Women's acceptance of the diaphragm: The role of relationship factors

The vaginal diaphragm is a candidate for a female‐controlled method that could reduce risk of HIV/STI acquisition. We examined the association between relationship and partner factors and three measures of diaphragm acceptability: current use, consistency of use, and satisfaction with use. We conducted a telephone survey with 448 female members of a managed care organization, aged 18–49, who currently used contraception (including 140 diaphragm users, 187 pill users, and 121 male condom users). Use of a specific contraceptive was significantly associated with relationship length, condom‐use negotiation self‐efficacy, importance of covert use, perceived motivation of partner to prevent HIV/STIs, and perceived satisfaction of partner with current method. In addition, among diaphragm users, communication about HIV/STIs and perceived partner motivation to use a diaphragm were related to consistent use. These results suggest that acceptability of contraceptive methods among women is influenced by their perceptions of their male partner and relationship factors.     

Women's acceptance of the diaphragm: the role of relationship factors

The vaginal diaphragm is a candidate for a female-controlled method of reducing risk of HIV/STI acquisition. We examined the association between relationship and partner factors and three measures of diaphragm acceptability: current use, consistency of use, and satisfaction with use. We conducted a telephone survey with 448 female members of a managed care organization, aged 18-49, who currently used contraception (including 140 diaphragm users, 187 pill users, and 121 male condom users). Use of a specific contraceptive was significantly associated with relationship length, condom-use negotiation self-efficacy, importance of covert use, perceived motivation of partner to prevent HIV/STIs, and perceived satisfaction of partner with current method. In addition, among diaphragm users, communication about HIV/STIs and perceived partner motivation to use a diaphragm were related to consistent use. These results suggest that acceptability of contraceptive methods among women is influenced by their perceptions of their male partner and relationship factors.     

Sexual decision making and safer sex behavior among young female injection drug users and female partners of IDUs

Data from interviews with 94 young women who were injection drug users (IDUs) or partners of IDUs were analyzed to examine associations between self-reported sexual decision making and condom use, contraceptive use, and relationship characteristics. Most women (73-85%) reported participating in decisions about condom use, contraception, and when to have sex. Adjusting for potential covariates, respondents who reported participating in decisions about condom use and when to have sex were 7 and 19 times, respectively, more likely than others to report recently using condoms. Respondents who reported participating in decisions about contraception were 20 times more likely than others to report recently using contraceptives. Longer sexual relationships were associated with decreased likelihood of condom or contraceptive use.     

Low‐Income Latina Mothers' Expectations for Their Pregnant Daughters' Autonomy and Interdependence

Forty‐five pregnant Latina adolescents and their mothers (23 English‐speaking, 22 Spanish‐speaking) were videotaped conversing about feelings and plans related to the adolescent's pregnancy. The prevalence of the mothers' messages about the daughter's reliance on the family unit (interdependence) and the daughter's self‐sufficiency (autonomy) were related to adolescents' reported and observed feelings about their pregnancies, pending motherhood challenges, and their relationships with their mothers. Increased interdependence messages appeared to denote positive family relations among Spanish‐speaking dyads, in that these adolescents reported more positive feelings about their pregnancy, perceived that their mothers felt more positive, and perceived more maternal social support and open communication. The role of interdependence messages was less clear for adolescents from English‐speaking families. Higher levels of maternal autonomy messages had positive associations for both groups, in that it was related to higher disclosure about concerns about childcare needs among adolescents from English‐speaking families, and about educational goals for adolescents from Spanish‐speaking families.     

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.     

A research note on male‐female differentials in the experience of heterosexual love

Debate regarding the morality of abortion has ranged from expressions of concern for the fetus by anti‐abortionists to assertions by those favoring legalized abortion that women should control their own bodies. The present research explored the possibility that the social acceptability of the sexual relationship and the extent of contraceptive conscientiousness of an abortion applicant influences favorability of response toward abortion. After responding to a measure of attitudes toward premarital contraceptive use, 40 college students read 10 brief case histories of young unmarried women who were purportedly requesting abortion. As hypothesized, participants' support for abortion was influenced by the source of contraceptive failure (method vs. personal), kind of contraceptive (artificial vs. natural), and kind of sexual relationship (steady vs. casual). Results were discussed in terms of the possibility that observers may wish to restore justice by giving greater support for abortion for conscientious contraceptive users involved in socially approved sexual relationships than for careless contraceptive users whose involvements are more casual. It was suggested that societal attitudes toward contraception for unmarried persons may interact with the reality of the prevalence of premarital sexual activity to increase the premarital pregnancy rate.     

