城市流动未婚人工流产女青年生殖健康状况分析

为了解城市流动人口未婚女青年生殖道感染(RTI)与性传播感染(STI)患病率，性暴力发生率，性和生殖健康知识，态度、观念和行为，我们对4个城市的1129名流动女青年进行了调查。     

青少年生殖健康影响因素研究

为了研究对未婚青少年生殖健康影响较大的几个主要因素 ,探讨这几个因素在未婚人工流产者中的发生现状 ,采用以医院为基础的描述性流行病学方法 ,使用匿名自填式调查表 ,对来寻求人工流产服务的未婚青少年进行问卷调查。结果 :在 2 164名未婚人工流产者中 ,有重复流产的占 3 1.0 % ( 670名 ) ,其中有 2次人工流产者占 2 3 .8% ,3次占 5 .2 % ,4次以上占 1.9% ;尽管 49.4%曾使用过避孕套 ,但能坚持每次都使用避孕套的仅占 8.7% ;初次同房使用避孕方法的仅占 2 9.9% ( 64 7名 ) ,在这 64 7名中 ,仅有 5 1.6%使用现代避孕方法 (避孕片或避孕套 ) ,有高达 3 9.9%使用传统避孕方法 (安全期、体外排精 ) ;48.1%经历过至少一次非意愿性行为 ,初次同房为非意愿性行为占 2 9.5 % ;有多性伴 (即至少与 2个以上男性发生性行为 )占 17.1% ;自我报告患过生殖道感染 ( RTI)占 12 .2 %。提示 :未婚青少年生殖健康的主要影响因素包括重复人工流产、无防护性同房、非意愿性行为、多性伴、RTI等 ,它们在未婚人工流产者中发生率较高     

人工流产与生殖健康及健康教育

人工流产是避孕失败后终止妊娠的有效措施[1] 。生殖健康是在生命所有阶段的生殖功能和过程中的身体、心理和社会适应的完好状态 ,而不只是无疾病或功能失调[2 ] 。健康教育是指通过一系列系统的、有组织、有计划的教育活动 ,促使人们自觉采纳有益于健康的行为和生活方式 ,消除或减轻影响健康的危险因素 ,预防疾病、促进健康、提高生活质量[3 ] 。我们知道 ,人工流产对妇女的生殖健康均有不同程度的影响。实施健康教育 ,可以消除或减轻这种影响。本文将从 3个方面论述三者之间的关系及影响过程。人工流产的现状人工流产 (简称人流 )虽说已被…     

流动人口中未婚女青年生殖健康调查研究

本文运用定性研究方法,访问了28位年龄16～29岁的流动未婚女青年,结果发现,她们普遍缺乏生殖健康知识,婚前性行为及人工流产后得不到充分休息的现象较为普遍,因此,生殖健康应从婚前抓起,加强生殖健康宣传和咨询服务,扫除“性”盲,满足未婚者对避孕服务的需求,切实保护外来人口的合法权益。     

上海市未婚女青年生殖健康知识状况分析

本文利用上海市5个区县2580名婚前体检的女青年问卷调查资料对上海市未婚女青年的生殖健康知识状况进行了分析。结果显示,婚检女青年中有性经历的比例为69．3％,首次性行为的平均年龄为21．8岁。相当一部分女青年缺乏生育、避孕和性病知识,有的具有错误的知识。多因素分析表明,影响女青年生殖健康知识水平的因素有：年龄、受教育程度、职业、经济收入、同胞数、是否有无话不谈的朋友、是否与人讨论过性问题、业务时间安排、有无避孕史及人工流产史、父母受教育程度等。调查提示,应通过学校、医院和书报传媒等途径加强未婚青年的生殖健康知识教育。     

未婚女青年对生殖健康合法权益的认知和态度

目的分析未婚女青年对生殖健康及其享有生殖健康合法权益的认知和态度,了解她们在生殖健康服务和生殖健康合法权益方面的需求和服务,为更好地开展这方面的工作、增进妇女的生殖健康提供科学依据.方法采用定性研究方法,于2001年12月6～28日在武汉市2个区对18～22岁的未婚青年女性进行座谈.结果未婚女青年对生殖健康及其合法权益的了解及认识并不全面;她们渴望了解这些知识;需求提供系统的全面的生殖健康知识和服务;希望男性也参与到女性生殖健康活动中来.结论未婚女青年对生殖健康及其合法权益缺乏了解及认知,加强对未婚女青年的生殖健康及合法权益的健康教育/健康促进,鼓励男性参与女性生殖健康活动,对促进女性生殖健康,维护女性生殖健康合法权益大有裨益.     

