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.     

Socio-economic and cultural differentials in contraceptive usage among Ghanaian women

Data from the Ghana Fertility Survey of 2001 married women in 1979-1980 were subjected to logistic regression to determine the factors influencing contraceptive use. In this Ghanaian sample only 22 women and no men were sterilized, 11% used an efficient contraceptive method and 8% were using an inefficient method. The most prevalent methods were abstinence by 6% and pill by 5%. The variables analyzed were birth cohort, age at 1st marriage, education, occupation, religion, ethnicity, rural/urban residence, northern/southern residence and number of children desired number of living children. All these factors were dichotomized, e.g., cohort: born before or after 1950. Factors positively significant for contraceptive use were younger women (20% more likely), married at age 20 or older (82% more), education (150% for any method, 67% for an efficient method), professional occupations, protestants, urban residence, southern residence, desire fewer children. Factors negatively associated with contraception were agricultural work (50% as likely), non-Christian religion, both traditional and Moslems (75%), desiring more children and living in the north. Unexpectedly, living in the northern undeveloped region was strongly linked with use of an efficient contraceptive. A factor without significant effect was ethnicity, Akan or non-Akan. These results were discussed with a general review of the literature on determinants of contraceptive use.     

Factors influencing college women's contraceptive behavior: An application of the integrative model of behavioral prediction

Objective: This study investigated variables within the Integrative Model of Behavioral Prediction (IMBP) as well as differences across socioeconomic status (SES) levels within the context of inconsistent contraceptive use among college women. Participants: A nonprobability sample of 515 female college students completed an Internet-based survey between November 2014 and February 2015. Methods: Respondents were asked about their contraception use, knowledge and information sources, demographic information, and IMBP factors, including attitudes, norms, and perceived behavioral control (PBC). Results: While overall attitudes, norms, PBC, and intentions for contraceptive use were high, only 46.8% of women used contraception consistently. Data also revealed only moderate levels of knowledge about contraception. While there were no differences across SES levels for attitudes, PBC, norms or knowledge, SES levels did differ in sources used to acquire contraceptive information. Conclusions: This study highlights the need to consider where college women acquire contraceptive information which is associated with SES.     

Willingness to Have Unprotected Sex

Little is known about people's willingness to engage in sex without protection from unwanted pregnancy. This study surveyed 1,497 women and men at 75 clinics and physician offices across California after their reproductive health care visits in late 2007 and early 2008. When asked if they would have sex without contraception, 30% said definitively that yes, they would have unprotected sex, and 20% indicated they would “sometimes” or “maybe” engage in unprotected sex. In multivariate models, compared to non-Latino White respondents, Latinos who responded to the survey in English were 52% more likely and African Americans were 75% more likely to report willingness to have unprotected intercourse. Wanting a child within the next three years was associated with increased willingness to have unprotected sex. Age, gender, parity, and relationship status were not significant in multivariate models. A considerable proportion of women and men may be willing to have unprotected sex, even with access to subsidized contraceptive services and even when recently counseled about birth control. The dominant behavioral models of contraceptive use need to acknowledge the widespread likelihood of occasional unprotected sex, even among people motivated to usually use contraceptives. Findings underscore the need to make contraceptive methods accessible, easy to use, and even pleasurable.     

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.     

