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Borges ALV, Duarte LS, Lay AAR, Fujimori E. Individual and context correlates of the oral pill and condom use among Brazilian female adolescents. BMC WOMENS HEALTH 2021; 21:307. [PMID: 34412604 PMCID: PMC8374415 DOI: 10.1186/s12905-021-01447-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 08/06/2021] [Indexed: 01/21/2023]
Abstract
Background Studies have examined the impact of contextual factors on the use of contraceptives among adolescents and found that many measures of income and social inequality are associated with contraceptive use. However, few have focused on maternal and primary health indicators and its influence on adolescent contraceptive use. This paper assesses whether maternal mortality rates, antenatal care visits, and primary healthcare coverage are associated with pill and condom use among female adolescents in Brazil. Methods We used data from the Study of Cardiovascular Risks in Adolescents (ERICA), a national, school-based cross-sectional study conducted in Brazil. A subsample of all female adolescents who had ever had sexual intercourse and were living in one of the 26 State capitals and the Federal District was selected (n = 7415). Multilevel mixed effects logistic regression models were estimated to examine the effect of contextual variables on pill and condom use. Results Sixty-five percent of female adolescents reported using pill while 21.9% reported using condom during the last sexual intercourse. Adolescents living in municipalities with low maternal mortality and high antenatal care coverage were significantly more likely to use pill during the last sexual intercourse compared to those from municipalities with high maternal mortality and low antenatal care coverage. Primary healthcare coverage (proportion of the population covered by primary healthcare teams) was not significantly associated with either condom or pill use during the last sexual intercourse. Conclusion Our findings suggest that promoting the use of pill among female adolescents may require approaches to strengthen healthcare systems rather than those focused solely on individual attributes. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-021-01447-6.
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Affiliation(s)
- Ana Luiza Vilela Borges
- Public Health Nursing Department, School of Nursing, University of São Paulo, São Paulo, Brazil. .,School of Nursing, University of São Paulo, Avenida Doutor Enéas de Carvalho Aguiar, 419, São Paulo, SP, 05403-000, Brazil.
| | - Luciane Simões Duarte
- Public Health Nursing Department, School of Nursing, University of São Paulo, São Paulo, Brazil.,School of Nursing, University of São Paulo, Avenida Doutor Enéas de Carvalho Aguiar, 419, São Paulo, SP, 05403-000, Brazil
| | - Alejandra Andrea Roman Lay
- Faculty of Health Sciences, University of Tarapacá, Avenida 18 de Septiembre, 2222, 1000000, Arica, Chile
| | - Elizabeth Fujimori
- Public Health Nursing Department, School of Nursing, University of São Paulo, São Paulo, Brazil
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The Sexual Risk Behaviors of Middle School Students According to School Nurse Placement Levels in Korea. Asian Nurs Res (Korean Soc Nurs Sci) 2020; 14:212-220. [PMID: 32781043 DOI: 10.1016/j.anr.2020.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 06/26/2020] [Accepted: 08/03/2020] [Indexed: 11/23/2022] Open
Abstract
PURPOSE This study aimed to provide basic data for the future development of school-based sexuality education and school nurse placement policies by examining the sexuality education experience in middle schools according to levels of school nurse placement and identifying factors influencing on adolescent sexual risk behaviors. METHODS This study examined data from the 2018 14th Korean Youth Risk Behavior Survey. The raw data from 30,229 middle school students enrolled in 400 schools were analyzed using descriptive statistics, Chi-square test, independent t test, and complex sample logistic regression analysis. RESULTS It is found that, in Korea, school nurse placement rates varied by region from 37.9% to 114.8%, resulting in different levels of sexuality and alcohol prevention education (p < .001). Sexuality and alcohol prevention education lowered the likelihood of sexual risk behaviors by 0.54 and 0.87 times, respectively. The experience of drinking alcohol increased a student's likelihood of committing sexual risk behaviors by 4.40 and 3.57 times, respectively, whereas the experience of using a drug increased the risk by 9.42 and 5.00 times, respectively. Personal factors (e.g., gender and academic achievement) and socioenvironmental factors (e.g., school type and perceived economic status) were also found to influence on the sexual risk behaviors of adolescents, although, not to the same degree as sexuality education or health risk behaviors. CONCLUSION To protect students' sex-related health equity, more elaborate support policies are needed to ensure adequate placement of school nurses able to provide professional sexuality and related health education.
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Mantzourani E, Hodson K, Evans A, Alzetani S, Hayward R, Deslandes R, Hughes ML, Holyfield G, Way C. A 5-year evaluation of the emergency contraception enhanced community pharmacy service provided in Wales. BMJ SEXUAL & REPRODUCTIVE HEALTH 2019; 45:bmjsrh-2018-200236. [PMID: 31395752 DOI: 10.1136/bmjsrh-2018-200236] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 07/03/2019] [Accepted: 07/21/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Access to emergency contraception (EC) has been a core component of attempts to address high teenage pregnancy rates in Wales. A national service was commissioned in 2011, allowing supply of EC free of charge from community pharmacies (CPs). This study investigated 5 years of the EC service, to describe its use and investigate changes in the pattern of use over time. METHODS Secondary analyses of data from all National Health Service funded CP EC consultations in Wales between 1 August 2012 and 31 July 2017 (n=181 359). Data comprised standardised clinical and demographic information, in the form of predefined service user responses, submitted for reimbursement by CPs. RESULTS Overall service provision remained relatively consistent over the study period, with women aged between 13 and 59 years accessing the service. An association was observed between the time since unprotected sexual intercourse and the day on which the service was accessed (Χ2(18)=16 292.327, p<0.001). Almost half (47.9%) of requests were because no contraception had been used, with a strong and positive association for teenagers and women aged 40+ years. A statistically significant and increasing percentage of consultations were accompanied by further sexual health advice (r=0.7, p<0.01). CONCLUSIONS Access to EC through CPs is contributing to reducing teenage conceptions and termination rates. However, action is needed to increase contraception use in all age groups. Reduced availability of CP services on Sundays is a barrier to timely EC access. Findings support an expanded role for community pharmacists in provision of regular contraception.
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Affiliation(s)
- Efi Mantzourani
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, UK
| | - Karen Hodson
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, UK
| | | | - Sarah Alzetani
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, UK
| | - Rebecca Hayward
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, UK
| | - Rhian Deslandes
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, UK
| | - Mary Louise Hughes
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, UK
| | | | - Cheryl Way
- National Health Service Wales Informatics Service, Cardiff, UK
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Othman S, Kong SZ, Mohd Mydin FH, Ng CJ. Knowledge, utilization and barriers to primary care services for sexual and reproductive health among adolescents in secondary schools in Selangor, Malaysia. MALAYSIAN FAMILY PHYSICIAN : THE OFFICIAL JOURNAL OF THE ACADEMY OF FAMILY PHYSICIANS OF MALAYSIA 2019; 14:10-17. [PMID: 31289626 PMCID: PMC6612277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Early sexual debut, partner violence, pregnancy and sexually transmitted infections contribute to negative health outcomes among adolescents. While the primary care clinics offer accessible sexual and reproductive health (SRH) services to adolescents, it is uncertain whether adolescents are aware of and utilize these services. This study aimed to examine Malaysian adolescents' knowledge, utilization and barriers to primary care services for SRH. A cross-sectional survey was conducted from August to November 2011 among adolescent from five randomly selected schools in Selangor, Malaysia. A self-administered questionnaire was used to assess their knowledge, attitudes, sexual behaviors and utilization of SRH services. A total of 680 adolescents participated in the study. One in ten of the adolescents were aware of the availability of SRH services, and only 6.9% of them had ever visited a primary care clinic for SRH. About 75% of them felt uncomfortable going to a primary care clinic for SRH services. Knowledge and utilization of primary care clinics for SRH among adolescents in Malaysia is poor.
