Reframing motherhood through the culture-centered approach: articulations of agency among young Nepalese women

Based upon the culture-centered approach that foregrounds the relevance of interrogating the taken-for-granted assumptions that circulate in the dominant models of health communication on family planning, this article argues that traditional approaches to reproductive health campaigns are concerned with safe motherhood (e.g., fertility, birth spacing, hospital delivery) rather than with the processes through which women construct, negotiate, and maintain meanings of motherhood and health within their cultural contexts. In doing so, this traditional framework leaves out the broader sociocultural, political, and economic contexts of social structures that constrain and enable the possibilities for health in the realm of motherhood. The culture-centered approach notes the erasure of these voices of women from dominant epistemic structures, and seeks to interrupt knowledge production by co-constructing meanings of reproductive health through dialogues with women at the margins. Therefore, in-depth interviews were conducted to centralize experiences of the cultural participants, allowing alternative health meanings to emerge within their local contexts. In particular, highlighting narratives of young Nepalese women living under poverty, we are able to understand how women actively (re)construct meanings of motherhood within their localized cultural spaces.

Racial and ethnic disparities in contraceptive method choice in California

CONTEXT

Unintended pregnancy, an important public health issue, disproportionately affects minority populations. Yet, the independent associations of race, ethnicity and other characteristics with contraceptive choice have not been well studied.

METHODS

Racial and ethnic disparities in contraceptive use among 3,277 women aged 18-44 and at risk for unintended pregnancy were assessed using 2006-2008 data from of the California Women's Health Survey. Sequential logistic regression analyses were used to examine the independent and cumulative associations of racial, ethnic, demographic and socioeconomic characteristics with method choice.

RESULTS

Differences in contraceptive use persisted in analyses controlling for demographic and socioeconomic characteristics. Blacks and foreign-born Asians were less likely than whites to use high-efficacy reversible methods-that is, hormonals or IUDs (odds ratio, 0.5 for each). No differences by race or ethnicity were found specifically for IUD use in the full model. Blacks and U.S.-born Hispanics were more likely than whites to choose female sterilization (1.9 and 1.7, respectively), while foreign-born Asians had reduced odds of such use (0.4). Finally, blacks and foreign-born Asians were less likely than whites to rely on male sterilization (0.3 and 0.1, respectively).

CONCLUSIONS

Socioeconomic factors did not explain the disparities in method choice among racial and ethnic groups. Intervention programs that focus on improving contraceptive choice among black and, particularly, Asian populations need to be developed, as such programs have the potential to reduce the number of unintended pregnancies that occur among these high-risk groups.

Race, ethnicity and differences in contraception among low-income women: methods received by Family PACT Clients, California, 2001-2007

CONTEXT

The extent to which racial and ethnic differences in method choice are associated with financial barriers is unclear. Understanding these associations may provide insight into how to address racial and ethnic disparities in unintended pregnancy.

METHODS

Claims data from the California Family PACT program, which provides free family planning services to low-income residents, were used to determine the proportions of women receiving each type of contraceptive method in 2001-2007. Bivariate and multivariate analyses were performed to identify associations between women's race and ethnicity and the primary contraceptive method they received in 2007.

RESULTS

Compared with white women, blacks and Latinas were less likely to receive oral contraceptives (odds ratios, 0.4 and 0.6, respectively) and the contraceptive ring (0.7 and 0.5), and more likely to receive the injectable (1.6 and 1.4) and the patch (1.6 and 2.3). Black women were less likely than whites to receive the IUD (0.5), but more likely to receive barrier methods and emergency contraceptive pills (2.6); associations were similar, though weaker, for Latinas. Racial and ethnic disparities in receipt of effective methods declined between 2001 and 2005, largely because receipt of the patch (which was introduced in 2002) was higher among minority than white women.

CONCLUSION

Although Family PACT eliminates financial barriers to method choice, the methods women received differed substantially by race and ethnicity in this low-income population. The reduction in racial and ethnic disparities following introduction of the patch suggests that methods with novel characteristics may increase acceptability of contraceptives among minority women.

