农村地区已婚育龄妇女人工流产原因分析

目的:了解农村已婚育龄妇女的人工流产原因。方法:采用结构式问卷调查方法对农村已婚育龄妇女进行问卷调查,分析人工流产情况及原因。结果:农村已婚育龄妇女的人工流产率为29.98％;人工流产原因中有35.15％是由于未避孕造成的,有超过一半(52.85％)的人工流产为避孕失败情况下采取的补救措施;避孕失败的原因中有65.09％为宫内节育器失败;婚前及婚后初产前的人工流产超过70％是未采取避孕措施造成的,而产后的人工流产主要是避孕失败造成的;多次人工流产妇女的避孕措施趋向多样化;而人工流产原因中避孕失败的比例增加。结论:应加强避孕方法知识的宣传以及避孕方法使用的指导,提高农村育龄妇女的避孕使用率及正确使用率,特别是对有人工流产(一次或多次)史的对象应加强避孕使用指导;对采用宫内节育器的妇女应进行定期检查,保证官内节育器的有效性。     

庄河农村育龄妇女避孕套使用调查

目的了解庄河市农村育龄妇女避孕套使用情况以及影响因素,为提高避孕套在农村育龄妇女中的使用率提供依据。方法采取整群随机抽样法,抽取庄河市农村的18个乡的123个村的5000名育龄妇女,由调查员入户对其进行问卷调查。结果5000名使用避孕套的育龄妇女中以前知道避孕套者占75．9％,不知道或不相信避孕套这种避孕方法的占24．1％;知道避孕套兼顾预防性传播疾病和生殖道感染的占53．4％;不知道的占46．6％;首选避孕套避孕方法作为长期避孕的占63．0％;避孕套使用者中由计划生育工作人员提前发放的占90．8％;认为避孕套避孕效果好的占92．5％。结论庄河市农村育龄妇女不知道避孕套兼顾预防性传播疾病和生殖道感染的比例高,但认为避孕套避孕效果好者所占比例高,计划生育工作人员服务较好。应在农村大力宣传和推广,来提高避孕套的知晓率和使用率。     

已婚男性避孕套使用情况及续用意愿调查

目的 了解我国已婚男性避孕套的使用情况及其续用意愿，分析影响因素。方法 2005年11～12月，采用分层、三阶段与规模成正比的容量比例抽样方法获得调查对象，由调查员入户对抽中男性进行面对面问卷调查。结果 89．3％的凋查对象知道避孕套可预防艾滋病。已婚男性现在避孕率为84．5％。避孕套占避孕方法构成比为14．3％。84．2％的男性选择避孕套的目的是避孕，不使用避孕套的最主要原因是已经使用了其他避孕方法。66．4％现在使用避孕套避孕的男性愿意继续选择使用避孕套。因素分析结果显示，避孕套的续用意愿主要受使用满意度影响，对避孕套使用情况满意的男性选择继续使用避孕套的可能性更大。结论 我国已婚人群中避孕套相关知识有了很大提高，但避孕套使用率和续用情况不理想，需加强相关宣传教育。将知识真正转化为行为。提高避孕套使用满意度，促进避孕套的广泛使用。     

上海市已婚育龄妇女非宫内节育器避孕方法使用情况

目的 对上海市已婚育龄妇女的非宫内节育器避孕方法使用的实际情况和实际效果进行调查，以期能为制订进一步提高避孕节育方法效果的对策提供科学依据。方法 采用分层和整群抽样相结合的流行病学调查方法，调查上海市常住户口年龄小于49岁已婚育龄妇女避孕方法的使用情况，效果和失败原因。结果 口服避孕药和注射避孕针、安全期、避孕套、外用避孕药和体外排精法的Pearl’s有效指数分别为96．5、95．1、93．3、92．4和91．0／100妇女年。口服避孕药和注射避孕针、避孕套和外用避孕药的使用失败占69．2％～81．7％，方法失败占18．3％～30．8％。在使用失败者中，口服避孕药和注射避孕针对象的漏服和漏注占89．3％；避孕套避孕中没有使用占52．2％，避孕套破裂占29．3％；外用避孕药没有使用占39．3％；安全期避孕失败中安全期算错占65．9％，月经变得不规则占34．1％。结论 为了进一步提高上述避孕方法的有效性，应加强个别的技术指导和咨询，特别是安全期的正确计算；并且在育龄人群中推广综合避孕方法。     