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Affiliation(s)
- S Othman
- MBBS, MMed (Family Medicine), PhD Department of Primary Care Medicine, Faculty of Medicine University of Malaya Malaysia
| | - S Z Kong
- MBBs (MBBS, MMed (Family Medicine) Klinik Kesihatan Sarikei, Sarawak Malaysia
| | - F H Mohd Mydin
- MBBS; MMed (Family Medicine) Department of Primary Care Medicine, Faculty of Medicine University of Malaya Malaysia
| | - C J Ng
- MBBS, MMed (Family Medicine), PhD Department of Primary Care Medicine, Faculty of Medicine, University of Malaya Malaysia
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Lee B, Seo DC. Socioeconomic Disparities in Health Risk Behavior Clusterings Among Korean Adolescents. Int J Behav Med 2018; 25:540-547. [PMID: 29728989 DOI: 10.1007/s12529-018-9723-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE This study aims to investigate the socioeconomic disparities in health risk behavior clusterings among Korean adolescents and to assess the mediating role of stress on this association. METHOD We analyzed the 2015 Korean Youth Risk Behavior Survey, a nationally representative sample of Korean middle and high school students aged 12-18 years (N = 68,043). The co-occurrence of multiple health risk behaviors (i.e., cigarette smoking, drinking, and unprotected sex) was used to operationalize health risk behavior clusterings that ranged from zero to three. Ordinal and multinomial logistic regressions were conducted to examine socioeconomic disparities in health risk behavior clusterings and mediating effect of perceived stress between socioeconomic status (SES) and health risk behaviors. RESULTS When SES was grouped into five groups, adolescents in the lowest SES [adjusted odds ratio (AOR) = 2.15, 95% confidence interval (CI) = 1.90-2.44] and the highest SES (AOR = 1.29, 95% CI = 1.18-1.40) showed a higher likelihood of risk behavior clusterings than any other SES groups. Stress partially mediated the relationship between SES and co-occurrence of multiple health risk behaviors while accounting for their demographic characteristics. Adolescents in the lowest and highest SES reported higher stress than other SES groups, which, in turn, was associated with the co-occurrence of multiple health risk behaviors. CONCLUSION The results suggest that perceived stress level partly explains why affluent as well as low-SES adolescents engage in multiple risk behaviors. The findings also discourage use of a linear approach in socioeconomic disparity investigation in relation to adolescent health behaviors.
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Affiliation(s)
- Boram Lee
- Department of Applied Health Science, Indiana University School of Public Health, Suite 116, 1025 E. 7th Street, Bloomington, IN, 47405-7109, USA
| | - Dong-Chul Seo
- Department of Applied Health Science, Indiana University School of Public Health, Suite 116, 1025 E. 7th Street, Bloomington, IN, 47405-7109, USA.
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Thongnopakun S, Pumpaibool T, Somrongthong R. The association of sociodemographic characteristics and sexual risk behaviors with health literacy toward behaviors for preventing unintended pregnancy among university students. J Multidiscip Healthc 2018; 11:149-156. [PMID: 29503563 PMCID: PMC5826208 DOI: 10.2147/jmdh.s156264] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose The aim of this study was to determine whether there is an associated effect between sociodemographic characteristics and sexual risk behaviors with health literacy in preventing unintended pregnancy among university students in Chon Buri province, Thailand. Participants and methods A cross-sectional study design was used. The data were collected between February and May, 2017. A self-administered questionnaire was developed by the Ministry of Public Health and supported by the evolving concept of health literacy of Nutbeam. This questionnaire was then applied to collect data from 418 university students. Descriptive statistical and binary logistic regression methods were used for data analysis in this study. Results Half the students exhibited inappropriate behaviors to prevent unintended pregnancies. However, half the respondents had been educated to prevent unintended pregnancies. Nearly one-third of the students had experienced sexual intercourse. Binary logistic regression was used to analyze an association between the behavior for unintended-pregnancy prevention with sociodemographic characteristics and the health literacy of university students. The factors assessed were current residence type (the adjusted odds ratio [aOR]=1.897, 95% CI=1.123-3.205), previous sexual intercourse (aOR=3.263, 95% CI=1.735-6.139), cognitive health to prevent unintended pregnancy (aOR=1.095, 95% CI=1.019-1.176), decision skills in choosing appropriate practices to prevent unintended pregnancy (aOR=1.289, 95% CI=1.182-1.405), and self-management to prevent unintended pregnancy (aOR=1.113, 95% CI=1.005-1.232). Conclusion This study indicated that university students who had experienced sexual intercourse and had low health literacy were more likely to exhibit inappropriate behaviors concerning the lack of prevention of unintended pregnancies. The results will provide health professionals with information to develop more effective prevention and intervention programs.
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Affiliation(s)
| | - Tepanata Pumpaibool
- College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Ratana Somrongthong
- College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand
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[Gender meanings of the risk of sexually transmitted infections/HIV transmission among young people]. Aten Primaria 2017; 51:61-70. [PMID: 29102221 PMCID: PMC6836995 DOI: 10.1016/j.aprim.2017.08.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 08/16/2017] [Accepted: 08/23/2017] [Indexed: 11/30/2022] Open
Abstract
Objetivo Establecer vínculos entre las representaciones sociales que usan los jóvenes para construir su identidad de género, sexualidad y el manejo del riesgo de infecciones de transmisión sexual. Emplazamiento Diferentes ámbitos de Atención Primaria de Girona. Participantes Jóvenes de 16 a 21años (32 en total) residentes en Girona. Método Estudio cualitativo socioconstrucionista, con muestreo intencional estratificado. Como técnicas de recogida de información se utilizaron grupos triangulares y entrevistas individuales. Los datos fueron analizados usando el análisis sociológico del discurso. Resultados Entre las chicas, la ideología del amor romántico va asociada a la dependencia de su pareja, resultando en una pérdida de la autonomía en la negociación del uso del preservativo. Los chicos representan su deseo sexual como un instinto que no pueden controlar debido a un hecho biológico como son las hormonas, lo que parece que justifica su despreocupación por el uso del preservativo. Estas creencias explican por qué las chicas son objeto de prejuicios sexistas cuando tienen relaciones sin afecto, mientras que los chicos en estas mismas situaciones aumentan su identidad masculina. El discurso sobre la confianza en la pareja frecuentemente resulta en el rechazo del preservativo, ya que este se asocia a significados no compatibles con la fidelidad. Conclusiones Estos resultados muestran la necesidad de que los profesionales de la Atención Primaria conozcan la influencia de los procesos psicosociales, especialmente aquellos relacionados con la construcción de las identidades de género y de la sexualidad masculina y femenina, en el manejo de los riesgos asociados con la actividad sexual.
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Pereira J, Pires R, Araújo Pedrosa A, Vicente L, Bombas T, Canavarro MC. Sociodemographic, sexual, reproductive and relationship characteristics of adolescents having an abortion in Portugal: a homogeneous or a heterogeneous group? EUR J CONTRACEP REPR 2016; 22:53-61. [PMID: 27960606 DOI: 10.1080/13625187.2016.1266323] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The aims of the study were to describe the sociodemographic, sexual, reproductive and relational characteristics of adolescents having an abortion in Portugal and to explore the differences between three adolescent age groups. METHODS We recruited a nationally representative sample of 224 adolescents (<16 years, n = 18; 16-17 years, n = 103; 18-19 years, n = 103) who had an abortion. Data were collected from 16 health care services that provide abortion. RESULTS The adolescents were predominantly single, were from non-nuclear families, had low-socioeconomic status and were students. Mean age at first sexual intercourse was 15 years and mean gynaecological age was 5 years. Most had had multiple sexual partners, and for most it was their first pregnancy. At conception, the majority were involved in a long-term romantic relationship, were using contraception but did not identify the contraceptive failure that led to the pregnancy. Significant age group differences were found. Compared with the younger age groups, the 18-19 year age group was more frequently married or living with a partner, had finished school, had attained a higher educational level (as had their partner), intended to go to university, and had a greater number of sexual partners. Compared with the other groups, those under 16 years of age reported earlier age at menarche and at first sexual intercourse, and had a lower gynaecological age. CONCLUSIONS Our study characterises the life contexts of Portuguese adolescents who had an abortion. It highlights the need to recognise the heterogeneity of this group according to age. The findings have important implications for the development of age-appropriate guidelines to prevent unplanned pregnancy.