Familial, cultural and psychosocial influences of use of effective methods of contraception among Mexican-American adolescents and young adults

STUDY OBJECTIVE

To compare culturally relevant factors associated with ever having used an effective method of contraception among a cohort of predominantly Mexican American females.

DESIGN

Face to face interviews were conducted in either English or Spanish. The survey used was developed directly for this study based on qualitative research with this population as well as the existing literature. Women were grouped as either adolescents (ages 13-20) or young adults (ages 21-25) for study purposes.

SETTING

Two community-based outpatient clinics on Chicago's West Side.

PARTICIPANTS

Non-pregnant Latina females between 13-25 years of age.

MAIN OUTCOME MEASURES

Comparison of familial, cultural and psychosocial factors associated with use of effective contraception using bivariate and multivariable analyses.

RESULTS

Final analysis included 267 participants. Multivariable models yielded three factors found to be statistically significant predictors of effective contraception use, but only one was significant for both age groups. Number of children was a strong predictor of effective contraceptive use among both Latina adolescents and young adults (P < 0.001 for adolescents and P = 0.049 for young adults). Partner communication predicted effective contraceptive use among Latina adolescents (P = 0.001). Acculturation level strongly predicted effective contraceptive use among Latina young adults (P < 0.001).

CONCLUSIONS

Findings demonstrate the need to tailor messages to Latina adolescent and young adults to reduce unintended pregnancy. Interventions to improve effective contraceptive use among Latina adolescents should promote effective forms of contraception in conjunction with communication with their partners about birth control. In contrast, efforts to address unintended pregnancy among Latina young adults should be sensitive to degree of acculturation.

Barriers to adoption of family planning among women in Eastern Democratic Republic of Congo

The objectives of this survey were to identify women's level of KAP toward FP; identify possible barriers to using FP; determine pregnancy spacing pattern; and ascertain the level of FP promotion by health workers. This was a 2-weeks cross-sectional survey at all maternity units in Butembo of post-partum women. 572 women were interviewed. FP knowledge was high (76%), perception good (80%). Majority used traditional methods (65%), mostly Calendar method (72%). Barriers to using modern FP included lack of knowledge, fear of side effects, religious considerations and husband opposition. Unmet need for spacing and limiting was high (21 & 31%). For majority (56%), pregnancy spacing met WHO's Healthy Timing and Spacing of Pregnancy recommendations. Promotion of FP was poor (42%). Training of health workers, advocating modern contraception, improving FP services in all public health facilities and promoting FP on each contact of women is highly recommended in this city.

Influence of culture on contraceptive utilization among HIV-positive women in Brazil, Kenya, and South Africa

Contraceptive choice and discontinuation are poorly understood among HIV-positive women, and HIV disease and culture may influence decisions. We assessed factors influencing contraceptive decision-making among HIV-positive women in three countries. This qualitative assessment of 108 HIV-positive women (36/site, selected by age and parity strata) was conducted in Rio de Janeiro, Brazil; Kericho, Kenya; and Soweto, South Africa. Freelist interviews assessed knowledge and attitudes towards contraception and were analyzed enumerating frequency and saliency of mentions. There was intersite consensus around list items but priority and themes varied. Site-specific factors influencing contraceptive choice were male partner wishes and fertility desire (Brazil), side-effects (South Africa), and impact on health and HIV progression (Kenya). Age, parity, and taking antiretroviral therapy (ART) impacted some themes. Contraceptive use among HIV-positive women is substantially influenced by culture and other factors. Counseling efforts should consider individual factors in method selection and offer method variety to accommodate changing needs.

The effect of spousal communication on contraceptive use in Central Terai, Nepal

OBJECTIVE

Family planning has several social and health benefits; it can reduce maternal mortality and the number of unplanned pregnancies, as well as increase educational and economic opportunities. Utilizing quantitative data from an endline household survey (July 2009) and data from focus group discussions, the Centre for Development and Population Activities (CEDPA) seeks to determine whether spousal communication increases contraceptive use among married women of child-bearing age in Nepal's Central Terai region.

