. The purpose of this study is to understand what disease-relevant sexual and reproductive health information is currently included in content outlines for each of the available pediatric subspecialty certifying examinations. The American Board of Pediatrics (ABP) offers 17 subspecialty certifying examinations; 13 content outlines are available on the ABP website which defines the body of knowledge to be tested. Each available outline underwent content analysis for sexual and reproductive health information. A team of adolescent medicine physicians identified seven thematic areas including: 1) puberty; 2) sexual behavior and identity; 3) fertility; 4) contraception; 5) sexually transmitted infections; 6) other genital pathology; 7) pregnancy. Across disciplines, learning objectives related to sexual behavior, sexual identity, fertility, contraception and pregnancy were the most limited. However, content related to puberty, sexually transmitted infections and other genital pathology was better represented. Overall, disease-and treatment-specific sexual and reproductive health information was sparse. Most subspecialty content outlines contain very little disease-specific sexual and reproductive health information despite the growing adolescent and young adult population with complex medical conditions in the care of pediatric subspecialists. Further studies are needed to explore if lack of sexual and reproductive information on board exams relates to the knowledge base and skill set of pediatric subspecialists.     

Unwanted sexual activity: the prevalence in college women.

This study investigated the prevalence of unwanted sexual activity among 949 college women who completed a history form for routine gynecological care at the health center of a private university. Included on the form were standard questions regarding gynecological and menstrual history, methods of contraception, sexual history, sexual dissatisfaction, and feelings of depression. In addition, the question "Have you ever experienced unwanted sexual activity?" was asked. Of the women sampled, 6.7% responded to this question affirmatively, far fewer than report such activity in anonymous surveys. These women were significantly more likely than their peers to be sexually active and to report having had abortions and pregnancies to term or having experienced sexual dissatisfaction and depression. Results highlight the tendency of victims of sexual violence to underreport their experiences and point to the importance of inquiry into unwanted sexual activity in campus primary care settings.     

Coerced Sexual Experiences Among Adolescent Substance Abusers: A Potential Pathway to Increased Vulnerability to HIV Exposure

This study describes the forced sexual experiences, serious internalizing problems, risky sexual behavior, and alcohol-related correlates of risky sexual behavior of 120 substance abusing adolescents and young adults (87 men, 33 women; mean age = 17.2 years) undergoing treatment. Prior coerced sexual experiences were associated with suicidal thoughts and attempts, higher levels of risky sexual behaviors, avoidance motives for drinking, and sexual decision-making conducive to risky sexual behavior. Sexual coercion was associated with patterns of sexual behavior and alcohol use that potentially increase vulnerability to HIV exposure. Social workers can play a number of significant roles in addressing ongoing psychological distress associated with sexual coercion among these predominantly female adolescents. Therefore, effective social work practice should enhance treatment effectiveness and reduce risk for a range of maladaptive outcomes including exposure to sexually transmitted diseases (STDs) and revictimization.     

Family influences on adolescent sexual and contraceptive behavior

Studies of adolescent pregnancy risk are relevant to understanding responsible adolescent sexual behavior because most investigators have focused on the key proximal determinants of pregnancy--sexual intercourse and contraceptive use--rather than analyzing pregnancy status per se. Lesser pregnancy risk is associated with teens remaining sexually abstinent, postponing onset of intercourse, and having intercourse less often or with fewer partners, as well as by using contraception at first or most recent intercourse and by using contraception consistently over time. Living with a single parent, in a lower SES family, having older sexually active siblings or pregnant/parenting teenage sisters, being a victim of sexual abuse, and residing in disorganized/dangerous neighborhoods all place teens at elevated risk of adolescent pregnancy. Parent-child closeness or connectedness, and parental supervision or regulation of children, in combination with parents values against teen intercourse (or unprotected intercourse), decrease the risk of adolescent pregnancy. Studies about parent-child sexual communication and adolescent pregnancy risk are less conclusive, largely because of methodological complexities.     

流动青少年生殖健康的家庭影响

流动青少年的生殖健康知识、态度和行为存在明显的弱质性:总体知识水平较低,尤其是性病与避孕知识缺乏严重;对早恋和对婚前性行为的态度日渐开放;性活动与性行为趋向活跃,意外妊娠和人工流产成为流动未婚青年生殖健康的严重问题。流动青少年家庭客观生存环境较差、父母主观重视不够、家庭教育能力不足、亲子关系欠佳、交流沟通不畅等因素,成为影响流动青少年的生殖健康的重要因素。必须要重视流动人口的家庭发展权,丰富家庭教育支持资源,逐步建立全方位、开放性的性教育和服务模式,促进流动青少年性与生殖健康发展。     

Sexual Behaviors in Mexico: The Role of Values and Gender Across Adolescence

Adolescent sexuality research has expanded to include noncoital behaviors, but there is limited knowledge about individual factors such as cultural values associated with these sexual behaviors outside of industrialized nations. Thus, we examined associations between Latino values (familism, sexual guilt, and importance of female virginity) and three sexual behaviors (making out, oral sex, and vaginal sex), among adolescents ages 12–19 (53% female) in Mexico. Findings indicate that sexual guilt and importance of female virginity were consistently associated with all sexual behaviors. Some associations differed by gender and school level. For instance, sexual guilt was a better predictor of high school girls’ oral and vaginal sex. This study expands our understanding of adolescent sexuality in Mexico.     

