Contraceptive confidence and timing of first birth in Moldova: an event history analysis of retrospective data

Objectives: To test the contraceptive confidence hypothesis in a modern context. The hypothesis is that women using effective or modern contraceptive methods have increased contraceptive confidence and hence a shorter interval between marriage and first birth than users of ineffective or traditional methods. We extend the hypothesis to incorporate the role of abortion, arguing that it acts as a substitute for contraception in the study context.Setting: Moldova, a country in South-East Europe. Moldova exhibits high use of traditional contraceptive methods and abortion compared with other European countries.Participants: Data are from a secondary analysis of the 2005 Moldovan Demographic and Health Survey, a nationally representative sample survey. 5377 unmarried women were selected.Primary and secondary outcome measures: The outcome measure was the interval between marriage and first birth. This was modelled using a piecewise-constant hazard regression, with abortion and contraceptive method types as primary variables along with relevant sociodemographic controls.Results: Women with high contraceptive confidence (modern method users) have a higher cumulative hazard of first birth 36?months following marriage (0.88 (0.87 to 0.89)) compared with women with low contraceptive confidence (traditional method users, cumulative hazard: 0.85 (0.84 to 0.85)). This is consistent with the contraceptive confidence hypothesis. There is a higher cumulative hazard of first birth among women with low (0.80 (0.79 to 0.80)) and moderate abortion propensities (0.76 (0.75 to 0.77)) than women with no abortion propensity (0.73 (0.72 to 0.74)) 24?months after marriage.Conclusions: Effective contraceptive use tends to increase contraceptive confidence and is associated with a shorter interval between marriage and first birth. Increased use of abortion also tends to increase contraceptive confidence and shorten birth duration, although this effect is non-linear—women with a very high use of abortion tend to have lengthy intervals between marriage and first birth

Condom use and incident sexually transmitted infection after initiation of long-acting reversible contraception

Background Use of more effective contraception may lead to less condom use and increased incidence of sexually transmitted infection. Objective The objective of this study was to compare changes in condom use and incidence of sexually transmitted infection acquisition among new initiators of long-acting reversible contraceptives to those initiating non-long-acting reversible contraceptive methods. Study Design This is a secondary analysis of the Contraceptive CHOICE Project. We included 2 sample populations of 12-month continuous contraceptive users. The first included users with complete condom data (baseline, and 3, 6, and 12 months) (long-acting reversible contraceptive users: N = 2371; other methods: N = 575). The second included users with 12-month sexually transmitted infection data (long-acting reversible contraceptive users: N = 2102; other methods: N = 592). Self-reported condom use was assessed at baseline and at 3, 6, and 12 months following enrollment. Changes in condom use and incident sexually transmitted infection rates were compared using χ2 tests. Risk factors for sexually transmitted infection acquisition were identified using multivariable logistic regression. Results Few participants in either group reported consistent condom use across all survey time points and with all partners (long-acting reversible contraceptive users: 5.2%; other methods: 11.3%; P < .001). There was no difference in change of condom use at 3, 6, and 12 months compared to baseline condom use regardless of method type (P = .65). A total of 94 incident sexually transmitted infections were documented, with long-acting reversible contraceptive users accounting for a higher proportion (3.9% vs 2.0%; P = .03). Initiation of a long-acting reversible contraceptive method was associated with increased sexually transmitted infection incidence (odds ratio, 2.0; 95% confidence ratio, 1.07–3.72). Conclusion Long-acting reversible contraceptive initiators reported lower rates of consistent condom use, but did not demonstrate a change in condom use when compared to preinitiation behaviors. Long-acting reversible contraceptive users were more likely to acquire a sexually transmitted infection in the 12 months following initiation