METHODS

Quantitative household survey and qualitative focus group discussions.

RESULTS

Women who discuss family planning with their husbands (OR=7.254), perceive husband approval on family planning (OR=5.558) and have born a son (OR=2.239) are more likely to use a modern contraceptive method. Qualitative data show that several other considerations can be motivating factors for contraceptive uptake.

CONCLUSION

While results do not explain the direction of causality, it is clear that spousal discussion and partner approval are significant in a woman's decision to use modern contraceptives in the Central Terai region of Nepal.

PRACTICE IMPLICATIONS

More research needs to be conducted on the effect of spousal communication and contraceptive use, in particular, the role of frequency, quality, and content of spousal communication, as well as individual motivations.

Reactions of heterosexual African American men to women's condom negotiation strategies

This study describes responses of 172 single heterosexual African American men, ages 18 to 35, to condom negotiation attempts. Strategies used included reward, coercive, legitimate, expert, referent, and informational strategies, based on Raven's (1992) influence model. The purpose was (a) to identify strategies influencing participant acquiescence to request and (b) to identify predictors of participant compliance/refusal to comply with negotiation attempts. Participants viewed six videotape segments showing an actress, portrayed in silhouette, speaking to the viewer as a "steady partner." After each segment, participants completed measures of request compliance, positive and negative affect, and attributions concerning the model and themselves. No significant differences were found in men's ratings across all vignettes. However, differences in response existed across subgroups of individuals, suggesting that, although the strategy used had little impact on participant response, the act of suggesting condom use produced responses that differed across participant subgroups. Subgroups differed on levels of AIDS risk knowledge, sexually transmitted disease history, and experience with sexual coercion. Also, the "least willing to use" subgroup was highest in anger-rejection and least likely to make attributions of caring for partner. Effective negotiation of condom use with a male sexual partner may not be determined as much by specific strategy used as by partner characteristics.

Re-framing microbicide acceptability: findings from the MDP301 trial

Microbicides are most usually conceptualised within a disease prevention framework and studies usually define acceptability in terms of product characteristics, willingness to use and risk reduction. This starting point has led to assumptions about microbicides which, rather than being challenged by empirical studies, have tended to foreclose the data and subsequent conceptual models. Few studies take an emic ('insider') perspective or attempt to understand how microbicides fit into the broader context of women's and men's everyday lives. As part of the integrated social science component of the MDP301 Phase III microbicide trial, in-depth interviews were conducted with female trial participants in South Africa, Zambia, Tanzania and Uganda. Women's experiences of the gel challenge several assumptions that have commonly been reiterated about microbicides. Our analysis suggests that current definitions and conceptual frameworks do not adequately account for the range of meanings that women attribute to gel. Even within the context of a clinical trial, it is possible to obtain a richer, ethnographic and cross-cultural concept of acceptability based on women's practice and emic interpretations. We now need to move beyond limited notions of acceptability and consider how microbicides fit into a more holistic picture of women's and men's sexuality and sexual health.

Beyond traditional gender roles and identity: does reconceptualisation better predict condom-related outcomes for African-American women?

African-American women continue to be at high risk for HIV and better prevention efforts are needed. The current paper sought to investigate the relationship between gender roles and condom-related outcomes among African American women. The sample consisted of 398 African-American women, who were administered a survey that contained measures of condom-related outcomes and gender role beliefs. We factor analysed their responses and three domains emerged: caretaking/mindful, interpersonal sensitivity and persistent/active coping. Results indicated that the interpersonal sensitivity domain was a significant predictor of condom use and intention with higher interpersonal sensitivity scores associated with less condom use and intentions. The persistent/active coping domain was a significant predictor of condom negotiation efficacy and condom use with higher scores in this domain associated with more condom negotiation efficacy and use. Results suggest that re-conceptualisations offer a better understanding of underlying traits that may influence condom-related outcomes for this population.

