Premarital sexual activity and contraceptive use in Santiago, Chile.

The Santiago Young Adult Reproductive Health Survey was conducted in 1988 to examine the sexual behavior of and contraceptive use among young adults in Chile. The survey was based on multistage household probability samples of 865 women and 800 men aged 15-24 who were living in Santiago in 1988. Findings show that 35 percent of females and 65 percent of males had had premarital intercourse. Among those who had done so, the median age at first experience was 18.4 years for women and 16.4 years for men. Only 20 percent of females and 19 percent of males used contraceptives at first premarital intercourse. Use of contraceptives increased with age at the time of that event. Fertility data reveal that 70 percent of first births were premaritally conceived, and more than one-third of these were born prior to union. The high rates of premarital and unintended pregnancy among young women and the low prevalence of effective contraceptive use indicate a need for greater emphasis on sex education and family planning services directed at adolescents and unmarried young adults in Santiago.     

Ethnic variations in sexual activity and contraceptive use: national cross-sectional survey

OBJECTIVES: Our objective was to compare data on contraceptive use in relation to reported sexual activity in women from different minority ethnic groups. DESIGN: We analyzed the National Survey of Sexual Attitudes and Lifestyles 2000. SUBJECTS: Women aged 16-44 years, numbering 6932 and residing in Britain, participated in this study. MAIN OUTCOME MEASURES: Our main outcome measures are as follows: percentage of women reporting sexual activity, use of contraception and type of contraception (hormonal, barrier or permanent methods). RESULTS: Overall, fewer women from the UK's four main ethnic minority groups reported recent sexual activity, compared with white women. Among sexually active women, contraceptive use was significantly lower in all ethnic minority groups than in white women, but this pattern differed according to marital status. In ever-married or cohabiting women, lower contraceptive use was reported by Indian (78%) and Pakistani women (74%) than by other groups. Among single women, black Caribbean (88%) and black African (82%) women reported using less contraception compared with white (95%) and Indian (100%) women. Women from all ethnic minority groups were less likely than white women to report using hormonal contraception and permanent methods and were more likely to use barrier methods. The differences between ethnic groups remained significant after adjusting for educational achievement and parity. Deprivation and acculturation did not account for the use of contraception or the type of contraceptive method used. CONCLUSION: Sexually active married Pakistani and Indian women reported the lowest overall use of contraception. Among sexually active single women, black African and black Caribbean women reported levels of contraceptive use that were lower than those reported by white women. Sexually active women from all four minority ethnic groups were less likely than white women to use reliable methods of contraception.     

The impact of government policies and neighborhood characteristics on teenage sexual activity and contraceptive use

OBJECTIVES: This study sought to examine the effects of government policies and neighborhood characteristics on adolescent female sexual behavior to better inform future public policy decisions. METHODS: Using a bivariate probit model and National Survey of Family Growth data on women aged 15 through 19 years, we estimated the probabilities of their being sexually active and, if sexually active, of their using contraceptives. RESULTS: Variables measuring the cost of obtaining an abortion are not good predictors of sexual activity or contraceptive use. However, the relationship between family planning availability and contraceptive use is statistically significant at conventional levels. CONCLUSIONS: Policymakers seem to have little leverage with regard to influencing the decision to become sexually active, although increased access to family planning services may encourage responsible contraceptive behavior. Neighborhood context is an important determinant of adolescent female sexual behavior.     

Rates of induced abortion in Iran: the roles of contraceptive use and religiosity

Iran has experienced a dramatic decline in fertility in recent decades, but limited access to legal abortion continues to lead many women whose pregnancies are unwanted or mistimed to undergo clandestine, unsafe abortions. No official data on the abortion rate in Iran have been collected, however. This study uses the 2000 Iran Demographic and Health Survey to estimate the abortion rate for the country as a whole and for specific regions, and to explore the role of contraceptive use and religiosity in explaining regional variations in abortion rates. We estimate the total abortion rate for the country to be 0.26 abortions per married woman, and the annual general abortion rate to be 7.5 abortions per 1,000 married women aged 15-49. We find that the negative effect of modern contraceptive use on the abortion rate is 51 percent greater than the negative effect of religiosity, and we highlight the implications of these findings for policies on reproductive health and family     