中国已婚育龄妇女避孕方法选择

目的了解中国已婚育龄妇女避孕知识知晓情况以及对避孕方法的选择。方法 2010年10月,在中国30个县采用与规模成正比的容量比例抽样方法获得调查对象,对6 753名已婚育龄妇女进行面对面问卷调查。结果在6 568名知道避孕套这种避孕方法的调查对象中,超过1/4的调查对象认为避孕套可以在阴茎疲软后再取下,超过30%的调查对象认为使用前吹气检查是否漏气或可以使用油质润滑剂;89.1%曾经使用过任何一种避孕方法,82.7%目前正在使用某种避孕方法;目前使用的避孕方法以宫内节育器(56.7%)、女性绝育(21.0%)和避孕套(18.5%)为主。结论中国已婚育龄妇女避孕率较高,但对宫内节育器、女性绝育和避孕套以外其他避孕方法的知晓率和使用率均比较低,且在避孕套的使用上存在错误认识。     

新疆生产建设兵团已婚育龄妇女人工流产状况分析

目的：了解新疆生产建设兵团已婚育龄妇女人工流产情况。方法：采用分层、四阶段、整群、概率比抽样方法,共调查已婚育龄妇女7026人,用单因素和多因素的方法对妇女人工流产水平及其影响因素进行分析。结果：兵团已婚育龄妇女的人工流产发生率为47．34％,居住地,民族、生育年龄、文化程度及曾生男孩或女孩数是妇女妊娠后是否做人工流产的影响因素。由于未避孕、避孕失败导致人工流产的比例分别占57．44％和40．68％,避孕失败的主要原因是节育器移位和避孕套破裂。结论：兵团已婚妇女的人工流产发生率较高,发生非意愿妊娠的主要原因是未避孕和避孕失败,提示应进一步加大避孕相关知识的宣传力度,同时保证有效避孕药具的供给,并加强随访,以降低人工流产发生。     

海安市已婚育龄妇女避孕现状的调查分析

目的:了解本地区已婚育龄妇女的避孕现状,为规范避孕服务提供依据。方法:对本地区2019年末的已婚育龄妇女采用知情调查问卷,根据年龄、受教育年限和居住地等分组进行避孕措施调查,并对结果进行分析。结果:本地区已婚育龄妇女避孕率为76.39%,主要措施为IUD、避孕套、口服药、女扎和外用药;年龄≤35岁组使用IUD和女扎低于年龄36岁组,使用避孕套增加,受教育年限9年组的使用避孕套、口服药和外用药的显著高于≤9年组,城镇组的使用避孕套、女扎和外用药高于≤9年组,差异有统计学意义(P0.05)。结论:本地区已婚育龄妇女的避孕措施落实率处于正常水平,但选择低效避孕措施比例较高,应加大宣传力度、提高避孕服务的规范性,提高育龄妇女的生殖健康水平。     

武汉市黄陂地区农村已婚育龄妇女人工流产原因分析

目的:了解黄陂地区已婚育龄妇女流产原因。方法:采用结构式问卷对2006年8月～2007年10月到黄陂区、乡两级计划生育服务站做终止妊娠手术的农村已婚育龄妇女进行问卷调查。结果:被调查者受教育水平以初中为主72.95%,有近50%的妇女认为流产引产对身体没有什么影响(23.41%)或者说不清(21.89%)。流产次数最高可达9次(2人),未采取避孕措施而流产的有1302人次,占46.60%。避孕失败的原因中有30.14%是因使用宫内节育器失败,有25.16%是使用避孕套失败。流产原因中因未计划妊娠有1997人次,占71.81%,政策不允许669人次,占24.06%。结论:应提高妇女的科学文化素质,加强避孕知识的普及和宣传,提高农村妇女的避孕使用率,提高正确选择和使用避孕工具的比率,通过这些措施来降低黄陂地区已婚育龄妇女的流产率。     