A prospective study of the sexual, emotional, and behavioral correlates associated with young women's first and usual coital events

CONTEXT

First coitus is considered a major transitional event imbued with cultural relevance. Research has focused on classifying women as virgins, with primary interest in pregnancy and sexually transmitted infection prevention and less on sexuality. This study prospectively explored young women's sexual interest and love at first and subsequent coitus.

METHODS

Daily diary data were collected during a longitudinal study of young women's sexual health (N = 387; 14-17 years at enrollment). Variables of interest included sexual interest, love, and contraceptive and disease prevention behaviors. Analysis of variance and multinomial logistic regression were utilized.

RESULTS

For first coital events, love and sexual interest were reported about "half of the day," with sexual interest significantly higher on the day of first coitus. Condom use was nine times more likely than no method at first compared to later coital events. For subsequent coitus, feeling of being in love was significantly higher compared to first coitus, with average sexual interest and love significantly higher with use of no contraceptive method over condoms. Condoms were associated with higher feelings of being in love, but lower sexual interest compared to hormonal contraception.

CONCLUSIONS

The results indicated that sexual interest and love are independent components of coital behavior. Yet the results also suggest that young women's first coitus does not fully capture the expected significance of "losing one's virginity." Thus, at first coitus, women can actively engage in protective behaviors and focus on pleasure.

Cultural adaptation among Hispanic women as related to awareness and acquisition of emergency contraception

BACKGROUND

The study was conducted to examine the relationship between cultural adaptation (acculturation), contraceptive use, personal history of induced abortion, and emergency contraceptive (EC) awareness and acquisition among a sample of young sexually active Hispanic women.

STUDY DESIGN

A total of 959 Hispanic women between 16 and 24 years of age (mean±SD 20.71±2.42 years) completed a survey containing questions on EC acquisition and awareness, acculturation, contraceptive used at last intercourse and history of induced abortion. Data were analyzed using logistic regression analyses.

RESULTS

Acculturation (p=.017), income (p=.024) and education (p<.001) were positively associated with awareness of EC. Additionally, acculturation (p=.003) and a history of an induced abortion (p=.026) were positively associated with acquisition of EC.

CONCLUSIONS

Educational programs should make an effort to include Hispanic women with lower acculturation levels as increasing their knowledge about EC use and its mechanism of action may greatly reduce the number of unplanned pregnancies in this population.

Racial disparities in contraceptive use between student and nonstudent populations

BACKGROUND

In order to explore opportunities for eliminating the persistent racial disparities in contraceptive use between Caucasian and African American young adults, we examined whether student populations display a reduced racial disparity in overall contraceptive use and use of highly effective contraceptives.

METHODS

Using data collected from the Behavioral Risk Factor Surveillance System (BRFSS) over 3 years, we conducted multivariate analysis to compare racial disparities in contraceptive use in the nonstudent, young adult (18-24 years) population with those in the student population. Analyses are controlled for age, income, education, and insurance status.

RESULTS

Both African American students and nonstudents demonstrate a trend of being more likely than their Caucasian counterparts to forego use of contraception, but the findings are statistically significant only for the impact of race on nonstudents (OR = 1.45, 95% CI 1.15-1.84). However, African American students show a greater disparity in using effective contraceptive methods compared with Caucasian peers (OR = 0.459, 95% CI 0.316-0.668) than in the nonstudent population (OR = 0.591, 95% CI 0.488-0.715).

CONCLUSIONS

Although race is not significant for predicting overall use of contraceptives among students, racial disparities are magnified among student populations with regard to use of highly effective contraceptives. Contraceptive counseling for African American young adults should focus on method effectiveness and consider additional issues, such as insurance coverage for contraceptives. For students, targeted counseling or interventions may be required.