Religious correlates of male sexual behavior and contraceptive use

This study sought to determine whether males classified according to sexual behavior and contraceptive use could be distinguished on the basis of religiosity. Subjects included 245 single male college students ages 16-19 years, 129 of whom were identified as being currently sexually active. These sexually active males were classified into 4 groups based on consistency of contraceptive use: 1) always, 2) most of the time, 3) sometimes, and 4) never. The Faulkner and DeJong Religiosity in 5-D Scale was used to provide a measure of religiosity. Discriminant analysis indicated that a set of religiosity items can differentiate among groups differing in regard to sexual behavior, especially those from the ritualistic dimension. Males who had not participated in sexual intercourse during the preceding year indicated a greater degree of religious commitment than other males on all items selected. Attitude toward sex was the item most highly distinguishing among males in terms of consistency of contraceptive use. It is concluded that health educators should recognize the influence of religious convictions on sexual behavior and attitudes. The churches are in a positive to help their members develop decision making skills and positive attitudes toward sexuality. Questions for further research include: 1) is religiosity predictive of behavior or does religiosity change following a change in behavior, and 2) what are the implications of religious commitment in terms of educational programming in the area of sexuality?     

School-based clinic use other factors affecting adolescent contraceptive behavior

Adolescent risk taking, preventive behavior, and contraceptive use were investigated using a self-administered questionnaire in a sample of 260 inner-city high school students targeted by a school-based health clinic. Multivariate models consisting of individual and environmental variables significantly predicted sexual activity and contraceptive use. Older age at first intercourse, higher number of welfare benefits received by the household (including Medicaid, food stamps, and free or reduced price lunch), and use of the school-based clinic were significant positive predictors of more frequent contraceptive use by adolescents.Results of our study suggest that programs may be having some success in encouraging and enabling sexually active adolescents to use contraception and to use it more consistently. Rigorous program evaluations should help program planners and policy makers design and refine adolescent pregnancy-prevention efforts.     

Repeat use of contraceptive crisis services among adolescent women

"They don't get pregnant twice unless they are hopeless." This was one Doctor's reported assessment of women who had more than one abortion. There is some evidence that the repeated use of pregnancy testing 'scares', emergency contraception and abortion is increasing across all women. However, there may also be an interaction between this general trend and the difficulties faced by particularly vulnerable groups of teenagers who also have higher rates of teenage parenthood. This paper aims to provide an overview of the research and international statistics in this sparsely researched area. It will draw on the author's own qualitative work with 'high risking' teenage girls, and that of other researchers, in order to attempt to reach an understanding of the mechanisms behind this increasingly common phenomenon. The indications from this work refutes the notion that these women form a special or 'hopeless' group, but point towards general problems with contraception and services common to all women that may become compounded through structural vulnerability such as deprivation.     

Family and friend closeness to adolescent sexual partners in relationship to condom use

PurposeThe role of closeness of sexual partners to family and friends (i.e., how well the participant’s family and friends knew their primary sexual partner) to a variety of relationship and sexual behavior measures was explored.MethodsA sample of 151 adolescent females (aged 14–17 years) was assessed. Areas assessed include family and friend closeness, relationship intimacy, length of sexual relationship, and condom use.ResultsBivariate correlations indicated that the integration of the sexual partner into the family and friend networks was related to greater relationship intimacy. Lowered condom use was related to a number of measures, including increased relationship intimacy and increased family closeness. A path analysis was conducted to assess for direct and indirect effects of family closeness, friend closeness, relationship length, and relationship intimacy on condom use. Social network closeness in family and friend networks was implicated in lowered condom use through higher relationship intimacy within adolescent dyads.ConclusionsSocial network theory is useful in understanding adolescent health-related behavior. In particular, the integration of adolescent sexual partners into both family and friend networks is related to the expression of adolescent sexual behavior.     

Patterns of contraceptive use within teenagers' first sexual relationships

CONTEXT Teenagers have a high unintended pregnancy rate, in part because of inconsistent use or nonuse of contraceptives. It is important to determine how partner and relationship characteristics are related to contraceptive use and consistency within adolescents' first sexual relationships. METHODS Logistic and multinomial logistic regression analyses of data from 1,027 participants in the first two waves of the National Longitudinal Study of Adolescent Health examined the influence of relationship and partner characteristics on ever‐use and consistent use of contraceptive methods during teenagers' first sexual relationships RESULTS Teenagers who had waited a longer time between the start of a relationship and first sex with that partner, discussed contraception before first having sex or used dual contraceptive methods had significantly increased odds of ever or always using contraceptives. Adolescents who had taken a virginity pledge, had an older partner, had a greater number of close friends who knew their first partner, or reported having a relationship that was not romantic but that involved holding hands, kissing and telling their partners they liked or loved them had decreased odds of contraceptive use or consistency. As relationship length increased, teenagers were more likely to ever have used a method, but less likely to always have used a method. CONCLUSIONS Parents and programs should encourage teenagers to delay sexual intercourse, discuss contraception with partners before initiating sex and be vigilant about contraceptive use, particularly in long‐term sexual relationships and in relationships with older partners.     