我国育龄人群避孕套使用情况及其影响因素

目的了解我国育龄人群中男性避孕套使用情况以及主要的社会人口学影响因素，为制定相应政策，提高避孕套在普通群众中的使用率提供依据。方法采用分层、三阶段、与育龄妇女人数规模成正比的三阶段的容量比例（PPS）抽样方法获得抽查对象，由调查员入户对其进行面对面的问卷调查。结果我国育龄人群的避孕套使用率很低．不到10％，并且存在严重的地区差异。东部地区明显高于中西部地区。而城市显著高于农村。对避孕套相关知识了解较少，55．5％的妇女不知道避孕套可预防艾滋病。多因素分析结果显示，分娩次数和第1次避孕方法对妇女现在避孕套的使用影响最大。结论我国育龄妇女中避孕套使用率非常低，避孕套相关知识欠缺，应该丰富健康教育方式，提高健康教育效果。     

育龄妇女避孕套知识掌握情况的调查

目的了解避孕套知识在育龄妇女中的掌握情况,为十一五农村卫生适宜技术推广宣传避孕套提供依据。方法采用横断面调查法,对庄河市18乡50村2436名18—45岁育龄妇女进行问卷调查。结果不知道避孕套避孕方法的占4．8％,其中未婚占83．6％,已婚占16．4％;不知道避孕套可防性病的占48．7％,其中未婚占62．3％,已婚占37．7％;不能正确说出避孕套使用方法的占16．20％,其中未婚占69．5％,已婚占30．5％。结论在育龄妇女中,应加强宣传用避孕套有避孕和防病双重功效,并且把未婚女青年作为计划生育宣传教育工作的重点对象。     

非意愿妊娠原因及对策的研究

为分析和探讨导致非意愿妊娠的原因,降低人工流产率,促进广大育龄妇女生殖健康提供科学依据,采用以医院为场所的描述性流行病学研究方法,1996年3月～1996年5月,在郑州市8家医院妇产科门诊,对来寻求计划生育服务的妇女采用填写调查表的方式进行调查。共调查1557例,其中行人工流产(包括手术流产和药物流产)者1099例,平均每例1.22次。流产者中38.8％是由于未采取避孕措施而致意外妊娠,61.2％为避孕失败造成的。55.6％能清楚记得避孕失败时间。通过对人流者既往避孕史的研究,发现有避孕失败史者占51.6％,其中避孕套失败最多,占37.0％;其次是安全期失败,占23.0％;宫内节育器失败居第三位,占21.0％。避孕失败妇女的年龄主要分布于性生活旺盛年龄组(21～29岁),占70.3％。结果表明导致非意愿妊娠的根本原因是避孕观念淡薄,避孕知识(包括紧急避孕知识)匮乏。建议对不同人群进行侧重点不同的有关避孕知识教育,并加强避孕药具的质量管理。     

Contraceptive failure--results from a study conducted among women with accepted and unaccepted pregnancies in Denmark

Most studies focusing on contraceptive failure in relation to pregnancy have focused on contraceptive failure among women having induced abortions, thereby neglecting those women who, despite contraceptive failure, accept the pregnancy and intend to carry the fetus to term. To get a more complete picture of the problem of contraceptive failure, this study focuses on contraceptive failure among women with diverse pregnancy outcomes.In all, 3520 pregnant women attending Odense University Hospital were included: 373 had induced abortions, 435 had spontaneous abortions, 97 had ectopic pregnancies, and 2614 received antenatal care. The variables studied comprise age, partner relationship, number of births, occupational and economical situation, and contraceptive use.Contraceptive failure, defined as contraceptive use (condom, diaphragm, IUD, oral contraception, or another modern method) at the intercourse where conception most likely occurred, were reported by 315 women, 52% of these women had induced abortions, 10% had spontaneous abortions, 3% had ectopic pregnancies, and 36% received antenatal care. Women aged 15-24 years were more likely to have experienced contraceptive failure in relation to use of condom and oral contraception than women aged 25-34 years. In addition, contraceptive failure was found to be associated with being single, a student, and having given birth twice or more previously. Regarding pregnancy acceptance, being 25-34 years of age was positively associated, whereas being single and a student was negatively associated with pregnancy acceptance.     