Son preference and reproductive behaviour in rural Punjab

This study examines the impact of son preference on desired family size and contraceptive usage among a rural population in Punjab, India. Data are obtained from a sample survey conducted for the Center for Research in Rural and Industrial Development in 1989-90 in 7 rural districts of Punjab. The sample includes 450 currently married women aged 15-44 years. Analysis pertains to mean desired family size, the percentage not desiring additional children, the percentage desiring additional sons and daughters, and current use of contraception by sex, birth order, and number of living children. The estimation of the extent to which contraception would increase and desired family size would decline is based on methods developed by Arnold (1985) that assume no sex preference at any parity. Findings indicate a strong son preference. At every parity, women with sons only desired fewer children and were more likely to use contraception. Among women who desired more children, there was no indication that women with sons only desired a balanced sex composition. None desired a second daughter, and many desired a second son. As the number of living sons increased, so did contraceptive use. Contraception was 20% among couples with no son, 50% among those with one living son, and 81% among those with two living sons. Sterilization acceptors had an average of 2.07 living sons. At parity 2, two times as many couples had boys only compared to girls only. At parity 3, there were 7 times more families with boys only than families with girls only. If sex preferences were completely eliminated in the Punjab, there would be a 9% decline in desired family size from 3.05 children to 2.77 children. Contraceptive use would increase by 14 percentage points from 58% to 72%. The cultural practices of the Jats ethnic group place girls in the position of being an economic liability.     

Willingness to have unprotected sex

Little is known about people's willingness to engage in sex without protection from unwanted pregnancy. This study surveyed 1,497 women and men at 75 clinics and physician offices across California after their reproductive health care visits in late 2007 and early 2008. When asked if they would have sex without contraception, 30% said definitively that yes, they would have unprotected sex, and 20% indicated they would "sometimes" or "maybe" engage in unprotected sex. In multivariate models, compared to non-Latino White respondents, Latinos who responded to the survey in English were 52% more likely and African Americans were 75% more likely to report willingness to have unprotected intercourse. Wanting a child within the next three years was associated with increased willingness to have unprotected sex. Age, gender, parity, and relationship status were not significant in multivariate models. A considerable proportion of women and men may be willing to have unprotected sex, even with access to subsidized contraceptive services and even when recently counseled about birth control. The dominant behavioral models of contraceptive use need to acknowledge the widespread likelihood of occasional unprotected sex, even among people motivated to usually use contraceptives. Findings underscore the need to make contraceptive methods accessible, easy to use, and even pleasurable.     

Changes in Diverse Sexual and Contraceptive Behaviors Across College

Researchers have made repeated calls for a better understanding of normative sexuality development during adolescence and young adulthood. We examined how the occurrence of seven penetrative, nonpenetrative, and contraceptive behaviors changed longitudinally across seven waves, and how individual (gender) and contextual (romantic relationship status) factors related to these changes in a sample of college students (N = 730, M age = 18.4 at Semester 1; 51% female; 26% Hispanic/Latino American, 22% Black/African American, 30% Asian American/Pacific Islander, 45% White/European American). Across college, reported kissing, touching, performing and receiving oral sex, and penetrative sex rates increased, and contraception use (any type) and condom use (in particular) rates decreased, demonstrating changes with age independent of young adults’ romantic relationship experiences. Rates of all sexual behaviors were higher, and of contraception use lower, when students were in serious romantic relationships. Contraception use decreased more for men than for women, particularly in semesters men were not in serious relationships. Condom use decreased for men, and for women in semesters they were in serious relationships. Findings demonstrate normative trends in sexuality development, as well as suggesting the value of enhanced sexual health promotion programming, with a particular focus on contraceptive behaviors, across college.     

Ukrainian medical students' experiences, attitudes, and knowledge about reproductive health.

In a 1999 classroom survey of sexual behavior among 689 1st-year medical students at Donetsk State Medical University, Ukraine, 59% of the women and 83% of the men revealed they had "ever" had sexual intercourse. The mean age of first intercourse was 15.7 years for the men and 16.6 years for the women. Thirty-two percent of the students reported they did not use contraceptives at their first intercourse, and 19% said they used no contraceptives at their most recent coitus. Condoms were the most frequent means of contraception, followed by coitus interruptus. Less than 5% used oral contraceptives, and 73% of students reported being afraid to use them. About 6% of the students reported they had had sexually transmitted infections (STI) and 10% had had an abortion. Improving knowledge concerning unwanted pregnancies and STI among Ukraine's future health providers may contribute to improving reproductive health issues in general in Ukraine.     

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.     