Ecological factors associated with adolescent sexual activity

Bronfenbrenner's (1979) ecological systems theory was used as an organizing framework for the research on teenage sexual activity. Per Bronfenbrenner's theory, the literature is discussed according to macrolevel (system-wide), mesolevel (immediate social environment), and microlevel (individual) factors that are associated with adolescent sexual involvement. Following the review, implications for social work are explored.     

Sexual initiation and contraceptive use among adolescent women in northeast Brazil

To estimate trends and determinants of sexual initiation and contraceptive use among adolescent women in Northeast Brazil, multivariate logistic hazard models are used that draw on data from three Demographic and Health Surveys conducted there between 1986 and 1996. Educational attainment is among the variables found to be associated most consistently with differential risk of engaging in first intercourse during adolescence, including premarital intercourse, and of contraceptive use during sexual initiation. Greater frequency of attending religious services and greater exposure to television are also associated with lower rates of sexual initiation and higher use of contraceptives. Seemingly diminishing returns of education on delayed sexual activity may help explain, in part, observed increases in the absolute level of adolescent sexual experience across survey periods, however. Multilevel modeling techniques pointing to the existence of cluster-level random variances underline the need for further research into community influences on individual sexual activity.     

The impact of sex education on sexual activity, contraceptive use and premarital pregnancy among American teenagers

Sixty percent of women and 52 percent of men now in their 20s took a sex education course by age 19, according to the 1984 National Longitudinal Survey of Work Experience of Youth. Whites are more likely than either blacks or Hispanics to have had a course by that age--57 percent compared with 53 percent and 48 percent, respectively. The survey also shows that large proportions of teenagers initiate coitus before they have taken a sex education course. Among young women who first have sex at age 15, for example, only 48 percent have already taken a course (i.e., have taken it at a younger age or at the same age); and among young women who first have intercourse at age 18, the proportion is 61 percent. Young men are even less likely than young women to take a course before they begin coitus--at age 15, the figure is 26 percent, and at age 18, 52 percent. Adolescent women who have previously taken a sex education course are somewhat more likely than those who have not to initiate sexual activity at ages 15 and 16 (though they are no more likely to do so at ages 17 and 18). However, the effect of prior sex education is small, and is weaker than that of virtually every other variable found to have a significant relationship with first intercourse at ages 15-16. Among the strongest determinants of first coitus at those ages are infrequent church attendance, parental education of fewer than 12 years and black race. Older sexually active girls who have previously had a course are significantly more likely to use an effective contraceptive method (73 percent) than are those who have never taken a course (64 percent). This relationship may offset any effect that a sex education course may have in raising the likelihood of early first coitus, since no significant association can be found between taking a sex education course and subsequently becoming premaritally pregnant before age 20.     

Ecological factors predicting adolescent contraceptive use: implications for intervention

Questionnaires addressing areas expected to relate to contraceptive use were completed by 230 female adolescents. Contraceptive use among the 130 sexually active subjects were predicted by a model composed of 12 scales assessing social permissiveness, costs and benefits of contraception, parent communication, boyfriend support, sex education and knowledge, attitudes about pregnancy and contraception, and access to contraception services. Scales from the predictive model which raise ideas for potential intervention strategies assessed parent communication, boyfriend support, and perceived costs and benefits related to contraception. Since there has been public concern that intervention programs for enhancing adolescent contraceptive use might also stimulate sexual activity, correlations were computed between the predictive scales and the measure of sexual experience among all 230 subjects. These data indicated that positive parent communication about sexuality and a perception of high benefits and low costs associated with contraceptive use were not positively correlated with sexual experience. Implications for the prevention of adolescent pregnancy are discussed with an emphasis on designing innovative sex education, improving parent-child communication, resolving conflicts in contraceptive decisionmaking, and supporting the role of boyfriends in contraceptive use.     

Oral contraceptive use and bone density in adolescent and young adult women

Background

Most of the millions of oral contraceptive (OC) users are under 30 years of age and in the critical period for bone mass accrual.