未婚青少年人工流产者生殖健康知识与心理健康状况调查

目的了解未婚人工流产青少年生殖健康相关知识的知晓情况及心理健康状况,为医院有针对性地对该人群提供完善的流产后心理疏导及院内避孕咨询提供支持。方法采用Zung抑郁自评量表(SDS)、Zung焦虑自评量表(SAS)及医院自行编制的生殖健康调查问卷进行匿名调查,并对资料进行统计描述。结果 82例被调查者平均年龄21岁;23.0%是大学生身份;以非北京户籍为主;首次性行为时的平均年龄为18.9岁,最小仅16岁。47.5%的被调查者通过朋友获得避孕知识;18.0%的被调查者性传播疾病知识得分为0。81.7%的被调查者抑郁量表得分≥50,有抑郁倾向;67.1%的被调查者焦虑量表得分≥50,有焦虑倾向。结论未婚青少年人工流产者的主要特征是发生性行为时的年龄较低,缺乏相关的性及生殖健康知识,且存在明显的抑郁及焦虑倾向。     

青少年生殖健康现状

2010年,全世界范围内共有18.22亿10~24岁的青少年,占世界人口的1/4。2010年我国第六次人口普查结果显示10~24岁青少年达3.02亿,占全国人口的22.67%。虽然各个国家、地区青少年初次性行为年龄及性活跃程度有所不同,但是青少年性早熟使得性行为普遍提前、婚前性行为比例增加,由于他们对青春期发育、性生理、避孕、性传播疾病(sexually transmitted diseases,STDs)和艾滋病/人类免疫缺陷病毒(acquired immune deficiency syndrome,AIDS/human immunodeficiency virus,HIV)及其他生殖健康知识缺乏认识,导致青少年非意愿妊娠率、人工流产率及STDS/AIDS(HIV)的感染率上升。     

Sexual Violence and Reproductive Health

Sexual violence is a significant public health problem, and has been linked to adverse effects on women's physical and mental health. Although some advances in the research have been made, more scientific exploration is needed to understand the potential association between sexual violence and women's reproductive health, and to identify measures that could be implemented in reproductive health care settings to assist women who have experienced sexual violence. Three general areas needing further study include (1) expansion of the theoretical frameworks and analytic models used in future research, (2) the reproductive health care needs of women who have experienced sexual violence, (3) and intervention strategies that could be implemented most effectively in reproductive health care settings.     

未婚人流女性生殖健康知识得分及影响因素研究

目的了解未婚人流女性生殖健康知识得分情况,并对其影响因素进行分析。方法对2009年3-8月在湖南省、市、县三级妇幼保健院计划生育门诊确诊妊娠并要求终止妊娠的未婚女性进行匿名访谈,收集、整理信息后用SPSS13.0进行统计分析。结果①未婚人流女性平均年龄为23.61岁,大部分来自外地,主要是公司职员、学生和无业者,月收入中等偏下;②大部分未婚人流女性对生殖健康知识有一定的了解,但了解不深,她们获得生殖健康知识的来源主要是书籍和媒体,最想了解的生殖健康知识分别是性生理卫生知识、避孕知识和优生优育知识;③文化程度、月收入、首次工作年龄、类型、更换工作的次数、家庭经济状况、父母婚姻状况、学校或社区的宣传以及与男友的交流等9个因素对未婚人流女性生殖健康知识得分有影响。结论在今后的计划生育和妇幼保健工作中,社区、学校、家庭应三位一体,借助书籍和媒体进行生殖健康知识宣教,为未婚女性提供更多有效的生殖健康教育和服务。     