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Affiliation(s)
- Joana Pereira
- a Faculty of Psychology and Educational Sciences , Cognitive-Behavioural Research Centre (CINEICC), University of Coimbra , Coimbra , Portugal.,b Psychological Intervention Unit , Daniel de Matos Maternity Hospital, Coimbra University Hospitals (CHUC EPE) , Coimbra , Portugal
| | - Raquel Pires
- a Faculty of Psychology and Educational Sciences , Cognitive-Behavioural Research Centre (CINEICC), University of Coimbra , Coimbra , Portugal.,c School of Psychology and Life Sciences, Lusófona University of Humanities and Technology , Lisbon , Portugal
| | - Anabela Araújo Pedrosa
- b Psychological Intervention Unit , Daniel de Matos Maternity Hospital, Coimbra University Hospitals (CHUC EPE) , Coimbra , Portugal
| | - Lisa Vicente
- d Division of Infant, Youth, Reproductive and Sexual Health , Directorate-General of Health , Lisbon , Portugal
| | - Teresa Bombas
- e Obstetric Service , Coimbra University Hospitals (CHUC EPE) , Coimbra , Portugal
| | - Maria Cristina Canavarro
- a Faculty of Psychology and Educational Sciences , Cognitive-Behavioural Research Centre (CINEICC), University of Coimbra , Coimbra , Portugal.,b Psychological Intervention Unit , Daniel de Matos Maternity Hospital, Coimbra University Hospitals (CHUC EPE) , Coimbra , Portugal
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Raselekoane NR, Morwe KG, Tshitangano T. University of Venda's male students' attitudes towards contraception and family planning. Afr J Prim Health Care Fam Med 2016; 8:e1-7. [PMID: 27542288 PMCID: PMC4948082 DOI: 10.4102/phcfm.v8i2.959] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 03/08/2016] [Accepted: 03/11/2016] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Many young men continue to disregard the importance of contraception and family planning in South Africa. The fact that even university students also do not take contraception and family planning seriously poses a serious threat to their own health and well-being. AIM This paper aims at investigating the attitudes of male students towards contraception and the promotion of female students' sexual health rights and well-being at the University of Venda. METHODS Quantitative research method is used to determine how attitudes of 60 male students towards contraception can jeopardise the health and well-being of both male and female students. RESULTS This study reveals that the majority of 60 male students at the University of Venda have a negative attitude towards contraceptives. As a result, male students at the University of Venda are not keen on using contraceptives. Male students' negative attitude and lack of interest in contraceptives and family planning also limit progress in achieving the Millennium Development Goals on primary health care, especially with regard to sexual and reproductive health and well-being of female students at the University of Venda. CONCLUSION The fact that more than half of the male students interviewed did not take contraception and family planning seriously poses a serious threat to health and well-being of students, including violation of female students' sexual and reproductive health rights in South Africa. This calls for radical health promotion and sexual and reproductive rights programmes which should specifically target male students at the University of Venda.
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Pergialiotis V, Vlachos DEG, Gkioka E, Tsotra K, Papantoniou N, Vlachos GD. Teenage pregnancy antenatal and perinatal morbidity: Results from a tertiary centre in Greece. J OBSTET GYNAECOL 2014; 35:595-9. [DOI: 10.3109/01443615.2014.991285] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Kanku T, Mash R. Attitudes, perceptions and understanding amongst teenagers regarding teenage pregnancy, sexuality and contraception in Taung. S Afr Fam Pract (2004) 2014. [DOI: 10.1080/20786204.2010.10874048] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Harrison C, Ratcliffe JM, Mitchell M, Smith MA. Cortisol reactivity to psychosocial stress is greater in sexual risk takers. Health Psychol Behav Med 2014; 2:221-230. [PMID: 25750779 PMCID: PMC4346022 DOI: 10.1080/21642850.2014.889571] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Accepted: 01/27/2014] [Indexed: 12/04/2022] Open
Abstract
Several studies have reported an association between deviant behaviour and cortisol reactivity to stress. However, relatively few studies have investigated the relationship between psychobiological stress reactivity and sexual risk-taking behaviours. In this study, cortisol reactivity to the Trier Social Stress Test (TSST) was measured in 26 healthy young adults prior to the administration of a sexual health and behaviour questionnaire. The cortisol response to the TSST was greater in those individuals who reported that at least one of their previous two sexual partners was someone whom they had just met. Results are discussed in the context of a model which suggests that early life stress dysregulates the hypothalamic–pituitary–adrenal axis and increases the likelihood of later life risk-taking behaviour. The findings have implications in terms of improving our understanding of psychobiological factors which predispose individuals to engage in adverse sexual health behaviours.
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Affiliation(s)
- Claire Harrison
- Department of Psychology, Northumbria University , Newcastle upon Tyne , UK
| | - Joanne M Ratcliffe
- Department of Psychology, Northumbria University , Newcastle upon Tyne , UK
| | - Melanie Mitchell
- Department of Psychology, Northumbria University , Newcastle upon Tyne , UK
| | - Michael A Smith
- Department of Psychology, Northumbria University , Newcastle upon Tyne , UK
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Baba S, Goto A, Reich MR. Recent pregnancy trends among early adolescent girls in Japan. J Obstet Gynaecol Res 2013; 40:125-32. [DOI: 10.1111/jog.12138] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Accepted: 03/25/2013] [Indexed: 12/01/2022]
Affiliation(s)
- Sachiko Baba
- Center for International Relations; Osaka University Graduate School of Medicine; Osaka Japan
| | - Aya Goto
- Department of Public Health; Fukushima Medical University School of Medicine; Fukushima Japan
- Takemi Program in International Health; Harvard School of Public Health; Boston Massachusetts USA
| | - Michael R. Reich
- Department of Global Health and Population; Harvard School of Public Health; Boston Massachusetts USA
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Abstract
Sexually transmitted infections (STIs), also referred to as sexually transmitted diseases, remain a growing worldwide problem and public health issue. This article covers the epidemiology of STIs, the history and physical findings, screening guidelines, and the general plan to combat STIs. Prevention is discussed using the latest information from the Centers for Disease Control and Prevention and other references. Infections discussed from the standpoint of cause, epidemiology, risk factors, clinical disease, diagnosis, and treatment include gonorrhea, Chlamydia trachomatis, Trichomonas vaginalis, syphilis, chancroid, Herpes simplex, lymphogranuloma venereum, granuloma inguinale, Herpes papilloma virus, Molluscum contagiosum, and pubic lice.
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Affiliation(s)
- William Markle
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
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Abstract
Taking into account the biological and psychosocial changes during the transition from childhood to adulthood adolescents would need a contraceptive method which ideally would be very effective, independent of compliance, without major health risks during use and no negative impact on the future health of the adolescent, protective against STI, favorable for bone development, with no or only few side effects and having some preventive and therapeutic potential with respect to frequent health problems of adolescent girls. Combined oral contraceptives (COC) used regularly and consistently have a more than 99% efficacy to prevent a pregnancy. COCs have a very low health risk (almost exclusively thromboembolic disease) which seems to differ marginally with respect to dosage and type of the components. Progestogen only oral contraceptives do not have any major negative health impact. The leading side effect is irregular bleeding which in COC users is mainly during the first 3 months and in progestogen only users during the period of use. Other side effects are reported but their frequency is similar to placebo. COC protect against endometrial and ovarian cancer and they may have beneficial effects on a variety of menstrual complaints and acne, which are frequent problems during adolescence. To be effective COCs have to be taken regularly which is frequently not the case. This diminishes considerably their effectiveness depending on the individual compliance. They do not protect against STI and may even have an inhibitory effect on the use of condoms. For most adolescents the risk benefit profile of oral contraceptives is favorable and makes this method valuable. At the same time the prescription of oral contraceptives for adolescents need to be individualized by taking into account the individual risk/benefit profile. Specialized counseling with a high degree of confidentiality adapted to the knowledge and needs of the individual adolescent is desirable.
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Affiliation(s)
- Johannes Bitzer
- Department of Obstetrics and Gynecology, University Hospital Basel, Basel, Switzerland.
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Nordin N, Wahab RA, Yunus FW. Psychological Well-Being of Young Unwed Pregnant Women: Implications for Extension Education and Programs. PROCEDIA - SOCIAL AND BEHAVIORAL SCIENCES 2012; 68:700-709. [DOI: 10.1016/j.sbspro.2012.12.260] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Kim KW, Kang KH, Jeong GH. Self-Efficacy and Sexual Autonomy among University Students. ACTA ACUST UNITED AC 2012. [DOI: 10.5932/jkphn.2012.26.1.051] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Schwarz TF, Huang LM, Medina DMR, Valencia A, Lin TY, Behre U, Catteau G, Thomas F, Descamps D. Four-year follow-up of the immunogenicity and safety of the HPV-16/18 AS04-adjuvanted vaccine when administered to adolescent girls aged 10-14 years. J Adolesc Health 2012; 50:187-94. [PMID: 22265115 DOI: 10.1016/j.jadohealth.2011.11.004] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2011] [Revised: 11/02/2011] [Accepted: 11/04/2011] [Indexed: 01/08/2023]
Abstract
PURPOSE Long-term immunogenicity and safety of the human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine when administered to adolescent girls was evaluated. METHODS This open-label, follow-up study (NCT00316706) was conducted in 31 centers in Taiwan, Germany, Honduras, Panama, and Colombia. In the initial study (NCT00196924), 1,035 girls aged 10-14 years received the HPV-16/18 AS04-adjuvanted vaccine at 0, 1, and 6 months. Here, geometric mean titers (GMTs) of antibodies against HPV-16, HPV-18, and monophosphoryl lipid A (MPL), a component of the AS04 Adjuvant System, were reported up to month 48. RESULTS In the according-to-protocol immunogenicity cohort (N = 563), GMTs at month 48 in initially seronegative participants were 2,374.9 (95% confidence interval: 2,205.7-2,557.0) EL.U/mL for anti-HPV-16 and 864.8 (796.9-938.4) EL.U/mL for anti-HPV-18, that is, six- and threefold higher than the plateau level in a reference study demonstrating vaccine efficacy in young women (age, 15-25 years). All participants remained seropositive for anti-HPV-16 and anti-HPV-18 at month 48. Most participants (81.8%) were seropositive for anti-MPL antibodies before vaccination. Anti-MPL antibody titers in initially seropositive participants increased initially, and then declined. Most initially seronegative participants for anti-MPL seroconverted; 69.6% remained seropositive at month 48, with anti-MPL antibody titers similar to the natural background level. The vaccine was generally well tolerated. No serious adverse events were considered related to vaccination. CONCLUSIONS In adolescent girls, the HPV-16/18 AS04-adjuvanted vaccine produces anti-HPV-16 and anti-HPV-18 antibody titers that are maintained for up to 4 years at higher levels than those in young women in whom vaccine efficacy against cervical lesions was demonstrated.