Changing aids‐ and fertility‐related behavior: The effectiveness of sexual education

A questionnaire was used to access the effectiveness of a ten‐week university course on human sexuality in changing students' AIDS‐ and fertility‐related behavior. The students' knowledge and behavior were evaluated (1) early in the class before there were any discussions or readings about sexual behavior, AIDS, or birth control and (2) three months later—approximately one month after completing the class. A randomly selected control group of students who did not take the class on sexuality was given the questionnaire at the same two points in time. Compared to the control group, the experimental group showed significant increases in knowledge about the likelihood of contracting the virus from one act of vaginal intercourse. The experimental group also reported increased worry about contracting AIDS from their sexual activity, while the control group did not. Further, compared with the control group, the experimental group increased certain cautious behaviors, such as being more selective in their choice of sexual partners and asking their partners more questions about their AIDS‐related behavior. However, the course did not lead students to: 1) significantly increase their use of the condom or other forms of contraception, 2) decrease their number of sexual partners, or 3) spend a longer time getting to know new partners before engaging in sexual activity. Implications for sexual education are discussed.     

Barrier versus oral contraceptive use: a study of female college students

Although they provide birth control and are easier to use, oral contraceptives (OCPs) are not the preferred approach to preventing sexually transmitted disease (STD). Do the knowledge, attitudes, and experiences of oral contraceptive users place them at greater risk for STDs than those who employ barrier methods? This study examined differences between sexually active female college students (ie, those who reported ever having had vaginal intercourse) who used OCPs and those who employed barrier methods of contraception at the time of their most recent intercourse. The authors analyzed HIV- and other STD-related knowledge, attitudes, and behaviors from three consecutive annual health surveys of young women about to begin their first year of college. Findings showed barrier and OCP users to be comparable in knowledge about the effectiveness of various contraceptive methods in protecting them against STDs, perceived personal susceptibility to HIV, and experiences with alcohol before sexual intercourse. Oral contraceptive users, compared with those in the group who used barrier methods, reported a greater number of recent partners (p less than .03) and greater perceived vulnerability to STDs (p less than .03). Student healthcare providers must develop creative educational strategies to encourage simultaneous use of both oral contraceptives and barrier methods to protect students against STDs and pregnancy.     

Negro folklore of male pregnancy∗

Contraceptive decision making is likely to become more complex when male oral contraceptives are marketed and as sex‐role preferences become more egalitarian. A mailed survey of 47 married couples selected from a newspaper “Birth Listing” column in Columbus, Ohio was used to contrast spouses' views, to assess levels of actual and perceived consensus among partners, and to identify predictors of greater stated likelihood of male pill usage. Modest support was found for the hypothesis that more egalitarian sex‐role preferences are positively related to a greater belief in contraception as a shared responsibility, wives: r = .35, p < .01, husbands: r = .21, p < .10. No support was found, however, for the hypothesis that beliefs in shared contraceptive responsibility would lead to greater acceptance of a male pill. Wives were also more accurate, r = .57, p < .001, than husbands, r = .21, p < .08, in perceiving then‐spouse's attitudes toward male pill adoption. Results suggest that researchers need to focus on the process by which contraceptive usage is negotiated and renegotiated among married couples.     

Socialization factors in contraceptive attitudes: Roles of affective responses,parental attitudes,and sexual experience

Attitudes about using specific contraceptives were hypothesized to be based mainly on heterosexual or autoerotic feelings. Affective responses to two stimulus themes were correlated with attitudes toward the use of contraceptives. The prediction was confirmed, moderated by levels of sexual experience and parental attitudes reported by the college student participants. Attitudes toward the use of contraceptives which involve genital manipulation, such as the diaphragm or condom, were positively correlated with feelings about masturbation themes presented in slides. Similarly, a positive relationship was found between attitudes about non‐genitally manipulative contraceptives, such as the pill, and heterosexual themes. Having little sexual experience or reporting negative parental attitudes toward sex increased the observed frequency of several of these predicted correlations. Explanations for these results included a reinforcement interpretation of the socialization experiences determining the development of attitudes toward using the various methods of birth control.     

Parent–Adolescent Sexual Communication and Its Association With Adolescent Sexual Behaviors: A Nationally Representative Analysis in the Netherlands

Sexual communication is a principal means of transmitting sexual values, beliefs, expectations, and knowledge from parents to children. Although this area has received considerable research attention, more studies with representative samples are needed to assure that findings are reflective of populations of interest. A nationally representative sample of parent–adolescent dyads (N = 2,965; mean adolescent age = 13.8 years) in the Netherlands was employed to examine the frequency of parent–adolescent sexual communication and its association with adolescent sexual behaviors (defined as sexual initiation, condom use, and contraceptive pill use). Nine communication topics in the areas of anatomy, relationships and rights, and protection and contraception were examined. In all, 75%of parents reported having discussed at least one topic multiple times with their adolescents. Romantic relationships were discussed most frequently. Hierarchical logistic regression analyses indicated that parent–adolescent sexual communication on protection and contraception was positively associated with adolescent sexual initiation and contraceptive pill use but not condom use. This may reflect that adolescents, when they become sexually active, are more likely to discuss sexuality with their parents. Findings are interpreted within the context of Dutch culture, which is generally accepting of adolescent sexuality and characterized by open sexual communication.     