Sexual Orientation and Sexual and Reproductive Health Among Adolescent Young Women in the United States

PurposeWe studied sexual and reproductive health among self-identified bisexual, lesbian, and heterosexual adolescent young women. Prior research has suggested that bisexual and lesbian young women may be at greater risk for many negative health outcomes, including risky sexual and reproductive health behavior.MethodsUsing data from the U.S. nationally representative 2006–2010 National Survey of Family Growth (NSFG), we examined sexual and reproductive health among young women 15–20 years of age as a function of sexual orientation. We used logistic regression and ANCOVA to examine differences in sexual and reproductive health across groups while controlling for demographic group differences.ResultsBisexual and lesbian young women reported elevated sexual and reproductive health risks. Bisexual and lesbian participants reported being younger at heterosexual sexual debut, and having more male and female sexual partners, than did heterosexual participants. Further, they were more likely than heterosexual young women to report having been forced to have sex by a male partner. Bisexual young women reported the earliest sexual debut, highest numbers of male partners, greatest use of emergency contraception, and highest frequency of pregnancy termination.ConclusionsOverall, sexual minority young women—especially those who identified as bisexual—were at higher sexual and reproductive risk than their heterosexual peers.     

Improving Adolescent Perceptions of Barriers and Facilitators to Sexual and Reproductive Health Services Through Sexual Health Education

PurposeThis study examines whether comprehensive sexual health education that provides information on clinical services can change adolescents’ perceptions of barriers, facilitators, and intention to use services and whether changes in perceptions differ by participant characteristics.MethodsAdolescent participants in a statewide sexual health education program in California were surveyed at baseline and at exit about their perceptions of barriers, facilitators, and intention to use clinical services. Linked baseline and exit surveys (n = 7,460) assessed change in perceptions after program completion. Logistic regression analyses that accounted for the clustered data structure assessed associations between participant characteristics and improvement in perceptions.ResultsAfter the program, there were significant reductions in two perceived barriers (worry about cost and judgment by staff), but there were also small but significant increases in perceptions of two barriers (worry about confidentiality of services and test results). There were significant increases in all three perceived facilitators and intention to use sexual and reproductive health services, which rose from 90.6% at baseline to 96.2% at exit. Younger youth were more likely than older youth to show improvement in all perceived facilitators and intentions. Girls and Black youth were more likely than boys and Hispanic youth to show improvement in two facilitators (knowing what to expect and access). No sociodemographic characteristics were consistently associated with reductions in perceived barriers.DiscussionComprehensive sexual health education that addresses adolescents’ questions and concerns regarding clinical services can help to reduce perceived barriers, increase facilitators, and increase intention to use services if needed.     

家庭暴力对流动人口已婚育龄妇女性与生殖健康的影响

目的：了解丈夫的身体暴力或性暴力对流动人口已婚育龄妇女性与生殖健康的影响。方法：在上海市某中心城区采用以社区为基础的多阶段整群抽样方法对符合条件的流动人口已婚育龄妇女进行问卷调查,共收回有效问卷958份。结果：曾经或最近1年遭受过身体暴力或性暴力的对象有不良妊娠结局、曾经或最近1年有生殖道感染症状、性生活不和谐、曾经感到缺乏性欲和最近1年感到缺乏性欲的比例显著高于同一时期从未遭受过任何暴力的对象。Logistic回归分析发现,遭受过身体暴力或性暴力的对象有不良妊娠结局、生殖道感染、妇科疾病、性生活不和谐和缺乏性欲的危险性是未遭受过任何暴力对象的2.05～4.79倍。结论：身体暴力或性暴力对流动人口已婚育龄妇女的性与生殖健康状况有显著影响。     

Development and Validation of the Sexual and Reproductive Empowerment Scale for Adolescents and Young Adults