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Affiliation(s)
- Tino F Schwarz
- Central Laboratory and Vaccination Centre, Stiftung Juliusspital Wuerzburg, Wuerzburg, Germany.
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Bailey JV, Murray E, Rait G, Mercer CH, Morris RW, Peacock R, Cassell J, Nazareth I. Cochrane Review: Interactive computer-based interventions for sexual health promotion. ACTA ACUST UNITED AC 2011. [DOI: 10.1002/ebch.885] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Salmon D. A qualitative study of how mothers and teenage daughters negotiate sex-related risk and independence. J Res Nurs 2011. [DOI: 10.1177/1744987111423165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Concern across more economically developed nations has focused on the role of parental communication and monitoring in predicting risk-taking behaviour and health outcomes. However, explorations of how mothers and daughters negotiate risk remain under-researched. This paper presents the findings of a qualitative study examining mothers’ and teenage daughters’ perceptions of risk-related health concerns around sexual behaviour and the implications for health policy, nursing practice and future research. A purposive sample of seven young women aged 14–16 years and their mothers ( n = 14) were recruited from low-income families living in the south-west of England. Data were collected through longitudinal in-depth interviews and were analysed for thematic content using constant comparative methods. Findings highlighted how mothers and daughters understand risks associated with sex and relationships and their implications for safety. Mothers’ concerns focused on their daughters’ vulnerability to the risk of sexual threat, particularly after alcohol consumption. Within relationships mothers did not advocate abstinence but developed harm minimisation approaches to minimise the impact of risk taking and maximise opportunities for independence. Strategies based on trust and openness were preferred to expectations of rigid adherence in rule negotiation. Clinical significance lies in building on maternal expertise to develop community-based initiatives that have the potential to improve health and clinical outcomes for young women.
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Affiliation(s)
- Debra Salmon
- Faculty of Health and Life Sciences, Bristol UWE, UK
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Abstract
BACKGROUND Adolescent pregnancy is an important health issue. Prevention programs are usually aimed at the prevention of repeat pregnancy, ignoring the adolescents at risk of becoming pregnant for the first time. OBJECTIVES To analyse if socio-economic status, family type and mother's age at first pregnancy are risk factors for adolescent pregnancy and to design a risk score of first-time adolescent pregnancy. METHODS A case-control study was performed: cases were primiparous adolescents and controls were primiparous adult women. Participants were asked about their socio-economic status and family structure during adolescence and the age at which their mothers' first pregnancy occurred. Odds ratio (OR) and 95% confidence intervals were calculated. A first-time adolescent pregnancy risk score was designed based on a multiple logistic regression model. RESULTS Sixty-six adolescents and 140 adults were interviewed. Belonging to a family other than nuclear or extended types was an independent risk factor for adolescent pregnancy (OR 9.37, 95% CI 3.36-38.07). Low socio-economic status and having a mother with history of adolescent pregnancy were not independent risk factors (OR 1.04, 95% CI 0.34-5.11 and OR 1.13, 95% CI 0.42-4.32, respectively), achieving significance only when simultaneously present (OR 6.01, 95% CI 2.36-20.79). The presence of all these factors determined the highest adolescent pregnancy probability (OR 10.49, 95% CI 3.43-51.00). A first-time adolescent pregnancy risk assessment score was designed, with an estimated sensitivity of 75.8% and specificity of 75.0%. CONCLUSIONS Adolescent pregnancy is associated with unfavorable precedents that can be used to identify adolescents at increased risk of early pregnancy.
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Affiliation(s)
- Maria Inês Santos
- Department of Pediatrics, S. Teotónio's Hospital Empresa Pública Empresarial, Viseu, Portugal
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Hsieh WS, Hsieh CJ, Jeng SF, Liao HF, Su YN, Lin SJ, Chang PJ, Chen PC. Favorable Neonatal Outcomes Among Immigrants in Taiwan: Evidence of Healthy Immigrant Mother Effect. J Womens Health (Larchmt) 2011; 20:1083-90. [DOI: 10.1089/jwh.2011.2809] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Wu-Shiun Hsieh
- Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chia-Jung Hsieh
- Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan
| | - Suh-Fang Jeng
- School and Graduate Institute of Physical Therapy, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Hua-Fang Liao
- School and Graduate Institute of Physical Therapy, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yi-Ning Su
- Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan
- Institutes of Clinical Genomics, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Shio-Jean Lin
- Department of Pediatrics, National Cheng-Kung University Hospital and National Cheng-Kung University College of Medicine, Tainan, Taiwan
| | - Pei-Jen Chang
- Department of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Pau-Chung Chen
- Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan
- Department of Public Health, National Taiwan University College of Public Health, Taipei, Taiwan
- Department of Environmental and Occupational Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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Increasing rates of cervical cancer in young women in England: an analysis of national data 1982-2006. Br J Cancer 2011; 105:177-84. [PMID: 21654675 PMCID: PMC3137412 DOI: 10.1038/bjc.2011.196] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: In England, cervical cancer is the second most common cancer in women aged under 35 years. Overall incidence of cervical cancer has decreased since the introduction of the national screening programme in 1988 but recent trends of incidence in young women have not been studied in detail. Methods: Information on 71 511 incident cases of cervical cancer in England, 1982–2006, in 20–79-year-olds was extracted from a national cancer registration database. Changes in incidence were analysed by age group, time period and birth cohort. Poisson regression was used to estimate annual percentage change (APC). Results: Overall incidence, during 1982–2006, fell significantly from 213 to 112 per million person years. However, in 20–29-year-olds, after an initial fall, incidence increased significantly during 1992–2006, (APC 2.16). In 30–39-year-olds incidence stabilised during the latter part of the study period. The pattern was most marked in the North East, Yorkshire and the Humber and East Midlands regions. Birth cohorts that were initially called for screening between 60–64 and 35–39 years of age show an incidence peak soon after the age of presumed first screen, whereas younger birth cohorts show a peak at about 35 years of age. Incidence in the 1977–1981 birth cohort has increased relative to that among women born between 1962 and 1976. Conclusion: These results have implications for cervical screening, human papilloma virus vaccination and other public health interventions targeting young people.
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Paton SL, Fernando I, Lamont RF. A comparison of sexual and reproductive health services provided by genitourinary and family planning clinics for adolescents. Int J STD AIDS 2011; 21:642-7. [PMID: 21097738 DOI: 10.1258/ijsa.2010.010189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The purpose of the study was to assess the use of sexual and reproductive health services by adolescents aged 15 years and younger. A case-note review was conducted at both a genitourinary medicine clinic and a family planning clinic in Edinburgh, UK. The demographics of the attendees, reasons for attending, risk factors, diagnostic tests undertaken and contraceptive advice given differed between the two clinics. Approximately 73% of attendees with documented responses used alcohol and 21% used recreational drugs, 5% reported self-harm, 25% reported being victims of sexual assault, 13% had a current sexually transmitted infection and 6% of girls had already been pregnant. While this group of young people understand the differences in emphasis between the clinics, adolescents may be intimidated and discouraged from attending or may fail to return, and the combination of overlap, together with omissions in cross-clinic function, suggests that for this age group the services of these clinics should be combined.
