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Liu R, Dong X, Ji X, Chen S, Yuan Q, Tao Y, Zhu Y, Wu S, Zhu J, Yang Y. Associations between sexual and reproductive health knowledge, attitude and practice of partners and the occurrence of unintended pregnancy. Front Public Health 2023; 10:1042879. [PMID: 36684880 PMCID: PMC9846217 DOI: 10.3389/fpubh.2022.1042879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 12/07/2022] [Indexed: 01/05/2023] Open
Abstract
Background Although global contraceptive coverage has increased significantly, high rates of unintended pregnancy remain the current global status quo. A comparative analysis of the differences and correlations of knowledge, attitude and practice (KAP) of sexual and reproductive health (SRH) of both partners will help guide public health work according to gender characteristics and needs, and reduce the occurrence of unintended pregnancy. Methods A questionnaire survey of people with unintended pregnancies including women and their male partners (n = 1,275 pairs) who sought help from the Shanghai General Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from October 2017 to October 2021. Data were collected on sexual and reproductive health knowledge, attitudes, and practices in both partners who had unintended pregnancies. Chi-square test and Logistic regression were used to analyze the relationship between the occurrence of unintended pregnancy and KAP and its influencing factors. Paired odds ratio and McNemar's test were used to estimate the difference and concordance of KAP between partners. Results This study included 1,275 partners with a mean age of 30.0 years. The partner's overall level of KAP is good. Compared with women, men had better knowledge (χ2 = 3.93, p = 0.047) and more active contraceptive practices (χ2 = 19.44, p < 0.001). In the analysis of partner concordance, male contraceptive intention was found to be better than female [matched pairs odds ratio (ORMP) = 2.56, p < 0.001], and the concordance of positive contraceptive practice between partners increased with male education [adjusted odds ratio (aOR) = 1.556, 95% confidence interval (CI) = 1.185-2.044, p = 0.001]. In partner-paired regression analysis, compared with good contraceptive knowledge in both men and women in the partner, the risk of negative contraceptive practice was 1.7 times (aOR = 1.721, 95% CI = 1.234-2.400, p = 0.001) higher with good contraceptive knowledge in women but negative in men, while women with poor contraceptive knowledge but men with good knowledge are 1.3 times (aOR = 1.349, 95% CI = 1.000-1.819, p = 0.05) more likely to have negative contraceptive practices. In addition, compared with partners with positive contraceptive attitudes, women with positive attitudes but negative men and women with negative attitudes but positive men had 1.7 and 1.4 times the risk of negative contraceptive practices, respectively. Conclusion The study found that unintended pregnancy occurs mainly in young people, and the younger age of first sexual intercourse, the low education background and the lack of discussion of contraception between partners are risk factors for not taking contraceptive measures. Men's better knowledge and contraceptive practices compared with female partners, and poor male contraceptive knowledge and attitudes may lead to a higher risk of negative contraceptive practices, the results suggest that male KAP plays an important role in promoting contraceptive use and reducing unintended pregnancy.