Contraceptive methods

El objetivo de nuestro estudio ha sido aumentar conocimientos y corregir errores, sobre el uso de métodos anticonceptivos y prevención de E.T.S. en una muestra de 30 alumnos de 3º de E.S.O. de un instituto de la provincia de Alicante. Pensamos que ante una necesidad tan evidente podíamos obtener resultados satisfactorios si utilizábamos una pedagogía participativa que atrajese a los alumnos. De este modo, por medio del paradigma sociocrítico conseguimos implicar a la muestra para que tomasen conciencia de sus propias necesidades. Se impartieron charlas a los alumnos sobre distintos temas de interés que más tarde serían evaluados. La metodología utilizada fue el test-retest. Se distribuyó un primer cuestionario antes de la primera charla para adaptar nuestra ponencia a las necesidades de la muestra, y un segundo test, de iguales características al primero, después de la última charla para evaluar los conocimientos adquiridos. Los alumnos tenían mayores problemas en aspectos como qué es la sexualidad, dónde acudir para informarnos sobre sexualidad, diferencia entre sexualidad y reproducción, dónde comprar preservativos, qué hacer ante la ruptura de un preservativo, utilización de lubricantes, vías de transmisión de las E.T.S., etc. En estos aspectos se consiguió un porcentaje de éxito en base a nuestros objetivos considerablemente elevado.The aim of our study was to increase knowledge and correct errors in the use of contraceptive methods and prevention of Sexual Transmission Diseases (STD) in a sample of 30 students in the 3rd year of ESO (GCE) from a school in the Alicante area. We considered that faced with such an evident need we could obtain very satisfactory results should we use an appealing pedagogical participation which attracted the students. So by means of a critical paradigm we managed to get them involved in the event, concerned of their own needs. Lectures on different interesting topics were given to the students, to be evaluated later on. The method used was that of the test/re-test. A questionnaire was provided before the first lecture so that we could adapt our information to their shown expressed needs; and a second questionnaire of equal characteristics was provided after the last lecture to evaluate their acquired knowledge. The students' major problems were in knowing: what sexuality means and where to go to get information about it; what is the difference between sexuality and reproduction; where to obtain sheaths; what to do if they get torn; use of lubricants, and means of sexual transmission of diseases (STD). According to our expectation the degree of success was really high

Womens Limited Choice and Availability of Modern Contraception at Retail Outlets and Public-Sector Facilities in Luanda, Angola, 2012-2015.

In Angola, many women want to use family planning but lack access to affordable and preferred methods. This article assesses the link between womens choice and availability of contraceptive methods in Luanda, Angola, drawing on data from 3 surveys: a 2012 survey among women ages 15-49 and 2 retail surveys conducted in 2014 and 2015 among outlets and facilities offering contraceptive methods. Descriptive statistics for womens contraceptive knowledge, use, and preferred methods were stratified by age group. We report the percentage of establishments offering different methods and brands of modern contraception, and the mean price, volume of units sold, and value (Angolan Kwanzas) for each brand. Data from the 2 retail surveys are compared to measure changes in availability over time. Results show that 51% of women reported having an unwanted pregnancy. Less than 40% of women knew about long-acting reversible contraceptives (LARCs). Overall, the method most commonly used was male condoms (32.1%), with a substantial proportion (17.3%) of women not using their preferred contraceptive. Trends in contraceptive use mirror availability: in 2015, condoms were available in 73.6% of outlets/facilities, while LARC methods were available in less than 10%. The availability of different methods also dropped significantly between 2014 and 2015-by up to 15 percentage points-with a subsequent price increase in many brands. To meet womens needs for contraception and make informed choice possible, Angola should reinforce demand creation and contraceptive supply in both the public and private sectors through behavior change programs aimed at both women and providers, improved quality of services, training of health personnel on method options and delivery, and improved supply chain distribution of contraceptives. This will allow women to find the methods and brands that best suit their needs, preferences, and ability to pay