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Affiliation(s)
- S L Paton
- GUM Department, New Royal Infirmary of Edinburgh, UK
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Conduct disorder symptoms and subsequent pregnancy, child-birth and abortion: a population-based longitudinal study of adolescents. J Adolesc 2010; 34:1025-33. [PMID: 21146202 DOI: 10.1016/j.adolescence.2010.11.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2008] [Revised: 10/15/2010] [Accepted: 11/11/2010] [Indexed: 12/28/2022]
Abstract
Research on teenage pregnancy and abortion has primarily focused on socio-economic disadvantage. However, a few studies suggest that risk of unwanted pregnancy is related to conduct disorder symptoms. We examined the relationship between level of conduct disorder symptoms at age 15 and subsequent pregnancy, child-birth and abortion. A population-based, representative sample of Norwegian adolescent girls (N = 769) was followed from early adolescence until their mid-20s. Even with control for socio-demographic and family variables, conduct disorder symptoms at age 15 were strongly associated with pregnancy in the 15-19 age group, and a weaker association persisted in the 20-28 age group. Similar results were obtained for abortions, but here a strong relationship with conduct disorder symptoms was found even after age 20. After adjustment, no significant association between conduct disorder symptoms and subsequent child-birth was observed. More targeted preventive programmes aimed at girls with conduct disorder symptoms may be warranted.
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Bailey JV, Murray E, Rait G, Mercer CH, Morris RW, Peacock R, Cassell J, Nazareth I. Interactive computer-based interventions for sexual health promotion. Cochrane Database Syst Rev 2010:CD006483. [PMID: 20824850 DOI: 10.1002/14651858.cd006483.pub2] [Citation(s) in RCA: 121] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Sexual health promotion is a major public health challenge; there is huge potential for health promotion via technology such as the Internet. OBJECTIVES To determine effects of interactive computer-based interventions (ICBI) for sexual health promotion, considering cognitive, behavioural, biological and economic outcomes. SEARCH STRATEGY We searched more than thirty databases for randomised controlled trials (RCTs) on ICBI and sexual health, including CENTRAL, DARE, MEDLINE, EMBASE, CINAHL, British Nursing Index, and PsycINFO. We also searched reference lists of published studies and contacted authors. All databases were searched from start date to November 2007, with no language restriction. SELECTION CRITERIA RCTs of interactive computer-based interventions for sexual health promotion, involving participants of any age, gender, sexual orientation, ethnicity or nationality. 'Interactive' was defined as packages that require contributions from users to produce tailored material and feedback that is personally relevant. DATA COLLECTION AND ANALYSIS Two review authors screened abstracts, applied eligibility and quality criteria and extracted data. Results of RCTs were pooled using a random-effects model with standardised mean differences (SMDs) for continuous outcomes and odds ratios (ORs) for binary outcomes. We assessed heterogeneity using the I(2) statistic. Separate meta-analyses were conducted by type of comparator: 1) minimal intervention such as usual practice or leaflet, 2) face-to-face intervention or 3) a different design of ICBI; and by type of outcome (cognitive, behavioural, biological outcomes). MAIN RESULTS We identified 15 RCTs of ICBI conducted in various settings and populations (3917 participants). Comparing ICBI to 'minimal interventions' such as usual practice, meta-analyses showed statistically significant effects as follows: moderate effect on sexual health knowledge (SMD 0.72, 95% CI 0.27 to 1.18); small effect on safer sex self-efficacy (SMD 0.17, 95% CI 0.05 to 0.29); small effect on safer-sex intentions (SMD 0.16, 95% CI 0.02 to 0.30); and also an effect on sexual behaviour (OR 1.75, 95% CI 1.18 to 2.59). Data were insufficient for meta-analysis of biological outcomes and analysis of cost-effectiveness.In comparison with face-to-face sexual health interventions, meta-analysis was only possible for sexual health knowledge, showing that ICBI were more effective (SMD 0.36, 95% CI 0.13 to 0.58). Two further trials reported no difference in knowledge between ICBI and face-to-face intervention, but data were not available for pooling. There were insufficient data to analyse other types of outcome.No studies measured potential harms (apart from reporting any deterioration in measured outcomes). AUTHORS' CONCLUSIONS ICBI are effective tools for learning about sexual health, and they also show positive effects on self-efficacy, intention and sexual behaviour. More research is needed to establish whether ICBI can impact on biological outcomes, to understand how interventions might work, and whether they are cost-effective.
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Affiliation(s)
- Julia V Bailey
- Research Department of Primary Care and Population Health, University College London, Upper Third Floor, Royal Free Hospital, Rowland Hill Street, London, UK, NW3 2PF
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Dale H, Watson L, Adair P, Moy M, Humphris G. The perceived sexual health needs of looked after young people: findings from a qualitative study led through a partnership between public health and health psychology. J Public Health (Oxf) 2010; 33:86-92. [PMID: 20688783 DOI: 10.1093/pubmed/fdq055] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Looked after young people (LAYP) have poorer sexual health outcomes than their peers. However, research seldom examines the health needs of, or intervenes with, this group. The aim of the current study was to identify LAYP's perceived sexual health needs and explore sources of sexual health information, knowledge levels, concerns and service preferences. METHODS Looked after young people within Fife, Scotland, were recruited through their workers and carers to participate in qualitative semi-structured interviews. Those aged 12-19 years were targeted for recruitment. National Health Services ethics approval was granted. Thematic analysis was conducted using NVivo. RESULTS Interviews were conducted with 10 LAYP. Key themes included gaps in knowledge, and gaps between knowledge and behaviour. Being 'looked after' may have negative consequences on knowledge, sources of support and safer sex. A flexible, one-to-one service, aimed at several lifestyle issues, not solely sexual health, was preferred by respondents. CONCLUSION Looked after young people require support to bridge the gap between knowledge and behaviour and several theories relevant to the findings have been identified. Participants desired more support around a range of health issues, which may come from school, workers and carers, as well as health professionals. Further research examining effective interventions with this group is crucial to improve outcomes.
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Affiliation(s)
- H Dale
- NHS Fife, Department of Psychology, Stratheden Hospital, Cupar, Fife, UK.
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Westwood J, Mullan B. Young people and sexual risk-taking behaviour in Central England. Sex Health 2009; 6:135-8. [PMID: 19457293 DOI: 10.1071/sh08090] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2008] [Accepted: 03/23/2009] [Indexed: 11/23/2022]
Abstract
BACKGROUND Sexually transmissible infections and the rate of teenage pregnancy in the UK are among the highest in the industrialised world. Research has suggested that high rates of risk-taking behaviours may account for the concerning increase in the rates of sexually transmissible infections and higher rates of teenage pregnancy in the UK. METHODS This cross-sectional analysis investigated the sexual risk-taking behaviours of a group of sexually active 12-15-year-old school pupils from a single county in Central England (n = 493). Data were analysed to investigate the sexual risk activity of adolescents, urban/rural location, and gender. RESULTS In this sample, rural students were more likely than their urban counterparts to have used drugs or alcohol the first time they had sex. Female students were more likely than male students to report ever having had sex without contraception. Male students were more likely than female students to have ever had a one night stand. CONCLUSIONS As expected there were differences in sexual risk-taking behaviour between pupils in urban and rural locations, and males and females. In most cases these differences were consistent with previous research on general trends, with a few exceptions that can be meaningfully interpreted using previous research in this area. In future, researchers may wish to investigate the underlying factors that determine these differences in risk-taking behaviour.
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Affiliation(s)
- Jo Westwood
- School of Health Sciences, University of Birmingham, Edgbaston B66 4EB, UK
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Saura Sanjaume S, Fernandez de Sanmamed Santos MJ, Vicens Vidal L, Puigvert Viu N, Mascort Nogué C, García Martínez J. [Perception of the risk to adquire a sexually transmitted disease in a young population]. Aten Primaria 2009; 42:143-8. [PMID: 19796848 DOI: 10.1016/j.aprim.2009.06.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2009] [Accepted: 06/08/2009] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To find out the perception of the risk of adquire a sexually transmitted disease (STD) in young people (15-21 years), and their attitudes and behaviour to adopt protective measures in sexual relationships. DESIGN Socioconstructive qualitative study performed between the years 2006 and 2008 SETTING Two Primary Care Centres in the city of Girona. PARTICIPANTS A total of 34 young people selected from lists provided by doctors and key informers. METHODS Theoretical sample from different designed profiles. The data was obtained and saturated by performing 5 group interviews. A thematic content analysis of the narrative data was made of the categorical subject. RESULTS They had partial knowledge on AIDS and very little on other STD. The risk of pregnancy has the most influence on adopting protective measures. Despite easy access and knowledge of condoms, in some cases they are not used either in stable relationships or in sporadic ones, with different reasons for having this risk behaviour. They have limited contact with the health services, and when they do it is mainly to ask for emergency contraception. CONCLUSIONS Health strategies should be directed towards adolescents, taking into account what they need from the health services as regards sexual health, in a different context from the health centre. Information should be focused on combating erroneous beliefs, such as AIDS is a disease of "others" and not "ours", and address these actions, not only to improve knowledge and attitudes but also changes in behaviour.