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Affiliation(s)
- Ruping Liu
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaotong Dong
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaoning Ji
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shihan Chen
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qingqing Yuan
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yi Tao
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yaping Zhu
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Sufang Wu
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jingfen Zhu
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Yongbin Yang
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Nguyen BT, Jacobsohn TL. Post-abortion contraception, an opportunity for male partners and male contraception. Contraception 2022; 115:69-74. [PMID: 35870483 PMCID: PMC9561074 DOI: 10.1016/j.contraception.2022.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 07/11/2022] [Accepted: 07/13/2022] [Indexed: 01/26/2023]
Abstract
OBJECTIVES Men who accompany their female partners at the time of an abortion represent a unique population who may be amenable to receiving postabortion contraceptive services. We sought to examine their interest in receiving both counseling and contraception when available. STUDY DESIGN We analyzed a subset of survey data on the experience of accompanying male partners at the time of an abortion at two urban family planning clinics. We examined their beliefs about shared contraceptive responsibility, attitudes towards participating in contraceptive counseling, and willingness to use novel male contraceptives. We conducted bivariate analyses and logistic regressions for sociodemographic and reproductive factors linked to these outcomes. RESULTS Of 210 male partners surveyed at the time of an abortion, nearly three-quarters characterized preventing unwanted pregnancy as a shared responsibility, believed in the importance of attending contraceptive counseling with their female partner, and reported willingness to use novel male contraceptives. Contraceptive method used when discovering the pregnancy was neither linked to men's attitudes towards counseling nor interest in using novel male contraceptives. Individuals between the ages of 25 to 34 (aOR: 2.69; 95%CI: 1.32-5.48), those with a college education (aOR: 5.49; 95%CI: 1.31-22.94), and those who had never experienced abortion (aOR: 2.21; 95%CI: 1.08-4.55) exhibited greater interest in using novel male contraceptives. Black respondents (aOR: 2.33; 95%CI: 1.01-5.38) exhibited greater interest in receiving contraceptive counseling with their partner and a counselor following the abortion. CONCLUSION For male partners, abortion may be an opportunity to engage men in contraceptive counseling and when available, offer new male contraceptives. IMPLICATIONS As few men receive comprehensive contraceptive counseling, engaging men when they accompany their female partners to family planning clinics may be an additional strategy to prevent unwanted pregnancy.
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Affiliation(s)
- Brian T Nguyen
- Section of Family Planning, Department of Obstetrics & Gynecology, Keck School of Medicine of the University of Southern California, Los Angeles, CA, United States; The Lundquist Institute at Harbor-UCLA Medical Center, Torrance, CA, United States.
| | - Tamar L Jacobsohn
- Contraceptive Development Program, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD, United States
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Surveying the persistence of age and gender-based restrictions on over-the-counter emergency contraception across pharmacies in Los Angeles County, California, USA. J Am Pharm Assoc (2003) 2022; 62:1654-1658. [DOI: 10.1016/j.japh.2022.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/08/2022] [Accepted: 04/08/2022] [Indexed: 11/17/2022]
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LeCroy CW, Milligan-LeCroy S, Lopez D. Guy Talk: A Gender-Specific Sexual Education Program to Reduce Sexual Risk Behaviors With High School Males. HEALTH EDUCATION & BEHAVIOR 2021; 49:593-602. [PMID: 34018423 DOI: 10.1177/10901981211010441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE The purpose of this study was to investigate the feasibility and effectiveness of a gender-specific intervention targeted to adolescent males to reduce sexual risks. METHOD This study used a randomized clinical trial comparing a broad-based male empowerment curriculum with a no-treatment control group. The sample (N = 580) was recruited from schools and was implemented in community-based settings mostly in an after-school context. Assessments were conducted at baseline, postintervention, and 3 months follow-up time periods. RESULTS There were significant differences between the two groups favoring the intervention group on several of the outcome indicators, including condom technical skills, attitudes toward women, social skills, peer assertiveness, and attitudes toward consent. Quality of implementation was rated high, and qualitative data suggest themes that reflect key lessons emphasized in the curriculum. CONCLUSIONS Gender-specific programs for adolescent males can help reduce indicators that are related to sexual risk reduction. More long-term follow-up is needed to assess impact on sexual behaviors. Efforts directed at male populations should continue to be researched for potential in reducing sexual risks.