Perceptions of the safety of oral contraceptives among a predominantly Latina population in Texas

BACKGROUND

Fear of side effects and previous negative experiences are common reasons for contraceptive nonuse.

STUDY DESIGN

We collected information about perceptions of oral contraceptive (OC) safety from 1271 women 18-49 years old in El Paso, TX, and compared their responses to a medical evaluation by a nurse practitioner. We also asked participants about their interest in obtaining OCs over the counter (OTC).

RESULTS

Among 794 women potentially at risk of unintended pregnancy, 56.0% said that OCs were medically safe for them. Reasons given for OCs being unsafe were related to fears of side effects and prior negative experiences rather than true contraindications. Older women and participants recruited at the less affluent recruitment site were significantly more likely to report that OCs were medically unsafe for them (p<.05). Nonusers who thought OCs were medically unsafe for them were as likely to be medically eligible for use as current hormonal users. Among nonusers or nonhormonal users and potential OC candidates (n=601), 60.2% said they would be more likely to use OCs if they were available OTC.

CONCLUSIONS

Women's perception of OC safety does not correlate well with medical eligibility for use. More education about the safety and health benefits of hormonal contraception is needed. OTC availability might contribute to more positive safety perceptions of OCs compared to a prescription environment.

Supply and demand challenges to modern contraceptive use in Azerbaijan

OBJECTIVES

We conducted a survey of health facilities and household members to determine supply and demand aspects of contraceptive use in Azerbaijan.

METHODS

In June 2005, we conducted interviews with 758 women and 253 men in a community-based survey in 40 communities in five districts. We also surveyed a sample of health facilities and pharmacies and conducted interviews with key informants.

RESULTS

Both men and women in these communities desire small families, yet significant supply and demand impediments exist. Despite community interest, lack of knowledge of contraception is prevalent. Fear of side effects plays a role in non-use and discontinuation of modern methods, although little opportunity exists for counselling on side effects, since few health workers are trained. An obstacle to use is legislation that only allows contraception to be prescribed by gynaecologists, who are mostly concentrated in the hospitals of urban centres. However, the main handicap to increased use of modern contraception, is insufficient contraceptive supply. Not only is there a lack of method choice nationally, but few of the facilities we surveyed had any contraceptives available. This situation threatens to worsen as the United Nations Population Fund (UNFPA) retracts commodities' funding.

CONCLUSIONS

The lack of knowledge of modern contraception, lack of trained staff and poor commodity availability signals that much remains to be done for the people of Azerbaijan to achieve their fertility control goals.

Do perceived health risks outweigh the benefits of modern contraceptives? A qualitative study in a suburban population in Istanbul, Turkey

OBJECTIVES

To evaluate the health concerns and the perceived non-contraceptive benefits of modern contraceptive methods through utilizing qualitative methods.

METHODS

Six focus group discussions were carried out with a total of 53 married women in a socio-economically disadvantaged community in Istanbul, Turkey.

RESULTS

Women had a vague knowledge of the mechanism of menstruation. Some women believed that the uterus was filled with blood -- termed 'dirty blood' -- which should be eliminated during menstruation in order to stay healthy. For this reason, amenorrhoea was recognized as the important disadvantage of the progestin-only injectable contraceptives. While the participants mentioned fallacious and exaggerated side effects related to modern methods they did not recognize their non-contraceptive benefits. Most women gained the information concerning side effects through their social networks. Sometimes the information acquired was based on rumours that biased women against the modern contraceptives.

CONCLUSIONS

Women outweighed the risks, some of which were fallacious and exaggerated, against the benefits of modern contraceptives. It is crucial to address health concerns of women and what they 'heard' from their peers during counselling sessions. Also the non-contraceptive health benefits of modern methods should be well emphasized. Since informal sources are prevalent, the effectiveness of peer education should be studied in this community.

Induced abortion frequency in Ankara, Turkey, before and after the legal regulation of induced abortion

OBJECTIVE

To determine the effects of the 1983 law that legalized induced abortion on the number and place of abortions, and on the use of family planning (FP) methods before and after abortion, and to determine the demographic characteristics and reproductive health features according to the order of abortion.