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Capuano S, Simeone S, Scaravilli G, Raimondo D, Balbi C. Sexual behaviour among Italian adolescents: Knowledge and use of contraceptives. EUR J CONTRACEP REPR 2009; 14:285-9. [DOI: 10.1080/13625180902926920] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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de Irala J, Osorio A, del Burgo CL, Belen VA, de Guzman FO, Calatrava MDC, Torralba AN. Relationships, love and sexuality: what the Filipino teens think and feel. BMC Public Health 2009; 9:282. [PMID: 19656369 PMCID: PMC2907520 DOI: 10.1186/1471-2458-9-282] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2009] [Accepted: 08/05/2009] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND In order to achieve a change among teens' sexual behavior, an important step is to improve our knowledge about their opinions concerning relationships, love and sexuality. METHODS A questionnaire including topics on relationships, love and sexuality was distributed to a target population of 4,000 Filipino students from third year high school to third year college. Participants were obtained through multi-stage sampling of clusters of universities and schools. This paper concentrates on teens aged 13 to 18. RESULTS Students reported that they obtained information about love and sexuality mainly from friends. However, they valued parents' opinion more than friends'. They revealed few conversations with their parents on these topics. A majority of them would like to have more information, mainly about emotion-related topics. Almost half of respondents were not aware that condoms are not 100% effective in preventing STIs or pregnancies. More girls, compared to boys, were sensitive and opposed to several types of sexism. After adjusting for sex, age and institution, the belief of 100% condom effectiveness and the approval of pornography and sexism were associated with being sexually experienced. CONCLUSION There is room for further encouraging parents to talk more with their children about sexuality, specially aspects related to feelings and emotions in order to help them make better sexual choices. Indeed, teens wish to better communicate with their parents on these issues. Condoms are regarded as safer than what they really are by almost half of the participants of this study, and such incorrect knowledge seems to be associated with sexual initiation.
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Affiliation(s)
- Jokin de Irala
- Preventive Medicine and Public Health, School of Medicine, University of Navarra, Irunlarrea 1, 31008 Pamplona, Spain
| | - Alfonso Osorio
- Department of Education, University of Navarra, 31008 Pamplona, Spain
| | - Cristina López del Burgo
- Preventive Medicine and Public Health, School of Medicine, University of Navarra, Irunlarrea 1, 31008 Pamplona, Spain
| | - Vina A Belen
- University of Asia and the Pacific, Pearl Drive cor St J Escriva Drive, Ortigas Center, Pasig City, Philippines
| | - Filipinas O de Guzman
- Research for Education Intervention and Development, CRC Foundation Incorporated, Manila, Philippines
- Unit 1103, Pacific Center Building, San Miguel Avenue, Ortigas Center, Pasig City 1605, Philippines
| | - María del Carmen Calatrava
- Preventive Medicine and Public Health, School of Medicine, University of Navarra, Irunlarrea 1, 31008 Pamplona, Spain
| | - Antonio N Torralba
- University of Asia and the Pacific, Pearl Drive cor St J Escriva Drive, Ortigas Center, Pasig City, Philippines
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Rawson H, Liamputtong P. Influence of traditional Vietnamese culture on the utilisation of mainstream health services for sexual health issues by second-generation Vietnamese Australian young women. Sex Health 2009; 6:75-81. [PMID: 19254496 DOI: 10.1071/sh08040] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2008] [Accepted: 09/11/2008] [Indexed: 11/23/2022]
Abstract
BACKGROUND The present paper discusses the impact the traditional Vietnamese culture has on the uptake of mainstream health services for sexual health matters by Vietnamese Australian young women. It is part of a wider qualitative study that explored the factors that shaped the sexual behaviour of Vietnamese Australian young women living in Australia. METHODS A Grounded Theory methodology was used, involving in-depth interviews with 15 Vietnamese Australian young women aged 18 to 25 years who reside in Victoria, Australia. RESULTS The findings demonstrated that the ethnicity of the general practitioner had a clear impact on the women utilising the health service. They perceived that a Vietnamese doctor would hold the traditional view of sex as held by their parents' generation. They rationalised that due to cultural mores, optimum sexual health care could only be achieved with a non-Vietnamese health professional. CONCLUSION It is evident from the present study that cultural influences can impact on the sexual health of young people from culturally diverse backgrounds and in Australia's multicultural society, provision of sexual health services must acknowledge the specific needs of ethnically diverse young people.
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Affiliation(s)
- Helen Rawson
- School of Public Health, La Trobe University, Bundoora, Vic. 3086, Australia
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Abstract
OBJECTIVES To determine the excess risk of non-chromosomal congenital anomaly (NCA) among teenage mothers and older mothers. DESIGN AND SETTING Population-based prevalence study using data from EUROCAT congenital anomaly registers in 23 regions of Europe in 15 countries, covering a total of 1.75 million births from 2000 to 2004. PARTICIPANTS A total of 38,958 cases of NCA that were live births, fetal deaths with gestational age > or = 20 weeks or terminations of pregnancy following prenatal diagnosis of a congenital anomaly. MAIN OUTCOME MEASURES Prevalence of NCA according to maternal age, and relative risk (RR) of NCA and 84 standard NCA subgroups compared with mothers aged 25-29. RESULTS The crude prevalence of all NCA was 26.5 per 1000 births in teenage mothers (<20 years), 23.8 for mothers 20-24 years, 22.5 for mothers 25-29 years, 21.5 for mothers 30-34 years, 21.4 for mothers 35-39 years and 22.6 for mothers 40-44 years. The RR adjusted for country for teenage mothers was 1.11 (95% CI 1.06-1.17); 0.99 (95% CI 0.96-1.02) for mothers 35-39; and 1.01 (95% CI 0.95-1.07) for mothers 40-44. The pattern of maternal age-related risk varied significantly between countries: France, Ireland and Portugal had higher RR for teenage mothers, Germany and Poland had higher RR for older mothers. The maternal age-specific RR varied for different NCAs. Teenage mothers were at a significantly greater risk (P < 0.01) of gastroschisis, maternal infection syndromes, tricuspid atresia, anencephalus, nervous system and digestive system anomalies while older mothers were at a significantly greater risk (P < 0.01) of fetal alcohol syndrome, encephalocele, oesophageal atresia and thanatophoric dwarfism. CONCLUSIONS Clinical and public health interventions are needed to reduce environmental risk factors for NCA, giving special attention to young mothers among whom some risk factors are more prevalent. Reassurance can be given to older mothers that their age in itself does not confer extra risk for NCA.
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Affiliation(s)
- M Loane
- EUROCAT, Faculty of Life & Health Science, University of Ulster, Jordanstown, Co Antrim, UK.
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Araújo MSPD, Costa LOBF. Comportamento sexual e contracepção de emergência entre adolescentes de escolas públicas de Pernambuco, Brasil. CAD SAUDE PUBLICA 2009; 25:551-62. [DOI: 10.1590/s0102-311x2009000300010] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2008] [Accepted: 08/25/2008] [Indexed: 11/22/2022] Open
Abstract
O objetivo deste estudo foi investigar o conhecimento e o uso do contraceptivo de emergência em 4.210 adolescentes (14-19 anos) da rede pública estadual de Pernambuco, Brasil. As informações foram coletadas pelo questionário Global School-Based Student Health Survey, previamente validado. Foi investigado o conhecimento, a freqüência e forma de uso do contraceptivo de emergência. As variáveis independentes foram divididas em sócio-demográficas e relacionadas ao comportamento sexual. A maioria dos adolescentes relatou conhecer e já ter recebido informações sobre o método, entretanto dentre os que já utilizaram apenas 22,1% o fez de forma correta. A análise ajustada de regressão evidenciou uma maior chance de conhecer o método entre as moças (OR = 5,03; IC95%: 1,72-14,69) e entre aqueles que já tiveram relação sexual (OR = 1,52; IC95%: 1,34-1,75), enquanto os residentes do interior possuem 68% menos chance. Em relação ao uso, os residentes do interior apresentam 1,68 (OR; IC95%: 1,09-2,25) mais chance de uso incorreto, enquanto as moças apresentam 71% menos chance. São necessárias ações de educação sexual e reprodutiva, sobretudo entre os rapazes e adolescentes do interior.