Multiple sex partners among college women and men: Sexual behaviors and sexual satisfaction revisited

The purpose of this investigation was to examine the effects of number of lifetime sex partners on sexual behaviors, sexual attitudes, and sexual satisfaction for never‐married college women and men. An anonymous questionnaire was administered in select classes at a midwestern state university. One‐partner group (one sex partner) women, in comparison to few‐partner (two to five sex partners) and many‐partner (six or more sex partners) group women, were more likely to have been older at first intercourse and to report psychological sexual satisfaction, mastur‐batory guilt, and commitment and love as conditions for sexual intercourse. For men, one‐partner group respondents were also more likely than few‐partner and many‐partner group respondents to report older age at first intercourse, masturbatory guilt, and commitment and love as conditions for sexual intercourse. In an era in which early sexual fulfillment clashes with concerns over unsafe sexual practices, these data provide insights into the influence of multiple partner experience on the sexual behavior patterns of young adults.     

Figuring It Out: How Late Adolescent and Young Adult Men and Women Perceive and Address Problems in Sexual Functioning

Although there are high rates of sexual problems and sexual dysfunction in adulthood (Mitchell et al., 2013), little is known about the circumstances under which problems are first experienced. A growing body of research addresses prevalence of problems in sexual functioning among adolescents and young adults, yet little is known about the meanings that young people give to these experiences or how they deal with them. We used content analysis of qualitative interviews with 53 heterosexual, sexually active Canadian adolescents (ages 18 to 21) to explore their perceptions of the sexual problems in functioning they had experienced and the strategies (if any) they used to address them over time. Problems among most young people originated early in their partnered sexual life. Figuring it out emerged as an intentional process directed toward improving sexual experiences, although certainly not all young people were successful. Strategies for figuring it out included informational or material help seeking, experimentation to inform future actions, mutual sharing and problem solving, and building emotional connection to improve sexual functioning. Implications for understanding the development of sexual dysfunctions in adulthood are discussed.     

Risk Factors and Life Processes Associated with Teenage Pregnancy: Results of a Prospective Study From Birth to 20 Years

Data gathered over the course of a 20‐year longitudinal study of 533 New Zealand women were used to (a) describe the extent and timing of pregnancies within the cohort up to age 20, and (b) examine the extent to which the risk of an early pregnancy was related to a range of social background, family, individual, and peer relationship factors measured over the course of childhood and adolescence. Results showed that by age 20, nearly a quarter of the sample had been pregnant at least once, with the majority of first pregnancies occurring between the ages of 17 and 20 years. The profile of those at greatest risk of a teenage pregnancy (<20 years) was that of an early‐maturing girl with conduct problems who had been reared in a family environment characterized by parental instability and maternal role models of young single motherhood. As young adolescents, these girls were characterized by high rates of sexual risk‐taking and deviant peer involvement. Exposure to social and individual adversity during both childhood and adolescence made independent contributions to an individual's risk of an early pregnancy. These findings were most consistent with a life course developmental model of the etiology of teenage pregnancy. Implications for teenage pregnancy prevention are discussed.     

Relative Efficacy of a Pregnancy,Sexually Transmitted Infection,or Human Immunodeficiency Virus Prevention–Focused Intervention on Changing Sexual Risk Behavior Among Young Adults

Abstract

Objectives: Despite findings suggesting that young adults are more concerned about experiencing an unplanned pregnancy or contracting a sexually transmitted infection (STI) than becoming human immunodeficiency virus (HIV) infected, no empirical work has investigated whether the specific focus of an intervention may be more or less efficacious at changing sexual behavior. Participants: Participants were 198 college students randomized to 1 of 4 conditions: pregnancy intervention, STI intervention, HIV intervention, or a control condition during 2008–2009. Methods: The authors compared the efficacy of 3 theory-based, sexual risk–reduction interventions that were exactly the same except for an exclusive focus on preventing pregnancy, STI, or HIV. Condom use and risky sexual behavior were assessed at baseline and 4-week and 8-week follow-up. Results: Participants exposed to the pregnancy or STI interventions reported greater condom use and less risky sexual behavior than those exposed to the HIV intervention. Conclusions: The focus of sexual risk–reduction interventions may lead to differential behavior change among young adults.     