Postpartum Visit Attendance Increases the Use of Modern Contraceptives

Background. Delays in postpartum contraceptive use may increase risk for unintended or rapid repeat pregnancies. The postpartum care visit (PPCV) is a good opportunity for women to discuss family planning options with their health care providers. This study examined the association between PPCV attendance and modern contraceptive use using data from a managed care organization. Methods. Claims and demographic and administrative data came from a nonprofit managed care organization in Virginia (2008–2012). Information on the most recent delivery for mothers with singleton births was analyzed (N = 24,619). Routine PPCV (yes, no) and modern contraceptive use were both dichotomized. Descriptive analyses provided percentages, frequencies, and means. Multiple logistic regression was conducted and ORs and 95% CIs were calculated. Results. More than half of the women did not attend their PPCV (50.8%) and 86.9% had no modern contraceptive use. After controlling for the effects of confounders, women with PPCV were 50% more likely to use modern contraceptive methods than women with no PPCV (OR = 1.50, 95% CI = 1.31, 1.72). Conclusions. These findings highlight the importance of PPCV in improving modern contraceptive use and guide health care policy in the effort of reducing unintended pregnancy rates

Contraceptive use and sexual function: a comparison of Italian female medical students and women attending family planning services

Objectives: The aims of the study were to understand how education relates to contraceptive choice and how sexual function can vary in relation to the use of a contraceptive method. Methods: We surveyed female medical students and women attending a family planning service (FPS) in Italy. Participants completed an online questionnaire which asked for information on sociodemographics, lifestyle, sexuality and contraceptive use and also included items of the Female Sexual Function Index (FSFI). Results: The questionnaire was completed by 413 women (362 students and 51 women attending the FPS) between the ages of 18 and 30 years. FSFI scores revealed a lower risk of sexual dysfunction among women in the control group who did not use oral hormonal contraception. The differences in FSFI total scores between the two study groups, when subdivided by the primary contraceptive method used, was statistically significant (p < 0.005). Women using the vaginal ring had the lowest risk of sexual dysfunction, compared with all other women, and had a positive sexual function profile. In particular, the highest FSFI domain scores were lubrication, orgasm and satisfaction, also among the control group. Expensive contraception, such as long-acting reversible contraception, was not preferred by this young population, even though such methods are more contemporary and manageable. Compared with controls, students had lower compliance with contraception and a negative attitude towards voluntary termination of pregnancy. Conclusion: Despite their scientific knowledge, Italian female medical students were found to need sexual and contraceptive assistance. A woman's sexual function responds to her awareness of her body and varies in relation to how she is guided in her contraceptive choice. Contraceptive counselling is an excellent means to improve female sexuality

Pregnancy and contraceptive use among women participating in an HIV prevention trial in Tanzania.

OBJECTIVES: Information on pregnancy rates and factors associated with pregnancy and contraceptive use is important for clinical trials in women in sub-Saharan Africa where withdrawal of investigational products may be required in the event of pregnancy with a consequent effect on sample size and trial power. METHODS: A prospective cohort analysis of pregnancy and contraceptive use was conducted in Tanzanian women enrolled in a randomised placebo-controlled trial of herpes simplex virus-suppressive therapy with acyclovir to measure the effect on HIV incidence in HIV-negative women and on genital and plasma HIV viral load in HIV-positive women. The cohort was followed every 3 months for 12-30 months. Women at each visit were categorised into users or non-users of contraception. Pregnancy rates and factors associated with pregnancy incidence and contraceptive use were measured. RESULTS: Overall 254 of 1305 enrolled women became pregnant at least once during follow-up (pregnancy rate: 12.0/100 person-years). Younger age, being unmarried, higher baseline parity and changes in contraceptive method during follow-up were independently associated with pregnancy. Having paid sex and being HIV positive were associated with lower risk of pregnancy. Uptake of contraception was associated with young age, being unmarried, occupation, parity and the number and type of sexual partners. CONCLUSIONS: Data on use of contraceptive methods and risk factors for pregnancy can help to guide decisions on trial eligibility and the need for additional counselling. Mandatory reliable contraceptive use in study participants may be required to reduce pregnancy rates in studies where pregnancy is contraindicated

