Contraceptive use patterns within females' first sexual relationships: the role of relationships, partners, and methods

This study used the 1995 National Survey of Family Growth (NSFG) to assess whether characteristics of females' sexual partners, relationships, and choice of contraceptive methods were associated with contraceptive use patterns within their first sexual relationship. White, black, and Hispanic females under age 25 (N=915) provided retrospective information on sexual activity and contraceptive use for first sexual relationships that occurred between 1991 and 1995. Females with older sexual partners and with same race/ethnicity partners (among Hispanics) had reduced odds of ever using contraception and/or uninterrupted use. Longer sexual relationships were associated with higher odds of ever using contraception but lower odds of uninterrupted use. Females who were older at first sex, who used hormonal methods (among whites), or who switched to more effective methods during their first sexual relationships had higher odds of ever using contraception and/or uninterrupted use. In contrast, switching to less effective methods during a first sexual relationship was associated with reduced odds of uninterrupted use.     

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.     

College student contraceptive use: A multivariate analysis

This study investigated the relationship of 22 variables—categorized as relating to sexual history, relationship, social support, contraception beliefs, and personality factors—to contraceptive use by college women and men. The use of effective contraception by both women and men was primarily associated with partner support for contraception; and the choice between oral contraceptives and condoms was associated with frequency of intercourse.     

Young and Sexual in Norway and Croatia: Revisiting the Scandinavian Versus Mediterranean Gendered Pattern of Sexual Initiation

ABSTRACT

This article describes and analyzes patterns of first sexual intercourse and contraception use from a bicultural perspective. Study results are based on a 2009–2010 large-scale national probability survey of young adults aged 18 to 24 years in Croatia (n = 1,005) and Norway (n = 871). The findings corroborated the persistence of the dual model of sexual initiation in Europe (Scandinavian vs. Mediterranean), in which Norwegian women and Croatian men reported coital debut at an earlier age than their gender counterparts. Age difference between partners and the prevalence of condom use at first coitus were similar in both countries, with differences in contraceptive choices emerging with time. Young Norwegian men and women switched from using condoms to hormonal contraception when having been coitally active for some time. Interestingly, “the pill” remains rather unpopular among young Croatian women. Controlling for selected variables, using a condom at most recent sexual intercourse was significantly associated with condom use at first intercourse in all groups except Norwegian men, as well as with years of coital activity (except among Croatian men). Additionally, the odds of a condom being used at most recent intercourse were significantly correlated with same-sex sexual experience (only among Norwegian men) and with reporting the most recent intercourse with a casual partner (only among Norwegian participants). Country-specific patterns of contraceptive use are discussed in the context of public health and prevention.     

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.     

Coitus‐dependent contraceptives: Factors associated with effective use

The factors associated with adequate contraceptive use among university women relying on coitus‐dependent contraceptives were examined. Sixty‐nine sexually active women between the ages of 18 and 34 completed daily logs of their sexual activity, contraceptive behavior and basal body temperature over three menstrual cycles. Contraceptive use was analyzed by menstrual cycle phase and results indicated that frequency of use was significantly higher during the ovulatory phase as compared to the menstrual period. Additional findings using discriminant function analysis indicated that compared to risk takers, non‐risk takers were more likely to initiate sexual intercourse, have more orgasms, have a non‐Catholic background, be living with their partners and have been in their relationships longer. These data suggest that women in less stable relationships and with more sexual inhibitions may be more at risk of an unwanted pregnancy.     

Gender Differences in Receptivity to Sexual Offers

Abstract

Recent research on both the concept of illusion of fertility control and infant-mother attachment theory have provided insight into the nature of people's sexual behavior. The present investigation examined the influence of both (a) illusion of fertility control and (b) attachment tendencies on contraceptive behavior. The participants were undergraduates at a small Midwestern university who received partial course credit for participation. Multiple regression analyses revealed that illusion of fertility control and attachment style were related to contraception. Two subscales of the IFCS were related to contraception. More specifically, a belief in bodily control was associated with less effective current contraceptive use. In addition, females who felt more independence from their partners in making sexual decisions were characterized by a higher contraceptive failure rate. Other results indicated that individuals with a dismissing attachment style reported a history of less reliable contraception.     

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.     

Sexual Behavior Among College Students in the AIDS Era

The sexual behavior of a 1988 midwestern college sample was compared to a highly similar 1982 sample to determine the impact of the AIDS epidemic. Contrary to expectations, sexual activity increased over the six-year period. More students in the 1988 sample had engaged in intercourse. They had also had more partners for intercourse and more lifetime intercourse experience. Age of first intercourse remained unchanged, however. Attitudes for both sexes became more permissive and males also perceived their parents to have become more permissive. A continuing double-standard was suggested. There were increases in contraceptive frequency, in contraception at last intercourse, and use of more sophisticated contraceptive methods. Increased condom use did not appear to be AIDS-induced, as there was no increase in use from first to last intercourse. Students sexual, contraceptive, and verbal behavior suggested no obvious concern about AIDS.     