Condom use within marriage: a neglected HIV intervention

OBJECTIVE: To assess the contraceptive effectiveness of condoms versus oral contraceptive pills and estimate the reproductive consequences of a major shift from pill to condom use. METHODS: Secondary analysis was performed on nationally representative cross-sectional surveys of women in 16 developing countries. FINDINGS: In the 16 countries, the median per cent of married couples currently using condoms was 2%, compared with 13% for the pill. Condom users reported a higher 12-month failure and higher method-related discontinuation rates than pill users (9% and 44% vs 6% and 30%, respectively). Condom users were more likely to report subsequent abortion following failure (21% vs 14%), and also more likely to switch rapidly to another method (76% vs 58%). The reproductive consequences, in terms of abortion and unwanted births, of a hypothetical reversal of the relative prevalence of condom and pill were estimated to be minor. The main reason for this unexpected result is that the majority of abortions and unwanted births arise from non-use of any contraceptive method. CONCLUSION: A massive shift from the more effective oral contraceptive pills to the less effective condom would not jeopardize policy goals of reducing abortions and unwanted births. However, such a shift would potentially have an added benefit of preventing human immunodeficiency virus (HIV) infections, especially in countries with generalized HIV epidemics.     

Trends and determinants of contraceptive use in Rakai District, Uganda, 1995-98

A prospective study conducted between 1995 and 1998 assessed trends in contraceptive use in rural Rakai District, Uganda. Over a period of 30 months, women's use of modern contraceptives increased significantly from 11 percent to 20 percent. Male condom use increased from 10 percent to 17 percent. The prevalence of pregnancy among sexually active women 15-49 declined significantly from 15 percent to 13 percent. Women practicing family planning for pregnancy prevention were predominantly in the 20-39-year age group, married, better educated, and had higher parity than others, whereas women or men adopting condoms were predominantly young, unmarried, and better educated. Condom use was particularly high among individuals reporting multiple sexual partners or extramarital relationships. Contraceptive use was higher among women who desired fewer children, among those who wished to space or terminate childbearing, and among women with previous experience of unwanted births or abortions. Self-perception of HIV risk increased condom use, but HIV testing and counseling had only modest effects. Contraception for pregnancy prevention and for HIV/STD prophylaxis are complementary.     

Contraceptive patterns among women and men in León, Nicaragua

The aim was to study the contraceptive patterns among men and women in León, Nicaragua. A questionnaire about sexual, contraceptive, reproductive and socioeconomic issues was directed to 7,789 households including 22% of all women of the municipality aged 15–49 years (n = 10,867). A subsample of 388 men and 413 women aged 15–49 years was drawn at random. Refusals were less than 2%. Private interviews revealed that among fertile women who had been sexually active within the last three months, non-pregnant and wishing to avoid pregnancy, 77% were contracepting. Female sterilization was the most common contraceptive method (39%), followed by intrauterine device (16%). Even though around 60% of women at some time had tried oral contraceptives, only 13% of contraceptors used them currently. The rhythm and interruption methods together constituted only 4%. Condom use was low and mainly occasional. Contraceptive use in sexually active women aged 15–44 years was lower among those having lower education, living in rural areas, and living under poverty conditions. The predominance of female sterilization and the occasional condom use—mainly reported by men—reflects a situation of relative male control over contraception and reproduction. This probably originates from “machista” values where men having many children with different women are considered strong. There was also a significantly higher use of contraceptives among the better-off women and men compared with the extremely poor. The situation of many poor women, in a country with limited contraceptive services, is worrving considering that abortion is illegal and the threat of HIV epidemic is growing. The situation for adolescents is particularly problematic with low experience in contraceptive use.     

人工流产女青年性行为和避孕现状研究

目的:了解北京市人工流产女青年的性行为和避孕现状,探讨人工流产、特别是重复流产的影响因素。方法:采用自填式问卷的方法,对北京市1 008名自愿要求人工流产、在1980年8月1日之后出生的女青年进行现状调查。结果:研究对象首次性行为的平均年龄为(20.70±1.95)岁,54%的人在20岁之前就开始了性生活;首次人工流产的平均年龄为(21.96±1.81)岁,首次流产在20岁之前的占17.0%;将近25%的人曾与2名及以上的男性发生过性关系;人流女青年本次怀孕的原因,60.2%是因为没有避孕,39.7%由于避孕失败;没有避孕的主要原因是"在没有准备好避孕药具的情况下同房"(41.5%)和"知道避孕方法但不想用"(39.7%);避孕失败的主要原因是全安期和体外射精(39.0%)、避孕套(32.7%)和紧急避孕(18.5%);过去3个月中,最常用的避孕方法为避孕套(75.5%)、全安期和体外射精(11.0%)、紧急避孕(8.2%);在避孕套使用者中,只有9.3%能坚持每次同房都用;77.2%的人认为口服避孕药对身体不好;32.4%的研究对象有重复流产。单因素分析发现,文化程度低、未婚同居、首次性生活和首次流产的年龄小、多性伴和不能坚持、正确使用避孕措施是重复流产的影响因素。结论:女青年首次性行为开始早、多性伴比例高、避孕药具使用率低或使用低效的避孕方法是非意愿妊娠和人工流产的主要原因,且重复流产现象比较严重;同时,流动人口在人流女青年中占了相当大的比例。因此,应当对未婚人群和流动人口女青年进行人工流产的危害以及避孕知识的宣传教育,提高现代科学的避孕药具使用率,避免不必要的意外妊娠和人工流产。     