Socio-Demographic Characteristics of Contraceptive Users in Ghana

ABSTRACT

This paper describes the social and demographic characteristics of contraceptive users in Ghana, using the Ghana Demographic and Health Survey (GDHS) data (1993). Analysis has revealed that contraceptive use among women is quite low. Women's age, marital status, educational level, and place of residence are some of the factors that relate significantly to contraceptive use. The reasons most frequently cited for non-use of a modern birth control method are the desire to have children, lack of knowledge, and health concerns. The data show little motivation among women to practice family planning. Suggestions for effective family planning are provided.     

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.     

Labor force participation and fertility: a study of married women in Bangladesh

Most researchers support the notion that a direct negative relationship exists between married women's labor force participation and fertility behavior, yet female employment shows no consistent, general relationship with declining fertility at individual and societal levels. Specific conditions under which employment lowers fertility are therefore explored for the case of Bangladesh. The economic, sociological, and world-system theoretical approaches to the relationship and empirical studies in developing countries including Bangladesh are reviewed. 1975-76 Bangladesh Fertility Survey data on births, deaths, nuptiality, and family planning knowledge and practice for 5772 currently married women of 6513 ever married women under 50 sampled are subjected to multivariate analysis for the study. Analysis revealed that women's modern and traditional occupation as well as higher and secondary education significantly lower their fertility, and that higher age, Islamic religion, use of modern contraceptives, and husband's occupation in transitional and modern sectors have significant positive effects on fertility. The correlation between higher fertility and contraceptive use may be due to women's delay in practicing family planning until reaching desired parity and/or high infant mortality driving women to cease practice in order to replace lost offspring. Future research should be conducted with larger samples and also consider occupations of both husbands and wives. Societal attitudes about women's education should be reformed in support of opening rural schools for women. With 90% of women residing in rural areas and women with traditional occupations having lower fertility, more traditional sector opportunities for women in cottage industry and agriculture production are also recommended, and would help balance skewed urban growth and hypertrophication of the tertiary sector. Finally, motivational efforts should be focused upon encouraging younger instead of older married couples to limit fertility.     

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.     

Development and Validation of a Scale to Measure Adolescent Sexual and Reproductive Health Stigma: Results From Young Women in Ghana

Young women’s experiences with sexual and reproductive health (SRH) stigma may contribute to unintended pregnancy. Thus, stigma interventions and rigorous measures to assess their impact are needed. Based on formative work, we generated a pool of 51 items on perceived stigma around different dimensions of adolescent SRH and family planning (sex, contraception, pregnancy, childbearing, abortion). We tested items in a survey study of 1,080 women ages 15 to 24 recruited from schools, health facilities, and universities in Ghana. Confirmatory factor analysis (CFA) identified the most conceptually and statistically relevant scale, and multivariable regression established construct validity via associations between stigma and contraceptive use. CFA provided strong support for our hypothesized Adolescent SRH Stigma Scale (chi-square p value < 0.001; root mean square error of approximation [RMSEA] = 0.07; standardized root mean square residual [SRMR] = 0.06). The final 20-item scale included three subscales: internalized stigma (six items), enacted stigma (seven items), and stigmatizing lay attitudes (seven items). The scale demonstrated good internal consistency (α = 0.74) and strong subscale correlations (α = 0.82 to 0.93). Higher SRH stigma scores were inversely associated with ever having used modern contraception (adjusted odds ratio [AOR] = 0.96, confidence interval [CI] = 0.94 to 0.99, p value = 0.006). A valid, reliable instrument for assessing SRH stigma and its impact on family planning, the Adolescent SRH Stigma Scale can inform and evaluate interventions to reduce/manage stigma and foster resilience among young women in Africa and beyond.     