Women’s Empowerment and Contraceptive Method Use in Egypt

Egypt’s fertility rate reached a 25-year high of 3.5 births per woman in 2014.It is assumed that women’s empowerment plays an important role in women’s choice of a specific contraceptive method. This research brief, by former PRC postdoctoral fellow Goleen Samari, found that use of long-acting methods fell in Egypt between 2005 and 2014, while use of short-acting methods increased. She also found that women’s empowerment increases the likelihood of contraceptive use in Egypt.Population Research Cente

Effects of post-abortion family planning services on contraceptive practices in China : protocol for a clustered randomized controlled trial

Study objectives: To determine whether integrating post-abortion services in hospital settings in China will increase the contraceptive use and decrease repeat abortion rates. Study design: Three-arms cluster randomised controlled trial in which the unit of randomisation is hospital. Participants: Women seeking induced abortion within 12 weeks of gestation age. Sites: Ninety hospitals from 30 provinces in China will be randomised to the three arms of the study stratified by province. In each province, eligible hospitals will be matched on the characteristics of abortion departments, especially the volume of abortions in the 2 months in the situation survey. Length of follow up: Six months. Intervention: Multiple interventions that aim to increase the use of more effective contraceptive methods, improve user adherence to reduce the unintended pregnancies and repeat induced abortions. Data collection: Data will be collected at four time points, one at baseline(month 0 at the time of enrolment) and twice during intervention (1st 3rd and 6th month after enrolment, respectively). Primary outcome: Unintended pregnancies or repeated induced abortions; immediate contraceptive uptake and the use of modern effective contraceptive methods

Contraceptive Use in the United States

WHO NEEDS CONTRACEPTIVES?There are 61 million U.S. women in their childbearing years (15–44). About 43 million of them (70%) are at risk of unintended pregnancy—that is, they are sexually active and do not want to become pregnant, but could become pregnant if they and their partners fail to use a contraceptive method correctly and consistently.Couples who do not use any method of contraception have an approximately 85% chance of experiencing a pregnancy over the course of a year.In the United States, the average desired family size is two children. To achieve this family size, a woman must use contraceptives for roughly three decades.WHO USES CONTRACEPTIVES?More than 99% of women aged 15–44 who have ever had sexual intercourse have used at least one contraceptive method.Some 62% of all women of reproductive age are currently using a contraceptive method.Ten percent of women at risk of unintended pregnancy are not currently using any contraceptive method.The proportion of women at risk who are not using a method is highest among 15–19-year-olds (18%) and lowest among women aged 40–44 (9%).Eighty-three percent of black women who are at risk of unintended pregnancy currently use a contraceptive method, compared with 91% of their Hispanic and white peers, and 90% of their Asian peers.Among women who are at risk of unintended pregnancy, 92% of those with incomes of 300% or more of the federal poverty level are currently using contraceptives, as are 89% of those living at 0–149% of the poverty line.A much higher proportion of married women than of never-married women use a contraceptive method (77% vs. 42%), largely because married women are more likely to be sexually active. But even among those at risk of unintended pregnancy, contraceptive use is higher among currently married women than among never-married women (93% vs. 83%).Unmarried cohabitors fall between married women and unmarried women who are not cohabiting with their partner: Ninety percent of at-risk cohabitors use a method.Contraceptive use is common among women of all religious denominations. Eighty-nine percent of at-risk Catholics and 90% of at-risk Protestants currently use a contraceptive method. Among sexually experienced religious women, 99% of Catholics and Protestants have ever used some form of contraception.Knowledge about contraceptive methods is a strong predictor of use among young adults: In a 2012 study among unmarried women aged 18–29, for each correct response on a contraceptive knowledge scale, women's odds of currently using a hormonal or long-acting reversible method increased by 17%, and their odds of using no method decreased by 17%.WHICH METHODS DO WOMEN USE?Sixty-seven percent of women who practice contraception currently use nonpermanent methods, primarily hormonal methods (the pill, patch, implant, injectable and vaginal ring), IUDs and condoms. The rest rely on female (25%) or male (8%) sterilization.The pill and female sterilization have been the two most commonly used methods since 1982