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Teenage pregnancy—New tools to support local health campaigns. Health Place 2009; 15:300-7. [DOI: 10.1016/j.healthplace.2008.06.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2007] [Revised: 05/23/2008] [Accepted: 06/15/2008] [Indexed: 11/24/2022]
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Odeyemi K, Onajole A, Ogunowo B. Sexual behavior and the influencing factors among out of school female adolescents in Mushin market, Lagos, Nigeria. Int J Adolesc Med Health 2009; 21:101-109. [PMID: 19526700 DOI: 10.1515/ijamh.2009.21.1.101] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
High rates of adolescent pregnancy, sexually transmitted infections, and unsafe abortions in Nigeria indicate the need for a greater understanding of factors that affect adolescent sexuality. The sexual health needs of adolescents remain poorly known and addressed particularly among vulnerable subpopulations like out-of-school adolescents. The objective of this study was to examine the sexual behavior of female out-of-school adolescents and to identify factors that influence their sexual behavior. This cross-sectional study was conducted among a representative sample of unmarried, out-of-school female adolescents (n = 332, mean age 17 y), selected using cluster sampling, who were working in a major market (Mushin) in Lagos, Nigeria. Data were collected using interviewer administered questionnaires. Many girls (43.7%) have had sexual intercourse. The mean age at initiation was 16 years. The main reason for initiation was curiosity. Risky sexual behavior and transactional sex was common. Nonconsensual sex was also reported. Sexual health knowledge was poor, and friends served as their main source of information on sexual health issues. Factors associated with the initiation of sexual activity were friends sexual behavior, the person adolescents reside with, parents marital status, availability of funds to meet basic needs, and watching pornography (p < .05). Out-of-school female adolescents engaging in risky sexual behavior are exposed to sexual abuse, lack skills to resist pressure, and have limited access to credible reproductive health information. Appropriate interventions including provision of sexuality education and a supportive environment must be instituted to address their needs.
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Affiliation(s)
- Kofoworola Odeyemi
- Department of Community Health, College of Medicine, University of Lagos, Lagos, Nigeria.
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de Irala J, Urdiain IG, López Del Burgo C. Analysis of content about sexuality and human reproduction in school textbooks in Spain. Public Health 2008; 122:1093-103. [PMID: 18614191 DOI: 10.1016/j.puhe.2008.01.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2007] [Revised: 08/27/2007] [Accepted: 01/07/2008] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The spread of sexually transmitted infections (STIs) inadolescents and teenage pregnancy rates are increasing. A decrease in the average age of youth's first sexual experience has also been noted. Sexual education programmes in schools have an important role to play in addressing these issues. The objective of this study was to analyse the content of textbooks in the areas of sexuality and human reproduction in order to evaluate the extent to which these textbooks promote healthy reproductive lifestyles, as well as avoidance of risk behaviour among adolescent students. STUDY DESIGN Descriptive study of the content of school textbooks. METHODS The study sample consisted of 12 textbooks (approximately 80% of all the textbooks used in Spanish secondary schools) which were edited in 2002. Content analysis evaluated the extent to which these books demonstrated reliable scientific information about: (a) condom effectiveness; (b) consequences, prevention and treatment of STIs; (c) family planning methods; (d) assisted reproductive technologies; and (e) the promotion of healthy reproductive lifestyles. RESULTS All textbooks presented inaccurate information in the areas studied. One hundred and fifty one quotes were identified that facilitated incomplete perception of sexuality or risky behaviour. On average, 12.6 incorrect messages were identified in each textbook. CONCLUSIONS The textbooks examined are neither appropriate nor sufficiently comprehensive for adolescent education on issues of sexuality. Results suggest a need for alternative textbooks based on better scientific evidence. It is essential that textbooks empower adolescents to make healthy decisions through the promotion of useful life skills that provide a more integrated concept of sexuality. There is a need for approaches to sexual education to integrate values commonly held by parents of the youth that use such texts.
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Affiliation(s)
- J de Irala
- Preventive Medicine and Public Health, School of Medicine, University of Navarra, Irunlarrea 1, 31080 Pamplona, Navarra, Spain.
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Kelly PJ, Lesser J, Paper B. Detained adolescents' attitudes about pregnancy and parenthood. J Pediatr Health Care 2008; 22:240-5. [PMID: 18590869 DOI: 10.1016/j.pedhc.2007.07.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2007] [Revised: 07/12/2007] [Indexed: 10/22/2022]
Abstract
INTRODUCTION The purpose of this study was to examine attitudes and behaviors associated with parenthood and pregnancy among adolescents in the juvenile justice system. METHOD A cross-sectional survey of attitudes and behaviors about parenthood was conducted with 300 adolescents residing in three juvenile detention centers. RESULTS Data revealed high rates of risky behaviors that resulted in parenthood/pregnancy and generally positive attitudes about being an adolescent parent. Positive attitudes about parenthood (P = .000) and lower self-efficacy to not have sex (P = .021) were significantly correlated with having been pregnant or having fathered a child. Logistic regression showed positive attitudes about parenthood and the combination of drinking and driving together were significant predictors of pregnancy (P < or = .05). DISCUSSION Pediatric nurse practitioners working with adolescents in the juvenile justice system who routinely provide prevention counseling and implement health promotion programs must take into account the reality that many adolescents in this population are or will become parents and do not consider pregnancy as an outcome to be necessarily avoided. Moving beyond primary and secondary prevention strategies to implement programs to prevent second pregnancies and enhance parenting skills will provide needed health benefits to these adolescent parents.
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Coleman LM, Testa A. Sexual health knowledge, attitudes and behaviours: variations among a religiously diverse sample of young people in London, UK. ETHNICITY & HEALTH 2008; 13:55-72. [PMID: 18066738 DOI: 10.1080/13557850701803163] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
OBJECTIVE To report young people's variations in sexual health knowledge, attitudes and behaviours by religious affiliation. DESIGN A cross-sectional, questionnaire-based survey administered in 16 Secondary/High schools in London, UK. The sample consisted of 3007 students in school Years 11-13 (aged 15-18), present in school on the day of questionnaire administration. Excluding those who described themselves as 'Other religious', 15.9% (n=418) described themselves as having no religious affiliation, 36.3% (n=957) were Christian, 25.8% (n=679) were Muslim and 22.1% were Hindu (n=582). The religious affiliation varied within and across different ethnic groups. METHOD Self-administered questionnaire completed under 'exam' conditions, either in tutor groups or a school hall. The 30-minute questionnaires were distributed and collected by a team of ethnically and religiously diverse fieldworkers. RESULTS Religious students, as opposed to those reporting no religious affiliation, generally reported poorer sexual health knowledge, and were more conservative in their attitudes to sex. Among males and females, those with no religious affiliation and Christian students reported the highest prevalence of sexual intercourse by some margin (around 20 percentage points) over the Hindus and Muslims. Christian males most frequently reported sexual intercourse at 49.7%, and Muslim females the least at 9.0%. Among those reporting sexual intercourse, risk behaviours among all religious and non-religious students were evident. Over one-third of Muslim females who had sexual intercourse did not use contraception on their first occasion compared to 10% of those with no religious affiliation, 12% of Christians and 20% of Hindus. Christian and Muslim females reported the highest prevalence of ever not using contraception at 55%, and non-use of contraception with two or more sexual intercourse partners at 14%. CONCLUSION The findings demonstrate diverse sexual health knowledge, sexual attitudes and sexual behaviours among young people with different religious affiliations. These variations demonstrate the importance of tailoring health education and promotion interventions to meet the specific needs of young people from a variety of different religions. The challenge ahead is to find ways to work with these young people to broach such sensitive issues.
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Krishnamoorthy N, Simpson CD, Townend J, Helms PJ, McLay JS. Adolescent females and hormonal contraception: a retrospective study in primary care. J Adolesc Health 2008; 42:97-101. [PMID: 18155036 DOI: 10.1016/j.jadohealth.2007.06.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2007] [Revised: 06/25/2007] [Accepted: 06/28/2007] [Indexed: 11/28/2022]
Abstract
PURPOSE The aim of this study was to assess change in the number of adolescent females prescribed hormonal contraception in primary care following the publication in the United Kingdom of the Social Exclusion Unit report on Teenage Pregnancy. METHODS We conducted a retrospective observational study of 320 primary care practices in Scotland. Hormonal contraceptive prescribing to girls aged <16 years and those aged 16-19 years was assessed for April 1 to March 31 for the study years 2000-2001 to 2005-2006 from Scottish primary care practice data. RESULTS Between 2000-2001 and 2005-2006, the proportion of girls aged <16 years and those 16-19 years who were prescribed hormonal contraception by their primary care physicians increased by 82% (p < .001) and 53% (p < .001) respectively. The increase became significant from age 12 years for the combined oral contraceptive, 14 years for the progestogen-only pill, and 15 years for depot progestogens. By 2005-2006, 2.9% of girls aged <16 years and 40.5% of those aged 16-19 years were prescribed some form of hormonal contraception by their primary care physicians. The small number of girls aged <12 years who were prescribed hormonal contraception remained constant over the study period. CONCLUSIONS Since the publication in the United Kingdom of the Social Exclusion Unit Report on Teenage Pregnancy, there has been a significant increase in the number of female adolescents aged > or =12 years prescribed hormonal contraception by their primary care physicians. However the number of individuals prescribed hormonal contraception still remains relatively low in comparison to the reported levels of sexual activity among adolescents in the United Kingdom.