The health belief model and the contraceptive behavior of college women: implications for health education

This study applied the "health belief model" in a comparison of the subjective perceptions, attitudes and beliefs between college women who were adequate or inadequate contraceptors. The 171 sexually active subjects were ascertained from clients of the Family Planning Clinic at the University of Illinois. A questionnaire was designed and tested to measure variables of perceived susceptibility to pregnancy, seriousness of unplanned pregnancy, benefits and barriers of contraceptive use. Inadequate contraceptors or risk-takers were defined as women who used no contraception, less effective methods such as rhythm, spermicides only or withdrawal, or effective methods sporadically. 49.5% of the subjects were risk-takers. Among the inadequate contraceptors, 17% were nonusers, 29% relied on ineffective methods, and 52% used effective methods sporadically. There was no difference between the 2 groups in their belief in seriousness of an unplanned pregnancy. The groups differed significantly in their perceived susceptibility to pregnancy (p.001). They also differed significantly in perception of overall costs and benefits of contraception (p.001), a score created by combining 12 questions on topics such as difficulty and embarrassment in obtaining contraceptives and inconvenience and awkwardness in dealing with them. There was a smaller significant difference (p.05) in a score termed "general use cost benefits," but no difference in a score called "method specific perceptions." These results were corroborated by a discriminate analysis which singled out the perceived costs and benefits and the perceived susceptibility variables as accurate predictors of the adequate contraceptor group. The health belief model showed considerable utility in explaining contraceptive behavior.     

The role of disclosing child sexual abuse on adolescent adjustment and revictimization

The role of disclosing child sexual abuse on adolescent survivors' symptomatology and the presence of additional unwanted sexual experiences was investigated in a subsample of 111 adolescents from the National Survey of Adolescents who reported child sexual abuse. Results indicated that prompt disclosure of sexual abuse to an adult moderated the influence of penetration during the abuse on the number of symptoms at assessment. Thus, prompt disclosure buffered the influence of more severe abuse. Disclosure also had a main effect on the likelihood of further victimization. Participants who told an adult promptly after the abuse were less likely to report additional unwanted sexual experiences.     

A Review of: “Adolescent Sexuality: A Historical Handbook and Guide” edited by Carolyn Cocca

Two well‐cited studies (Fisher, 1980; Schwartz, 1973) have suggested that people with negative emotional orientations toward sexuality (i.e., “erotophobia” or “sex guilt”) have difficulty learning contraceptive information. However, a recent laboratory study (Goldfarb, Gerrard, Gibbons, &; Plante, 1988) has raised doubts about this conclusion by demonstrating that erotophobic women can learn contraceptive information if they are exposed to it. The current study was designed to further clarify the relationship between emotional orientation toward sex and ability to learn sexually relevant material. Specifically, it compared pretest and post‐test knowledge of contraception and AIDS in erotophobic and erotophilic students in a university class on human reproduction. While the results indicated that male erotophobics initially knew less, there were no knowledge differences between males and females or erotophobics and erotophilics at the end of the course. Thus, these results support the conclusion that erotophobics are capable of learning sexual material if they are exposed to it. The implications of these results for educational strategies for decreasing unplanned pregnancy and sexually transmitted diseases are discussed.     

Gender Differences in the Sexual Well-Being of Mexican Adolescents

Objective: This study examines the associations of gender roles and sexual power with the sexual wellbeing of Mexican adolescents. Particularly we look at the role played by adolescent’s attitudes toward gender roles and sexual power regarding three aspects of their sexual well-being: satisfaction with one’s sex life; consistent condom use; and the refusal of unwanted sexual contact with one’s partner. Methods: we used logistic regression models to analyze possible associations between attitudes toward gender roles, and sexual power, with the sexual well-being of adolescents, using a random and representative sample of 4,738 sexually active teenagers from three Mexican states. Results: egalitarian attitudes are positively associated to high sexual satisfaction for female adolescents, whereas for males they favor the refusal of unwanted sex. Sexual power shows significant associations with consistent condom use for both males and females, and it also significantly increases the likelihood of high sexual satisfaction and refusal of unwanted sex among females. Conclusions: the findings suggest the relevance of overcoming traditional sex roles to achieve adolescent sexual well-being. In this sense, health and population policies should direct more substantial efforts in the promotion of gender equality among the adolescents and in the development of critical attitudes towards traditional gender norms.     

Sexual perceptions and practices of young people in Northern Thailand

This study draws together survey and qualitative data on sexual practices among more than 1,750 young Northern Thai people aged 17-20 years. The survey data indicate that sexually active young people frequently engage in, or are subjected to, risk-taking behaviours that may expose them to sexually transmitted infections and unwanted pregnancies. These include having multiple sexual partners and quite frequent partner turnover. High percentages also engage in unprotected sexual intercourse with various types of sexual partner (steady, casual and paid), and young women especially had often experienced sexual coercion. Qualitative data revealed a mixture of perceptions and practices affecting sexual intercourse among the young, such as having unplanned sex, engaging in sexual relations to display love or cement committed relationships, and having serial relationships, both monogamous and non-monogamous. We conclude that condom use should be a central focus of activities aimed at preventing adverse sexual health outcomes, but that new intervention approaches to encourage use of other contraceptives are also needed. Changes in sexual norms among young people also need to be acknowledged and accepted by older Thai generations in order for programs and interventions to combat negative sexual and reproductive health consequences to be more effective.