Dynamic Change Between Intimate Partner Violence and Contraceptive Use Over Time in Young Adult Men’s and Women’s Relationships

The negative association between intimate partner violence (IPV) and contraceptive use is well established, but much of this research treats the association as static (e.g., similar across all relationships over development or time). Such studies do not account for individual development of sexual and romantic relationship mental, social, and behavioral well-being, which relate to contraceptive use. These studies are also predominantly woman-focused; such work could be complemented by examining men’s associations. The current study examined how associations between sexual and physical IPV and consistent condom and birth control (BC) use changed across up to seven sequential relationships in young adulthood over a five-year period within a nationally representative sample. Results indicated that physical IPV–contraception associations were significant only across earliest or latest relationships. Sexual IPV–contraception associations were significant over more relationships but often changed in valence (negative to positive). There were few significant differences in these associations between men and women. Developmental context (e.g., prior relationship/IPV experience) may be important when considering IPV–contraception associations. In addition, although the IPV–contraception association does not appear to be a unique problem for women, research needs to explore how underlying mechanisms explaining this association may be a result of gendered and nongendered contexts.     

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.     

Body Appreciation and Contraceptive Use Among College Women: A Brief Report

Research suggests that body image and sexual behaviors are related, with poor body image associated with risky behaviors and positive body image related to protective behaviors. However, few studies explore the relationships between positive body image and contraceptive use. Accordingly, the current study investigated the relationship between body appreciation and barrier and hormonal contraceptive use among college women (N = 399). Body appreciation was significantly related to male condom use and to the use of both male condoms and a hormonal contraceptive. These findings are promising as dual contraceptive use is the best way to prevent unintended pregnancy and sexually transmitted infections (STIs).     

The “Cougar” Phenomenon: An Examination of the Factors That Influence Age‐Hypogamous Sexual Relationships Among Middle‐Aged Women

Using data from the National Survey of Family Growth, the authors considered the prevalence of the “cougar” phenomenon and the characteristics of middle‐aged women who reported having sexual relationships with younger men in the past 12 months. They found that roughly 13% of sexually active women between ages 35 and 44 had slept with a man who was at least 5 years younger. Contrary to conventional assumptions, the results show that women with low incomes and those who self‐identify as “other race” (not White or Black) are more likely to be in an age‐hypogamous sexual relationship. Relative to all other relationship statuses, previously married women are the most likely to choose younger partners. Finally, the results suggest that age‐hypogamous relationships are not simply “flings”; a majority of them last at least 2 years, and a sizable share of “cougars” are married to their younger partners. These results highlight the need to reconsider our conventional understanding of women's sexual relationships at midlife.     

Sexual fantasies about one's partner versus someone else: Gender differences in incidence and frequency

Gender differences in the proportion of sexual fantasies involving someone other than a current partner (extradyadic fantasies) were explored using an anonymous questionnaire administered to 349 university students and employees (ages 18 to 70) who reported that they were currently in heterosexual relationships. Eighty‐seven percent of the sample (98% of men and 80% of women) reported having extradyadic fantasies in the past 2 months. A hierarchical regression analysis revealed that, compared to women, a larger percentage of men's sexual fantasies were extradyadic even after controlling for the effects of relationship length, number of prior sex partners, any prior incidents of actual extradyadic sexual behavior or “cheating” on the current partner, and socioeconomic status. In addition, it was found that the proportion of extradyadic fantasies increased as a function of relationship length for both genders, while prior incidents of extradyadic sexual behavior and a larger number of prior partners were associated with a higher proportion of extradyadic fantasies for women only.     

Cycle-Related Changes in Mood,Sexual Desire,and Sexual Activity in Oral Contraception-Using and Nonhormonal-Contraception-Using Couples

Findings on women's sexuality across the menstrual cycle are inconsistent. One relatively consistent finding is a midcycle and premenstrual peak in sexual desire in freely cycling women. Results on the cycle-related effects on sexual behavior are less clear. Large proportions of reproductive-aged women use combined oral contraception (COC), but studies on potential cycle-related shifts in sexual desire and behavior are sparse. A prospective diary study assessed sexual desire, sexual behavior, and mood in 89 heterosexual couples. Women were using one of four contraceptive methods: (1) nonhormonal contraception, (2) low-dose COC containing 20 mcg ethinylestradiol and 75 mcg gestoden or desogestrel, (3) COC containing 35 mcg ethinylestradiol and 2 mg cyproteronacetate, and (4) COC containing 30 mcg ethinylestradiol and 3 mg drospirenone. No cycle effects of sexual desire were established in the COC group, but frequency of sexual intercourse declined in the last days of active pill taking. These results were similar in both female and male partners. Negative affect did not covary with sexual desire.     