Study Design

This cross-sectional study of 606 women aged 14-30 years examined both OC duration and estrogen dose and their association with bone mineral density (BMD) at the hip, spine, and whole body (dual-energy X-ray absorptiometry).

Results

Of 389 OC users and 217 nonusers enrolled, 50% were adolescents (14-18 years). Of OC users, 38% used “low-dose” OCs [<30 mcg ethinyl estradiol (EE)]. In adolescents, mean BMD differed by neither OC duration nor EE dose. However, 19- to 30-year-old women's mean BMD was lower with longer OC use for spine and whole body (p=.004 and p=.02, respectively) and lowest for >12 months of low-dose OCs for the hip, spine and whole body (p=.02, .003 and .002, respectively).

Conclusions

Prolonged use of today's OCs, particularly <30 mcg EE, may adversely impact young adult women's bone density while using these agents.     

Oral contraceptive pill use after an initial visit to a family planning clinic

A retrospective study of 1,311 women making initial family planning visits to metropolitan-area health department clinics found that many women switch methods or discontinue use in the first year following the clinic visits. Among a subgroup of women, most of whom selected the pill as their primary method and who used the pill for at least one of the months in the study period, almost half either changed methods or used no method at some point during a follow-up period averaging eight months. This includes 13 percent of women who made two or more changes. In addition, only 42 percent said they took a pill every day, and only half of these said they always took their pill at about the same time every day. Despite such irregularities, pill users were approximately one-third as likely to get pregnant during the study period as women making an initial family planning visit to a health department clinic who did not use the pill at all.     

Neighborhood,family and individual characteristics related to adolescent park-based physical activity

BackgroundLocal parks are an important community resource that may influence levels of physical activity among youth. However, few population-based studies have investigated park-based physical activity among youth.PurposeThis study examines sociodemographic, family, and neighborhood characteristics associated with park-based physical activity among adolescents.MethodsData were from the 2007 California Health Interview Survey (CHIS), a population-based survey of California households, and were analyzed in 2012–2013 and 2015. This study examined individual (age, gender, race/ethnicity, and nativity), family (household income, parental education, and nativity), and neighborhood characteristics (urbanicity, perceived park availability, perceived park safety, neighborhood income, and racial composition) associated with engaging in park-based physical activity among adolescents.ResultsIn California, 71% of adolescents reported being physically active the last time they visited a park. In adjusted multinomial logistic regression analyses, older adolescents and females were less likely to be physically active in parks. Adolescents with a park within walking distance of home and those with a safe park nearby were more likely to be physically active during a park visit.ConclusionsPark availability and perceptions of park safety are important predictors of engaging in park-based physical activity among adolescents. These findings provide information that can help inform interventions intended to increase physical activity among youth. Strategies that increase availability and safety of parks and other recreation spaces may be particularly effective.     

Public and private domains of religiosity and adolescent smoking transitions

We used data from a nationally representative sample of US adolescents in school grades 7 through 12 to explore the effects of public and private religiosity on initiation, escalation, and cessation of smoking. We found that adolescents' decisions to experiment with smoking are influenced by both their individual practice of their faith and by participation in a larger faith community. However, the effects of private and public religiosity are specific to different decision points on the smoking uptake process. Private religiosity was protective against initiation of regular smoking among nonsmokers. It also was protective against initiation of experimental smoking but only when the young person frequently attended religious services or a religious youth group. Although private religiosity appeared to discourage the uptake of smoking, it was unrelated to reduction or cessation once a young person has become addicted to cigarettes. In contrast, public religiosity did predict reduction and cessation of cigarette use among regular smokers. Taken together, these findings demonstrate that the domains in which religiosity are important extend beyond the individual and include religious institutions.     

Risky parental behavior and adolescent sexual activity at first coitus

Data from the National Longitudinal Study of Adolescent Health (Add Health) were used to examine the impact of parents' behavior on adolescents' sexual experience and contraceptive use. All else being equal, adolescents whose parents engage in risky behaviors are especially likely to be sexually active and to have had sex before age 15. These findings are only partly attributable to the link between parents' risky behaviors (smoking, drinking, driving without seatbelts) and adolescents' risky behaviors (smoking, drinking, delinquent activity, association with substance-using peers). Although parental behaviors are effective predictors of adolescents' sexual activity, they are not effective predictors of contraceptive use or of method choice at first coitus. Overall, parents with low levels of self-efficacy seem to be especially likely to have children at risk of engaging in problem behaviors.