METHOD

This study included 2455 married, widowed or divorced women presenting at Mother and Child Health-Family Planning Centres in Ankara. A questionnaire was used for data collection.

RESULT

Nearly three out of 10 (28.7%) of the women had undergone at least one induced abortion. In the age groups 45-54 and 55-64, 49 and 37.3%, respectively, had had one or more terminations of pregnancy (TOPs). The induced abortion rate increased following the enacting of the law. In the 15-24 and in the 55-64 age group, 55.6 and 89%, respectively, of the women had been aborted by a private physician. Before the index pregnancy, 63.1% were not using contraception compared with 37.3% thereafter. The rate of use of FP increased after the law was passed.

CONCLUSION

Although the most common reason for having an abortion was unwanted pregnancy in all age groups and nearly 60.0% of the women aged less than 55 reported that they were not using any FP method at the time of the TOP, the proportion of women having undergone at least one of these procedures increased after the law was passed, indicating that abortion is used as a FP method.

Sexual risk-taking among adult dating couples in the United States

CONTEXT

Knowledge of sexual and contraceptive behaviors as risk factors for STDs is largely based on women's or men's separate reports of their attitudes and behaviors. Little research has been based on couples.

METHODS

Data from the 2005-2006 National Couples Survey were used to examine the sexual risk-taking behavior of 335 dating couples. Associations between each partner's characteristics and the couple's probability of recently having had anal sex and of having done something to protect themselves from STDs were assessed using logistic regression analyses. Models included measures of power dynamics and partners' perceptions of who controls sexual and contraceptive decisions.

RESULTS

Couples in which the female partner reported that her male partner made the decisions about sex and contraception had increased probability of having had anal sex during the four weeks prior to the interview. In addition, partners' relationship power and their perception of control over sex and contraception moderated associations between couples' behavior and partners' characteristics, experiences and beliefs. For example, although couples in which the male partners had known someone with AIDS were less likely than others to engage in anal sex, that association was much greater for males with high income-and thus greater power-than for those with low income.

CONCLUSIONS

Sexual behaviors are not controlled by any one individual in a relationship; characteristics of each partner are important. Couples-based interventions that take into consideration relationship-especially power-dynamics may enable individuals to initiate and sustain safer-sex practices.

Structural and environmental barriers to condom use negotiation with clients among female sex workers: implications for HIV-prevention strategies and policy

OBJECTIVES

We investigated the relationship between environmental-structural factors and condom-use negotiation with clients among female sex workers.

METHODS

We used baseline data from a 2006 Vancouver, British Columbia, community-based cohort of female sex workers, to map the clustering of "hot spots" for being pressured into unprotected sexual intercourse by a client and assess sexual HIV risk. We used multivariate logistic modeling to estimate the relationship between environmental-structural factors and being pressured by a client into unprotected sexual intercourse.

RESULTS

In multivariate analyses, being pressured into having unprotected sexual intercourse was independently associated with having an individual zoning restriction (odds ratio [OR] = 3.39; 95% confidence interval [CI] = 1.00, 9.36), working away from main streets because of policing (OR = 3.01; 95% CI = 1.39, 7.44), borrowing a used crack pipe (OR = 2.51; 95% CI = 1.06, 2.49), client-perpetrated violence (OR = 2.08; 95% CI = 1.06, 4.49), and servicing clients in cars or in public spaces (OR = 2.00; 95% CI = 1.65, 5.73).

CONCLUSIONS

Given growing global concern surrounding the failings of prohibitive sex-work legislation on sex workers' health and safety, there is urgent need for environmental-structural HIV-prevention efforts that facilitate sex workers' ability to negotiate condom use in safer sex-work environments and criminalize abuse by clients and third parties.