山东农村育龄妇女避孕节育知情选择的影响因素

目的了解山东省农村已婚育龄妇女避孕节育知情选择开展现状及其影响因素。方法采用问卷调查,对4024名20~29岁的农村已婚育龄妇女避孕节育知情选择开展现状及其影响因素进行调查,采用χ2检验进行单因素分析,采用非条件Logistic回归进行多因素分析。结果(1)调查对象中,能够知情选择避孕节育方法的人占71.92%(2894/4024),不能者占28.08%(1130/4024);(2)影响避孕节育知情选择的因素为年龄、文化程度、避孕知识得分、是否听说过避孕节育知情选择、是否知道“选择”的含义、服务站技术人员向调查对象介绍避孕节育方法的种类等。结论应加强管理层认知,改善技术服务人员的业务水平,提高育龄妇女的自身素质。     

Contraceptive Use and Unintended Pregnancies Among HIV-Infected Women in Mumbai

Background:

Access to reproductive health services in Human Immunodeficiency Virus (HIV) programs can greatly enhance program''s potential to limit the spread of disease, reduce unintended pregnancies and safeguard the health of infected people.

Objectives:

To assess (i) knowledge, attitude, and use regarding contraceptives; safe sex and dual protection; (ii) fertility desires and unintended pregnancies post HIV and (iii) symptoms of reproductive tract infection/sexually transmitted infection (RTI/STI) among women infected with HIV.

Materials and Methods:

A cross-sectional study among 300 currently married HIV-positive women who had not undergone permanent sterilization with no immediate desire for pregnancy. Study site was Integrated Counseling and Testing Centers (ICTC) in tertiary hospitals of Mumbai and women were interviewed using a semistructured questionnaire.

Results:

In spite of good awareness about modern methods, 42.7 felt that contraceptives other than condoms were harmful to use due to their HIV status. Knowledge on dual protection was limited to condom (75%). Condom use increased from 5.7% pre-HIV to 71.7% post-HIV, with 89.6% reporting regular use. Future fertility desire was expressed by 8.7% women. Induced abortions post-HIV was reported by16.6% women, as pregnancies were unintended. About 69% wished to use dual contraceptive methods for effective protection if it was not harmful to be used by people living with HIV (PLHIV).

Conclusion:

Data reveals a need to promote modern contraceptive methods along with regular condom use to prevent unintended pregnancies and improve health-seeking behavior for contraception. Health system models that converge or link HIV services with other reproductive health services need to be tested to provide comprehensive reproductive healthcare to infected women in India.     

Teenagers and condom use: choices by young Brazilians from three Brazilian State capitals in their first and last sexual intercourse

Condom use has increased among Brazilian youth, although condoms are not used in all sexual relations; in addition, their use varies over the course of an individual's affective and sexual history. This study focused on the prevalence and factors associated with condom use during sexual initiation and in the most recent sexual relations in young men and women (18-24 years of age). The data are from the GRAVAD Research Project, a cross-sectional study with a stratified probabilistic sample using household interviews in three Brazilian State capitals. The analysis used multinomial logistic regression with a hierarchical model. Prevalence of condom use in first sexual intercourse among individuals who used any contraceptive method was 80.7% for females and 88.6% for males. This proportion dropped to 38.8% and 56%, respectively, for the most recent intercourse. In both events, and for both genders, condom use was associated with social belonging and age at initiation. Condom use at sexual initiation was correlated with use in the most recent intercourse (OR = 2.42 for males and 1.89 for females). Increased condom use among youth does not mean continuing use. Women used condoms less than men in the events studied here.