PurposeWe developed and validated a measure that assesses the latent construct of sexual and reproductive empowerment among adolescents and young adults. A specific measure for this group is critical because of their unique life stage and circumstances, which often includes frequent changes in sexual partners and involvement from parents in decision-making.MethodsAfter formative qualitative research, a review of the literature, and cognitive interviews, we developed 95 items representing nine dimensions of sexual and reproductive empowerment. Items were then fielded among a national sample of young people aged 15–24 years, and those who identified as sexually active completed a 3-month follow-up survey. We conducted psychometric analysis and scale validation.ResultsExploratory factor analysis on responses from 1,117 participants resulted in the Sexual and Reproductive Empowerment Scale for Adolescents and Young Adults, containing 23 items captured by seven subscales: comfort talking with partner; choice of partners, marriage, and children; parental support; sexual safety; self-love; sense of future; and sexual pleasure. Validation using logistic regression demonstrated that the subscales were consistently associated with sexual and reproductive health information and access to sexual and reproductive health services measured at baseline and moderately associated with the use of desired contraceptive methods at 3-month follow-up.ConclusionsThe Sexual and Reproductive Empowerment Scale for Adolescents and Young Adults is a new measure that assesses young people’s empowerment regarding sexual and reproductive health. It can be used by researchers, public health practitioners, and clinicians to measure sexual and reproductive empowerment among young people.     

医学生性观念、生殖健康及相关问题的调查

目的 了解医学生人群中性观念、生殖健康知识的认知和需求情况,以便开展有针对性的生殖健康教育.方法 采用自行设计的调查表,对我校两系大一大二2 156名学生进行问卷调查.结果 医学生人群中性观念相对开放,大多数学生能从期望的途径获取生殖健康知识,生殖、节育、人工流产有关知识相对缺乏,虽然对人工流产的后果有一定认识,但性安全意识和知识缺乏.结论 医学生人群中性观念、生殖健康知识的认知情况令人堪忧,只有为学生提供有效的生殖健康教育服务,才能提高生殖健康水平.     

武汉市流动人口中已婚妇女性健康状况调查

目的:了解武汉市流动人口中已婚妇女的性健康状况。方法:采用分层整群随机抽样,对2187名已婚流动妇女进行现场问卷调查。结果;婚前新婚性教育覆盖率为4.85％(106例),接受过新婚性教育的人群性生活和谐度高(x~2=11.07,P=0.004)。夫妻感情好的妇女性生活和谐度也较高(x~2=278.93,P=0.001)。非条件的Logistic回归分析显示,夫妻感情、是否患妇科疾病、家庭收入、妻子的年龄、丈夫的文化程度等因素依次对性生活和谐度有影响。调查对象中,共194人患有泌尿生殖器官疾病,患病率为8.87％,其中炎症占68.1％。人工流产率为40.8％。结论:应加强流动人口的婚前性教育,采取综合措施促进其性健康,减少生殖器官疾病。     

上海市大学生生殖健康状况调查及干预研究

目的：了解上海市大学生的生殖健康现状及进行干预措施的有效性,为大学生生殖健康教育及服务决策提供借鉴。方法：2004年7月～2008年6月,通过自制问卷调查了上海市14所高校共5422名在校大学生。问卷内容涵盖了4个方面主题：生殖健康知识需求、性行为和性态度、色情读物／影像接触情况以及性卫生／性病知识。其中188名学生接受了后期的生殖健康课程,对问卷部分内容作了前后对照研究。结果：共收回有效问卷5255份（96．9％）,其中男女生比例接近1：1（2621：2634）,医学生与非医学生各占17．51％和82．49％。38．4％的大学生曾接受过生殖健康教育,多数学生认为学校开展相关教育必要或者非常必要。反对婚前性行为的占17．47％。39．15％的学生能正确选出问卷中的3种性传播疾病。84．09％的学生知道HIV的传播途径,但仅56．94％的学生知道安全套的使用时机。59．05％的学生知道安全套有预防艾滋病传播的作用。通过进行生殖健康选修课这样的干预措施后,大学生们在性卫生／性病知识方面的认识具有极为显著的提高。结论：大学生生殖健康服务落后于现实需求。在大学生性观念日益开放的同时缺乏对生殖健康及STDs／AIDS的认识。选修课形式进行生殖健康教育是有效方法之一。