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.     

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.     

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.     

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.     

Determinants of contraceptive choice among Japanese women: ten years after the pill approval

The Japanese government approved the use of oral contraception (OC) in 1999, but OC users remain a small minority in Japan. Using the results of an online survey conducted in 2010, I examine the factors determining Japanese women’s choice of contraceptive method by estimating multinomial choice models. The estimation results indicate that OC use is positively associated with age, willingness to pay for contraceptive effectiveness, frequency of intercourse and experience with abortion or emergency contraception. These findings suggest that OC use increases as women learn from experience and that the low and declining frequency of intercourse in Japan offers one explanation for the slow diffusion of OC. Additionally, the findings indicate that OC use is more prevalent among women with a higher risk of unintended pregnancies. Subjective probabilities regarding each contraceptive method’s contraceptive effectiveness, disruption of romantic moods, partner disapproval, side benefits and minor, non-life-threatening side effects are important determinants of contraceptive choice. The perceived risk levels of OC side effects are significantly higher than the population-based probabilities, implying that increased medical knowledge might increase OC use.     

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.     

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.     

People Will Know We Are in Love: Evidence of Differences Between Vocal Samples Directed Toward Lovers and Friends

Research has documented the tendency for individuals to change their voices as a function of different emotional and motivational states, but little attention has been devoted to examining voice modulation in romantic relationships. The present research was conducted to determine (1) the way in which individuals alter their voices when speaking to romantic partners versus friends and (2) if independent raters perceive these differences. Independent raters (N = 80) listened to vocal clips obtained from telephone calls directed toward close same-sex friends and romantic partners. For several clips, raters were able to identify conversational partner (romantic versus friend) with greater than chance accuracy, and this accuracy was positively correlated with vocal pitch and perceived romantic interest. In addition, raters who listened to content-filtered clips judged callers less favorably when talking to their romantic partners than their friends. Results are interpreted in light of the “longing” but vulnerable condition of intense romantic love, and integrated into affection exchange theory and communication accommodation theory.     

Perceived Relational Support in Adolescence: Dimensions,Configurations, and Adolescent Adjustment

The perceived relational support from four key providers (father, mother, special sibling, and best friend) on five provisions (quality of information, respect for autonomy, emotional support, convergence of goals, and acceptance) was examined for 2,262 adolescents (aged 12 – 18 years). In a variable‐centered approach, factor analyses yielded five dimensions of support: three specific to providers (parent, friend, and sibling support) and two specific to provisions (convergence of goals and respect for autonomy). Only parental support was found to change (decrease) across age. In a person‐centered approach, five types of adolescents with different configurations of perceived support were identified. The first three types differed in overall level of support (high, average, and low) for all of the five dimensions; the fourth type represented extremely low support from parents with above‐average support from best friends; the fifth type consisted of adolescents with no best friend. These configurations were significantly related to different patterns of adolescent adjustment in various domains (psychological well‐being, delinquency, substance use, and peer‐group functioning).     

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.     

Attachment Style With Mother,Father, Best Friend,and Romantic Partner During Adolescence

Self‐reported attachment styles with mother, father, best friend, and romantic partner were assessed longitudinally across adolescence. Three cohorts (ages 13, 16, and 19 years; N=373) from a community sample were followed across 2 years. There was only one change in attachment styles with age: the oldest adolescents were more dismissive than the younger. Adolescents were more secure with mother than with father, and most dismissive and fearful with father. Boys were more dismissing than girls, who were more fearful with a romantic partner (n=158). Across time, attachment insecurity with father was associated with insecurity with a best friend. Attachment insecurity with a romantic partner was associated primarily with insecurity with friend, but changes over time tended to be associated with insecurity with mother. Results support the view of a differentiated hierarchy of attachment figures in adolescence, with the quality of parental attachment contributing to close extra‐familial relationships.     

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.     

Social and attitudinal determinants of contraceptive choice: Using the health belief model

The factors associated with choice of birth control pills or a diaphragm were examined, using concepts derived from the Health Belief Model (Rosenstock, 1974). Women who visited a suburban family planning clinic completed a self‐administered questionnaire (N— 632) indicating their contraceptive choice, attitudes about different methods of contraception, and perceived threat of pregnancy. Using discriminant function analysis, pill users were distinguished from diaphragm users by (a) their reported perception of greater support from others for using the pill, (b) their reported belief the diaphragm was more inconvenient to use and the pill more convenient, (c) expressing less concern about the pill's side effects, (d) believing they were more protected from pregnancy when using the pill and more susceptible when not using it, and (e) knowing less about contraception in general. They also were younger and more likely to be involved in a committed sexual relationship. Results are consistent with the Health Belief Model and also support the inclusion of a subjective‐norm factor into the model.     

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.     

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.     

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.     

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.     

Effect of Sex Education on the Sexual and Contraceptive Practices of Female Teenagers in Mexico City

After having carried out a review of the literature on the relationship between sex education and sexual and contraceptive behavior, the National Research Council (1987) recently concluded that the existing evaluation of the effects of sex education on sexual and contraceptive practices is helpful but not sufficient. One possible explanation for the different results obtained are the diverse sociodemographic characteristics of the sample or samples of teenagers under consideration. Another aspect that can account for the differences found in the literature focuses on the areas covered in the course. In Mexico no studies have been carried out which deal with the relationship between sex education and sexual and contraceptive behavior. A study was carried out with 392 female teenagers between 16 and 17 years old of lower and middle lower socioeconomic level. Results show that the mere fact of attending a sex education course did not affect the initiation or continuation of sexual activity, contraceptive behavior or even the perception of accessibility to contraception. Providing information on sexuality, relationship with the partner and where to obtain contraceptives does not have an effect on sexual activity. Receiving information on pregnancy prevention and on where to obtain contraceptives was found to be related to contraceptive use. Although less dramatic, information about the relationship with the partner and on sexuality also produced increases in contraceptive use.     

Desired Characteristics of Spouses and Best Friends: Do They Differ by Sex and/or Gender?

In view of the salutary effects that having one's spouse as one's best friend are said to impart (G. R. Lee 1988; Schwartz 1994), we investigated the relationship between desired characteristics of a best friend and of a spouse. Consistent with earlier scholarship in this area, we found that desired characteristics overlap considerably for those two roles. We also found that men's and women's selection of characteristics are highly similar and that having a current same-sex or cross-sex best friend did not modify the characteristics chosen for either best friends or spouses. We discuss these findings in terms of the trend toward nontraditional gender role identities and expectations in close relationships.