Unmet demand for short-acting hormonal and long-acting reversible contraception among community college students in Texas

Objective: To identify preferences for and use of short-acting hormonal (e.g., oral contraceptives, injectable contraception) or long-acting reversible contraception (LARC) among community college students in Texas. Participants: Female community college students, ages 18 to 24, at risk of pregnancy, sampled in Fall 2014 or Spring 2015 (N = 966). Methods: We assessed characteristics associated with preference for and use of short-acting hormonal or LARC methods (i.e., more-effective contraception). Results: 47% preferred short-acting hormonal methods and 21% preferred LARC, compared to 21% and 9%, respectively, who used these methods. A total of 63% of condom and withdrawal users and 78% of nonusers preferred a more effective method. Many noted cost and insurance barriers as reasons for not using their preferred more-effective method. Conclusions: Many young women in this sample who relied on less-effective methods preferred to use more-effective contraception. Reducing barriers could lead to higher uptake in this population at high risk of unintended pregnancy.     

Who Cares What Others Think? the Indirect Effect of Others’ Attitudes on Condom Use Intentions

ABSTRACT

This qualitative exploratory research project was conducted to determine how women involve their sexual partners in decisions to obtain emergency contraception (EC) after unprotected sex or contraceptive failure. Using a grounded theory framework, I found that the most important determinant of partner inclusion in this decision was relationship status. More specifically, if the respondent was in a longer-term dating relationship at the time of the incident, she was more likely to involve her partner in the decision-making process compared with those respondents in casual relationships. The reason for being at risk for pregnancy (e.g., a broken condom vs. a missed birth control pill) also influenced partner inclusion. And finally, I found that often it was the men who initiated the conversation about obtaining EC originally. Overall, this research demonstrates that men do indeed have a part to play in EC decision making and need to be included in future research.     

Own‐Choice Marriage and Fertility in Turkey

Goode's foundational work on the fertility transition identified own‐choice marriage as a factor driving fertility decline, part of a widening repertoire of choice pertaining to marriage and childbearing. Yet research supporting this connection in today's transitional societies is scarce and somewhat contradictory, and it is unclear how other marital traditions, such as consanguineous marriage, shape this relationship. This study evaluates Goode's theorized connection using pooled Demographic and Health Survey data from Turkey, comparing children ever born, use of contraception, and parity progression across four types of marriage: own‐choice and arranged marriage and marriage to a cousin versus an unrelated spouse. Results are largely consistent with the idea that a move toward own‐choice marriage reflects a widening repertoire of choice that also leads to fertility decline. However, they also show that hybrid models like own‐choice marriage to a cousin tempers these effects.     

Predicting the Condom Assertiveness of Collegiate Females in the United States From the Expanded Health Belief Model

ABSTRACT. Collegiate females in the United States are susceptible to sexually transmitted infections (STIs) due to their propensity for sexual exploration, multiple sexual partnerships, and inconsistent safe-sex practices. Despite the potential for safe-sex communication to contribute to safer sex, little is known about the predictors of this form of sexual communication. Research on condom assertiveness—the unambiguous messaging that sex without a condom is unacceptable—is especially rare. This study employed the Expanded Health Belief Model (EHBM) in an attempt to understand why some collegiate females are more condom assertive than others. Compared with less condom-assertive females, more condom-assertive females have more faith in the effectiveness of condoms, believe more in their own condom communication skills, perceive that they are more susceptible to STIs, believe there are more relational benefits to being condom assertive, believe their peers are more condom assertive, and intend to be more condom assertive. Overall, EHBM variables accounted for nearly 70% of the variability in condom assertiveness. Several of these associations, however, were moderated by sexual compulsivity and general assertiveness. Implications of these findings for sexual health practitioners are discussed, and directions for future research are suggested.     

“No strings attached”: A qualitative exploration of gay and bisexual men’s motivations for and attitudes toward engaging in casual sex while on vacation

Prior quantitative research with gay and bisexual men (GBM) has documented high rates of sexual risk behavior during recreational travel. Although some associations are known (e.g., substance use at the tourist destination is associated with sexual risk), less is known about GBM’s motivations for travel and the cognitive and attitudinal factors that influence their sexual behavior while vacationing. In the present study, we conducted qualitative interviews with 46 GBM recruited from three popular gay tourist destinations. Using the Health Belief Model (HBM) as a guiding theoretical framework, the findings of the study revealed that the gay-friendly, tropical, relaxing environments resulted in men letting their guard down and engaging in more risk than when they are at home. Various barriers such as peer pressure and substance use affect GBM’s ability to engage in healthier behaviors while traveling, with condom negotiation and HIV status disclosure as additional issues that impact the sex practices of this population. Results highlight the applicability of HBM constructs to provide insight for intervention development for this population.