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Affiliation(s)
- Craig Winston LeCroy
- Arizona State University, Tucson, AZ, USA.,LeCroy & Milligan Associates, Inc., Tucson, AZ, USA
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Harrington J. Facilitating Access to Emergency Contraception. J Midwifery Womens Health 2020; 65:745-748. [DOI: 10.1111/jmwh.13173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 08/30/2020] [Accepted: 09/16/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Jamie Harrington
- Department of Nursing, College of Health Professions Wichita State University Wichita Kansas
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Monteiro DLM, Pereira MFVR, Herter LD, Avila R, Raupp RM. Emergency hormonal contraception in adolescence. ACTA ACUST UNITED AC 2020; 66:472-478. [PMID: 32578781 DOI: 10.1590/1806-9282.66.4.472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 11/04/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To analyze the degree of knowledge of Brazilian adolescents regarding emergency contraception (EC) such as correct administration, frequency of use, efficacy, mechanism of action, adverse effects, and complications. METHODS Cross-sectional study. Adolescents aged 11-19 years answered a questionnaire containing questions about sexuality, knowledge, and use of EC. RESULTS Out of 148 adolescents who were interviewed 8% did not know about the EC. Among the sexually active, 56.7% used EC at least once. The chance of obtaining EC information with friends triples between 15-19 years old [p=0.04; OR=3.18 (1.08-10.53)]. Most used single-dose EC. They said that EC prevents 80% of pregnancy and should be used within 72 hours after unprotected sex. Only 41.2% between 10-14 years old and 82.4% between 15-19 years old know that it prevents fertilization. As reasons for using they cited: rape and unprotected sex in 58.3% of those aged 10-14 years old and 79.6% between 15-19 years old. About side effects, 58.8% of 10-14 years old and 17.6% of those aged ≥15 years old could not answer, but 60.5% between 15-19 years old mentioned nausea and vomiting. A significant portion (17.6-41.2%) believes that EC causes abortion, cancer, infertility, and fetal malformations. Over 80% of the girls agree that it can cause menstrual irregularity. CONCLUSION Knowledge regarding EC is not satisfactory, especially regarding its risks, regardless of the age and education of the groups evaluated. Improved knowledge may lead to greater adherence to EC and lead to a reduction in unplanned pregnancies.
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Affiliation(s)
- Denise Leite Maia Monteiro
- . Universidade do Estado do Rio de Janeiro (UERJ) - Rio de Janeiro, RJ, Brasil.,. Centro Universitário Serra dos Órgãos (UNIFESO) - Teresópolis, RJ, Brasil
| | | | | | - Renata Avila
- . Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) - Porto Alegre, RS, Brasil
| | - Roberta Monteiro Raupp
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde (ICICT), Fundação Oswaldo Cruz (FIOCRUZ) - Rio de Janeiro, RJ, Brasil
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Abstract
Despite significant declines over the past 2 decades, the United States continues to experience birth rates among teenagers that are significantly higher than other high-income nations. Use of emergency contraception (EC) within 120 hours after unprotected or underprotected intercourse can reduce the risk of pregnancy. Emergency contraceptive methods include oral medications labeled and dedicated for use as EC by the US Food and Drug Administration (ulipristal and levonorgestrel), the "off-label" use of combined oral contraceptives, and insertion of a copper intrauterine device. Indications for the use of EC include intercourse without use of contraception; condom breakage or slippage; missed or late doses of contraceptives, including the oral contraceptive pill, contraceptive patch, contraceptive ring, and injectable contraception; vomiting after use of oral contraceptives; and sexual assault. Our aim in this updated policy statement is to (1) educate pediatricians and other physicians on available emergency contraceptive methods; (2) provide current data on the safety, efficacy, and use of EC in teenagers; and (3) encourage routine counseling and advance EC prescription as 1 public health strategy to reduce teenaged pregnancy.
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Evaluating Community Pharmacy Responses About Levonorgestrel Emergency Contraception by Mystery Caller Characteristics. J Adolesc Health 2018; 63:32-36. [PMID: 29475729 DOI: 10.1016/j.jadohealth.2017.11.303] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 11/28/2017] [Accepted: 11/28/2017] [Indexed: 11/20/2022]
Abstract
PURPOSE Since restrictions on nonprescription sales were removed in 2013, levonorgestrel emergency contraception (EC) should be available without a prescription at pharmacies for consumers of all genders and ages. Using mystery callers, we assessed variations in availability of and access to EC. METHODS In 2015-2016, three sets of mystery callers (two female physicians, two adolescent females, and two adolescent males) each called all licensed retail pharmacies in five U.S. cities using standardized call scripts. Scripts assessed same-day availability and subsequent access to EC for 17-year-olds. Data on various characteristics of calls were collected and compared by caller type. RESULTS Among the 993 pharmacies called, same-day availability for EC was approximately 80%, with no differences by caller types (p = .34). However, 10.7% of calls made by the adolescent male caller and 8.3% made by the adolescent female caller resulted in incorrectly being told they could not obtain EC based on age, compared to only 1.6% of calls made by the physician (p < .01). Pharmacy staff stated correctly that EC was available over-the-counter more often to adolescent male callers (62.0%) than adolescent females (51.6%) or female physicians (57%) (p < .01). Physicians were more likely to be placed on hold, talk to a pharmacist, or be transferred to a pharmacist (p < .01) than adolescents. CONCLUSIONS Persistent barriers to accessing EC exist for adolescents despite regulatory changes to make EC available over-the-counter, especially for females. Additional work to remove these barriers is needed to assure timely access for those who require effective pregnancy prevention.