[Knowledge of contraception, pregnancy, and sexuality in ninth grade pupils in the municipality of Viborg during a 21-year-period]

INTRODUCTION

A study of the sources of and the changes in the knowledge about contraception, pregnancy, and sexuality during a 21-year-period.

MATERIAL AND METHODS

A questionnaire was handed out on the same day in all ninth grade classes in the Municipality of Viborg without prior notice to teachers or pupils. The results were compared with similar studies performed in 1986, 1993, and 2000.

RESULTS

In all 394 of 398 questionnaires were answered. The answers revealed that forty-three percent knew at which time in the cycle pregnancy can occur; boys with sexual debut scored lowest. The time limits for legal abortion were known by 64%, the girls had a higher level of knowledge on this item than the boys. The abortion limits for 16-year-old girls were known by 58%, but here the boys, who had made sexual debut, scored highest and the girls with no prior sexual experience scored lowest. The sources of knowledge changed over the years; screen-based media (TV, internet) now cover more than 30% of both gender's sources, and magazines/pornography comprise more than 50% of girls' and 30% of boys' sources of knowledge. The school's and friends' share in sexual education remained constant, while books and parents as knowledge sources show a downward trend.

CONCLUSION

School and friends still play a substantial role in the sexual education of ninth grade pupils, but screen-based media and magazines are now the third-most important source of information and their importance have increased considerably over the past seven years. Knowledge of time limits for abortion, early pregnancy signs and cycle has not changed except for slight gender differences.

Contraceptive use by women in Accra, Ghana: results from the 2003 Accra Women's Health Survey

The study was to determine the predictors of use of modern contraception among women in Accra, Ghana. Data were collected by trained interviewers using questionnaires. Complete data for 2199 women were analysed using Stata 8.2. The study showed that educational status was the most significant predictor of contraceptive use. Women with no formal education had a 48% reduction in the odds of having ever used contraception and a 66% reduction in the odds of currently using contraception. Regular use of health facilities did not affect contraceptive use. Female education should continue to be a priority of the Ghanaian government. Education about family planning and the effects of having large families should be integrated into the school curriculum. Ghanaian health workers need to be active in promoting the use of modern contraceptive methods.

Knowledge and practice of university students in Lebanon regarding contraception

We evaluated knowledge and practice of Lebanese university students regarding contraception in a cross-sectional, comparative study on students in public and private universities using an Arabic language self-administered questionnaire. We found low levels of knowledge of contraception. The majority of males (73.3%) and a few females (21.8%) declared previous sexual relations: the majority of males had used a condom (86.1%), but females had generally not used contraceptives (75.6%).

Contraceptive use and attitudes among female college students

Unintended pregnancy is a social issue that severely jeopardizes the quality of life for parents and their children. College age women between the ages of 20-24 have one of the highest rates of unintended pregnancies due to lack of contraceptive use and unsafe sexual practices. Since 80% of college females are sexually active and not seeking to become pregnant, it is important to provide these women with effective contraceptive options. Among this population, Black and Hispanic woman have a disproportionate rate of unintended pregnancies. The purpose of this study was to examine contraceptive attitudes and demographic characteristics among female college students. Participants were grouped into those who use contraceptives consistently, intermittently, or not at all. The sample consisted of 120 racially diverse female college students who were sexually active within the past 3 months. Participants completed the Contraceptive Attitude Scale, contraceptive use tool, and demographic tool. The results showed that there was no significant difference in demographic characteristics and contraceptive attitudes for race, age, marital status, years of college education and income between the contraceptive groups. A majority of participants had a positive attitude regarding contraceptives. Women with higher contraceptive attitude scores were significantly more likely to be consistent contraceptive users. Uninterrupted contraceptive users had significantly higher mean contraceptive attitude scores than intermittent users and nonusers. The results of this study may enable healthcare providers to develop more effective methods of increasing contraceptive use and simultaneously decrease unintended pregnancy rates. Nurses play an integral role by providing women with contraceptive counseling that will assist these women in making an informed decision about contraception use.