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Coleman L. Preferences towards sex education and information from a religiously diverse sample of young people. HEALTH EDUCATION 2007. [DOI: 10.1108/09654280810842148] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Buston K, Williamson L, Hart G. Young women under 16 years with experience of sexual intercourse: who becomes pregnant? J Epidemiol Community Health 2007; 61:221-5. [PMID: 17325399 PMCID: PMC2652914 DOI: 10.1136/jech.2005.044107] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND The UK has the highest rate of teenage pregnancies in western Europe. Although there is a large body of literature focusing on predictors of conception among this age group, almost all the work compares those young women who have become pregnant with their peers, regardless of whether or not their peers have experienced sexual intercourse. OBJECTIVE To compare 16-year-old young women who have become pregnant with their peers who also have experience of sexual intercourse, but who have not conceived. DESIGN Analysis of data from the baseline and follow-up surveys conducted as part of a trial of sex education. SETTING AND PARTICIPANTS Female school students aged 14-16 years from the East of Scotland. MAIN RESULTS Young age of self and partner, and non-use of contraception, all at first intercourse, are most strongly associated with pregnancy. CONCLUSIONS Those who engage in sexual intercourse at a relatively young age will often have had more opportunity to become pregnant than those whose sexual debut comes later. Similarly, the fact that those who use contraception at first intercourse have been less likely to conceive than those who do not could reflect the overall patterns of contraceptive use: young women who have used contraception at each occasion of intercourse will have had less chance to conceive than those who have not. Having a young partner at first intercourse suggests that, if this pattern continues, the couple may lack the resources needed to prevent a pregnancy due to the immaturity of both partners.
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Affiliation(s)
- Katie Buston
- MRC Social and Public Health Sciences Unit, University of Glasgow, 4 Lilybank Gardens, Glasgow G12 8RZ, UK.
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MacPhail C, Pettifor A, Pascoe S, Rees H. Predictors of dual method use for pregnancy and HIV prevention among adolescent South African women. Contraception 2007; 75:383-9. [PMID: 17434021 DOI: 10.1016/j.contraception.2006.12.020] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2006] [Revised: 12/02/2006] [Accepted: 12/15/2006] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Dual contraceptive method use is advocated for adolescent women to prevent pregnancy, sexually transmitted diseases and HIV. METHODS We examined data from a nationally representative sample of South African women aged 15-24 years to establish factors associated with dual method use. RESULTS Only 7% of current contraceptive users reported using dual methods, although this percentage increased to 28.1% when women reporting hormonal contraception and condom use at last sex were included. In multivariate analyses, having talked about condoms with a partner was most strongly associated with dual method use (adjusted odds ratio (AOR), 12.3; 95% confidence interval (CI), 6.1-25.1) and suggests that communication skills might be the most effective way of increasing dual method use. Difficulty in accessing condoms was associated with lower odds of dual method use (AOR, 0.5; 95% CI, 0.2-1.0). CONCLUSION We conclude with recommendations to increase male involvement and encourage communication between partners for the integration of HIV prevention and other reproductive health care services.
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Affiliation(s)
- Catherine MacPhail
- Reproductive Health & HIV Research Unit, Department of Obstetrics and Gynaecology, University of the Witwatersrand, PO Bertsham 2013, Johannesburg, South Africa.
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Coleman L, Testa A. Experience of sexual intercourse and reported risk behaviour among an ethnically diverse sample of young people. Sex Health 2007; 3:169-77. [PMID: 17044222 DOI: 10.1071/sh06004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Certain Black and Minority Ethnic (BME) groups have been identified as bearing a disproportionate burden of sexual ill health in the UK. There still exists a significant gap in the evidence-base concerning the sexual behaviours of BME youth. METHODS We conducted a cross-sectional survey of 16 secondary schools in London, where the proportion of BME students exceeded two-thirds of the intake. The aim was to identify the factors associated with sexual intercourse and sexual risk behaviours. RESULTS 2801 students aged 15 to 18 completed questionnaires. Compared with White British males, Black males were significantly more likely to report sexual intercourse (OR 3.04, 95% CI 1.92-4.81). Compared with White British females, Asian females were significantly less likely to report sexual intercourse (OR 0.43, 95% CI 0.27-0.69). Both sexes reporting school as their main source of information, as opposed to their family, had a lower likelihood of intercourse (males OR 0.33, 95% CI 0.21-0.53, females OR 0.39, 95% CI 0.25-0.62). Compared with White British males, contraceptive use at first ever intercourse was significantly less likely among Black males (OR 0.35, 95% CI 0.16-0.98) and males of Mixed ethnicity (OR 0.24, 95% CI 0.06-0.92). Among females, higher sexual health knowledge was associated with contraceptive use (OR 4.69, 95% CI 1.76-12.49). Males reporting higher sexual health knowledge were more likely to be 'sexually competent' at first ever intercourse (OR 2.28, 95% CI 1.10-4.69). CONCLUSIONS Given the importance of sexual health knowledge, ensuring this is improved among all ethnic groups, especially the Black and Mixed male groups, is a key message to arise from this study. Delivering this information in a 'culturally competent' manner is an important goal.
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Affiliation(s)
- Lester Coleman
- Trust for the Study of Adolescence, 23 New Road, Brighton BN1 1WZ, United Kingdom.
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Abstract
BACKGROUND Advanced paternal age has been reported to impair pregnancy outcome. Here, we investigated the association of advanced paternal age with preterm birth by using a very large national data set. METHODS We analyzed data from 1990 to 1998 on Italian firstborn singletons to mothers 20-24 and 25-29 years of age (n = 1,510,823). Odds ratios for overall preterm (<37 weeks' gestation), very preterm (<32 weeks), and moderate preterm (32-36 weeks) births were evaluated through logistic regression models in paternal age classes (20-24, 25-29, 30-34, 35-39, 40-44, 45-49, 50+ years) after adjustment for confounders. Nonparametric regression models were used to fit the effect of paternal ageing on the incidence of very preterm births. RESULTS Odds ratios increased with paternal age more rapidly for very preterm than for moderate preterm births; among 45- to 49-year-old fathers, odds ratios for very preterm births reached 1.91 (95% confidence interval = 1.08-3.38) and 1.72 (1.25-2.36), respectively, in 20- to 24- and 25- to 29-year-old mothers. CONCLUSIONS This study confirms that paternal age contributes to the risk of preterm birth. The effect is stronger on very preterm births but also influences moderate preterm births.
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Affiliation(s)
- Paola Astolfi
- Department of Genetics and Microbiology, A. Buzzati-Traverso, University of Pavia, Pavia, Italy.
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Epstein RJ. Primary prevention of human papillomavirus-dependent neoplasia: No condom, no sex. Eur J Cancer 2005; 41:2595-600. [PMID: 16223580 DOI: 10.1016/j.ejca.2005.06.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2005] [Accepted: 06/23/2005] [Indexed: 11/17/2022]
Abstract
Cervix cancer is one of several neoplastic disorders that arise following transfer of human papillomavirus (HPV) during unprotected sexual intercourse, and like most other sexually transmitted diseases (STDs), is largely preventable by consistent condom use. This primary prevention strategy has received little support, however, when compared with massive secondary prevention initiatives involving cervical screening. The reasons for this anomalous situation are complex, and include: (i) the asymptomatic nature of most primary HPV infections; (ii) widespread ignorance concerning the venereal aetiology of HPV-related cancers; (iii) the common but incorrect belief that condom use does not reduce HPV transmission; (iv) the perceived irrelevance of safe sex campaigns based on reducing transmission of human immunodeficiency virus (HIV) in high-HPV but low-HIV countries such as the Philippines; (v) the promotion of oral contraception by the medical and pharmaceutical sectors as the sexual prophylaxis of choice; and (vi) the assumption that HPV vaccines will solve the problem. Here it is proposed that the high prevalence of non-HIV STDs, including distressing disorders such as genital warts and herpes simplex, can be exploited with greater efficacy as a public health deterrent to unsafe sex and HPV transmission. Targeting a "mutually assured infection" campaign at vulnerable subgroups such as teenagers and oral contraceptive users could help reverse the global expansion of HPV-related cancers.
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Affiliation(s)
- Richard J Epstein
- Division of Haematology and Medical Oncology, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Room 404, Professorial Block, Pokfulam Road, Hong Kong
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