Child Support Enforcement and Sexual Activity of Male Adolescents

Strong child support enforcement requires fathers to take financial responsibility for their children and may also encourage more responsible sexual behavior. Using the 1997 – 2001 waves of the 1997 National Longitudinal Survey of Youth (N = 4,272), this article examines the association between child support enforcement and the sexual activity of male adolescents. Stronger child support enforcement was associated with fewer sexual partners, less frequent sexual intercourse, and a higher likelihood of using contraceptive methods among adolescents who had had sexual intercourse in the 12 months preceding data collection. The effects of child support enforcement were particularly strong for non‐White adolescents and those living in high‐poverty areas. These findings suggest that strengthening child support enforcement may be associated with reductions in some aspects of male adolescents’ sexual activity.     

Contraceptive Method Choice Among Young Adults: Influence of Individual and Relationship Factors

Because decisions related to contraceptive behavior are often made by young adults in the context of specific relationships, the relational context likely influences use of contraceptives. Data presented here are from in-person structured interviews with 536 Black, Hispanic, and White young adults from East Los Angeles, California. We collected partner-specific relational and contraceptive data on all sexual partnerships for each individual, on four occasions, over one year. Using three-level multinomial logistic regression models, we examined individual and relationship factors predictive of contraceptive use. Results indicated that both individual and relationship factors predicted contraceptive use, but factors varied by method. Participants reporting greater perceived partner exclusivity and relationship commitment were more likely to use hormonal/long-acting methods only or a less effective method/no method versus condoms only. Those with greater participation in sexual decision making were more likely to use any method over a less effective method/no method and were more likely to use condoms only or dual methods versus a hormonal/long-acting method only. In addition, for women only, those who reported greater relationship commitment were more likely to use hormonal/long-acting methods or a less effective method/no method versus a dual method. In summary, interactive relationship qualities and dynamics (commitment and sexual decision making) significantly predicted contraceptive use.     

Regional Prevalence,Patterns and Correlates of Sexual Coercion Among Women in Sub-Saharan Africa: A Multi-Country Population-Based Study

Abstract

Objective: This study investigates the prevalence, perpetrators, and factors associated with forced sexual acts. Methods: Pooled secondary data from the most recent Demographic and Health Survey (DHS) in 22 sub-Saharan African countries was used in this study. The individual woman components of the questionnaire involving 148,720 women of reproductive age (15-49?years) were analyzed. Percentages and graphs were used to present distribution of study variables. Multivariable logistic regression was used to examine factors associated with sexual coercion. Results: Forced sexual acts were prominent in Rwanda (15.7%), Gabon (12.3%) and Democratic Republic of Congo (10.9%). The lowest mean age at first forced sexual acts was recorded in Gabon (14.1?years), Comoros and Mali (14.9?years each), whereas the maximum was recorded in Namibia (25.9?years). Results from adjusted logistic regression models identified that factors such as high women decision making power, large spousal age difference, rural residence, Islamic religious beliefs and listening to radio were significantly associated with reduction in the odds of forced sexual acts. Conversely, high-risk partner’s behavior, older age at start of first marriage, early age at sexual debut, most disadvantaged community, education, and the use of newspapers were significantly associated with higher odds of forced sexual acts. Conclusion: Based on the findings of this study, policies should be reinforced to handle perpetrators of sexual violence especially non-intimate partners. Population-based preventive measures of sexual coercion are essential to complement justice system responses. Our findings also showed the importance of building gender equity as part of sexual violence prevention approach.     

Sexual Transformations and Intimate Behaviors in Romantic Relationships

To understand the association between sexual transformations (i.e., changes in sexual behavior for the partner), intimate behaviors, and relationship quality among couples in romantic relationships, this study used Actor Partner Interdependence Models to examine frequency of sexual transformations, feelings about sexual transformations, and intimate behaviors as predictors of relationship satisfaction among 96 couples (N = 192). Sexual transformations were also examined as a moderator of the association between intimate behavior and relationship satisfaction. Results indicated that relationship satisfaction was positively associated with partners’ frequent sexual transformations, actors’ positive feelings about sexual transformations, and intimate behavior from the partner. Further, in less intimate relationships, relationship satisfaction was greater when partners reported making more sexual transformations.