Gendered Dimensions of the HIV Pandemic: A Cross‐National Investigation of Women's International Nongovernmental Organizations,Contraceptive Use,and HIV Prevalence in Less‐Developed Nations

The human immunodeficiency virus (HIV) pandemic has a profound impact on women as a result of social and biological vulnerabilities to the infection. In this article, we explore the influence of democracy, women's international nongovernmental organizations (INGOs), and contraceptive use on female HIV rates, using indirect‐effect modeling techniques to properly test the interrelationships among key variables. Structural equation models reveal that democracy and women's INGOs work to reduce female HIV rates indirectly, by promoting the use of contraceptives among women in less‐developed nations. Despite these promising findings, the analyses also reveal that INGOs are negatively associated with sociohealth dimensions of female empowerment, which thus serves to promote HIV rates. The results suggest that interventions undertaken by INGOs may not be as successful as government programs in addressing inequalities in health and social resources for women in poor nations.     

Social Support and College Student Contraceptive Use

The present study investigated the relative levels of four sources of perceived support for contraceptive use-mother, father, best same-sex friend, sexual partner-and motivation to comply with influence from those sources by young men and women who used or did not use effective contraception. Overall, best friend and coital partner were perceived as providing the most support, and the same-sex parent the least. However, among nonusers of effective contraception, best friend support exceeded partner support, which was seen as no greater than parental support. Only partner support was related to contraceptive use, and motivation to comply with partner was greater than for the other sources. Possible explanations for these findings are discussed.     

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.     

Community and individual acceptance: family planning services in the Sudan

The Sudan Community-Based Health Project, initiated by the University of Khartoum in cooperation with the Ministry of Health in 1980, sought to test the proposition that government-trained village midwives could provide maternal-child health and birth spacing services in addition to their ongoing obstetrical duties. The project area encompassed 92,000 people in 93 villages. The 120 midwives serving the project area received training in 4 interventions -- oral rehydration therapy, maternal and child nutrition, immunization, and birth spacing -- and introduced these services by means of 3 rounds of household visits over a 5-month period. Comparison of pre- and post-intervention survey data indicates that village midwives can indeed be used successfully to promote not only contraceptive use, but also health attitudes and practices that are positively associated with fertility regulation. Between the 2 surveys, the percentage of women who ever used contraception increased from 22% to 28%, while the percentage of current users rose from 10% to 13%. Parity was significantly related to current use; each child born multiplied the likelihood of contraceptive acceptance (by a factor of 0.76 in the post-intervention sample). Maternal education was the socioeconomic variable that most enhanced receptivity to contraceptive acceptance after the project's interventions. In terms of community-level variables, village location along the Nile and proximity to a paved road were significant correlates of contraceptive use. When variables related to the project itself were analyzed, women with vaccinated children were found to be twice as likely to contracept as those with nonvaccinated children and women who believed breast feeding should be continued during diarrhea episodes were 1.5 times more likely to use birth spacing than those who did not. Although midwives did not specifically emphasize contraceptive use, it appears women who were encouraged by midwives to take positive steps in the area of child health were also likely to become more innovative in terms of fertility regulation.     

Feminist issues in teenage parenting

The focus of this article is on unmarried teenage parents. It is argued that sexism particularly afflicts programs and policies for these young people as well as the behaviors that lead up to their becoming unmarried parents, namely, nonmarital coitus, failure to use effective contraceptives consistently, nonuse of abortion, decision not to place the child for adoption, and decision not to marry. Sexism is defined and the origins of sexist attitudes outlined. Sexism is examined in the context of sexuality education; of research about adolescent sex behavior and in that of programs and policies. It is argued that the availability of more systematic information about female adolescent sexuality than male adolescent sexuality perpetuates the assumption that birth control, pregnancy, childbearing and child rearing are the concern of females to to a far greater extent than for males. These assumptions play into the storong tendency for adoescent sexuality-related services to be developed almost exclusively for young women. Some negative effects of sexism are discussed with respect ot attitudes toward sexual relationships, consequences of teenage parenthood, contraception and abortion. Sexism in these attitudes places unfair burdens on young women and dehumanizes young men. It is important to recognize that both young men and young women tend to have equal needs, feelings and responsibilities with respect ot their relationships with each other and with respect to the families they may or may not found.