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Abstract
PURPOSE OF REVIEW Although teenage pregnancy is declining in many parts of the world, it remains associated with considerable social, health, and economic outcomes. Pregnancy prevention efforts focus primarily on young women, with minimal attention to young men. This review highlights recent literature pertaining to the role of young men in pregnancy prevention. RECENT FINDINGS Young men have varying views on contraception as well as which partner(s) should be responsible for its use. Limited contraception knowledge reduces young men's sexual health communication as well as their contraception use. Healthcare providers play a major role as one of the main sources of sexual health information for young men, but there are gaps in young men's sexual health care so new guidelines have emerged. SUMMARY Recent literature highlights young men's range of views on contraception as well as their low sexual health knowledge and sexual health communication. To address teenage pregnancy and improve young men's overall wellness, healthcare providers should routinely address sexual health. Healthcare providers may use our newly proposed acronym, HIS BESTT, (Hello. Initiate. Sexual health assessment. Both condoms and female dependent methods. Examine genitals. STI screening. Talking to partner(s). Talking to parent(s) or guardians), to incorporate current clinical recommendations.
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Richards MJ, Peters M, Sheeder J, Kaul P. Contraception and Adolescent Males: An Opportunity for Providers. J Adolesc Health 2016; 58:366-8. [PMID: 26753546 DOI: 10.1016/j.jadohealth.2015.10.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 10/17/2015] [Accepted: 10/19/2015] [Indexed: 11/17/2022]
Abstract
PURPOSE To examine young men's awareness of emergency contraception (EC) and its association with their contraceptive decision-making contributions within a relationship. METHODS A convenience sample of English-speaking male patients aged 13-24 years were surveyed regarding their childbearing intentions, contraceptive awareness (including EC), perceived contraceptive knowledge, and communication about birth control with providers and within a relationship. RESULTS An ethnically diverse sample of adolescent males was recruited with a mean age of 18.9 years. Most had previously been sexually active (75%) and felt it was important to avoid pregnancy (84%) and 61% reported ever having spoken to a health care provider about birth control (other than condoms), but only 42% had heard of EC. Participants who had heard of EC were more likely to have spoken to a health care provider about contraception in the past (51.5% vs. 29.8%; p = .050), to feel they should participate in contraceptive decisions in a relationship (97.4% vs. 76.5%; p = .006), and to have discussed contraception with a partner (76.9% vs. 29.2%; p < .001). CONCLUSIONS Counseling young men about EC, as well as other methods of birth control, may empower them to become actively involved in contraceptive decisions within a relationship if they do not desire fatherhood.
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Affiliation(s)
- Molly J Richards
- Section of Adolescent Medicine, Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
| | - Marissa Peters
- Section of Adolescent Medicine, Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
| | - Jeanelle Sheeder
- Section of Adolescent Medicine, Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
| | - Paritosh Kaul
- Section of Adolescent Medicine, Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado.
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Munro ML, Dulin AC, Kuzma E. History, policy and nursing practice implications of the plan b(®) emergency contraceptive. Nurs Womens Health 2015; 19:142-153. [PMID: 25900585 DOI: 10.1111/1751-486x.12186] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Numerous policy changes have expanded access to emergency contraception, such as Plan B®, in recent years. Plan B® is a progesterone-based medication that prevents pregnancy from occurring up to 120 hours after unprotected intercourse by preventing ovulation and tubal transport. Increased access to Plan B® allows women to make independent decisions regarding reproductive health. Nurses play an important role in providing education as well as comprehensive, compassionate and holistic care.
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