北京市未婚人工流产女青年避孕知识、态度、行为的调查研究

目的：研究未婚人工流产（人流）女青年的避孕知识,态度、行为以及影响避孕行为的因素。方法：以Lawrence的PROCEDE-pROCEED健康促进计划模式为基础的调查问卷,对306例自愿要求人工流产,年龄在18－24岁的未婚女青年进行断面的调查。结果：近12个月以来,仅有13％和女青地持每次性行为都使用避孕方法,偶尔使用和从未使用者的比例分别为26％和275,在224例曾经用过避孕方法的女青年中,最常用的方法分别是避孕套（495）、体外排精（285）、安全期（165）,在从未使用任何避孕方法的女青年中,735认为没想到会怀孕是最主要的不避孕的原因。logistic 逐步回归分析显示,女青年对避孕知识的了解,对意外妊娠风险的认识,男友对避孕方法使用的态度。与男友讨论避孕方法,对占孕服务可及性的感受是影响女 年既往避孕行为的主要因素,结论亟需对未婚青年开展有关避孕知识的性教育,提高对意外妊娠风险和人工并发症的认识促进男性积极参与避孕,加强性伴侣之间有关避孕方法的交流。     

Family discussions about contraception and family planning: a qualitative exploration of black parent and adolescent perspectives

CONTEXT: Parent‐adolescent communication is associated with increased adolescent contraceptive use. However, studies of this association are limited by their lack of examination of the communication process, reliance on cross‐sectional designs and infrequent comparison of parent and adolescent perspectives. Examining communication in black families is particularly important, given the high pregnancy rate among black adolescents. METHODS: Between December 2007 and March 2008, a total of 21 focus groups were conducted with 53 black families (68 parents and 57 adolescents) in Pennsylvania. Separate groups were held for males and females, and for parents and adolescents. The discussion guide explored family communication about sexual health topics, including contraception, family planning and abortion. Sessions were audio‐recorded; data were transcribed and analyzed using a grounded theory approach to content analysis and the constant comparison method. RESULTS: Five key themes emerged among both parents and adolescents. First, discussions about contraception were indirect and framed in terms of the need to avoid negative consequences of sex. Second, contraceptive knowledge was low. Third, parents more often reported helping male adolescents get condoms than helping females get contraceptives. Fourth, discussions emphasized planning for the future over contraception. Finally, negative attitudes toward abortion were prevalent. CONCLUSIONS: Parent‐adolescent communication interventions should improve contraceptive knowledge, help parents understand the harmful effects of gender biases in information dissemination, and provide mothers and fathers with communication skills tailored to enhance the role they play in their adolescents’ sexual development.     

Reflections on Two Decades of Research on Teen Sexual Behavior and Pregnancy

During the past 20 years, both researchers and program developers made great progress in their efforts to reduce adolescent unprotected sex and prevent teen pregnancy. Research studies are now more likely to employ experimental designs with random assignments, to have large sample sizes with adequate statistical power, to measure actual sexual and contraceptive behaviors, to measure longer term effects, to employ proper statistical methods, and to report results in an unbiased manner. As a result of this body of research, large advances have occurred in our understanding of: 1) the incidence of teen pregnancy, and its consequences; 2) the effects of improving adolescent knowledge, increasing access to contraception, and improving parent/child communication; and 3) the characteristics of effective programs. The on-going evaluation of sex and HIV education programs coupled with creativity and perseverance on the part of program developers led to two groups of effective programs--sex and HIV education programs that reduce sexual risk-taking behavior, and youth development programs that reduce teen-age pregnancy and childbearing.     

Involving parents in their adolescents' health: a role for school clinics.

School clinics are rapidly becoming effective in adolescent health care and health promotion; viability would be increased with increased efforts to reach and involve parents in the health of their children. Schools can act as catalysts for family communication, catalysts for school and parent communication, and promoting consistent contraceptive use. Parents report a desire for more information on health topics, although parental attendance is low for parents of "high risk" children in disadvantaged communities. Family communication is reported to have an effect on the likelihood that an adolescent will use contraception, rather than on the initiation of sexual activity. Parental supervision of dating, however, is an important regulator of adolescent sexual activity. Studies show that children of authoritative parents are the most successful in school and in avoiding the consequences of high risk behavior. Findings also indicate that the majority of parents favor programs on preventing teen pregnancy, sexually transmitted diseases, and HIV infections. Many parents find it difficult to communicate with their children. National surveys report strong support for sex education, school-based clinics and school-based reproductive health care. Harassment has come from a minority of conservative fundamentalist pressure group who have a louder voice in expressing opposition. Agreement is only on the importance of parents in adolescent health.     

The relationship context of contraceptive use at first intercourse

CONTEXT: Despite widespread efforts to increase contraceptive use to prevent both pregnancy and sexually transmitted diseases among sexually active adolescents, most prior work examining adolescent contraceptive use does not explicitly recognize that sexual decision-making inherently involves both partners in a couple. METHODS: An analytic sample of 1,593 females who first had intercourse during adolescence (prior to age 18) was drawn from the 1995 National Survey of Family Growth. Logistic regression and multinomial logistic regression techniques were used to model the effects of sexual partners' characteristics and relationship type on contraceptive use at first intercourse and contraceptive method selected at first intercourse. RESULTS: Approximately 31% of respondents used no contraceptive method at first intercourse. Roughly half (52%) of adolescents who had just met their sexual partner used no method, compared with 24% of those who were going steady. Whereas 75% of teenagers who practiced contraception at first intercourse used a condom, 17% relied on the pill. In multivariate models, net of other variables, adolescents who had just met their partner had 66% lower odds than those who were going steady of practicing contraception at first intercourse. Individual-level factors that influenced contraceptive use at first intercourse were age at first intercourse, race or ethnicity family type, parents' education, grades in school and receipt of birth control education prior to first intercourse. Differences between respondents and their partner in age and race or ethnicity mostly were not significantly related to method use at first intercourse. One exception was that adolescents who first had sex with a man six or more years older had reduced odds of practicing contraception. Type of relationship was significantly associated with method selection only among adolescents who were just friends with their first partner, who had higher odds of using "other" methods rather than the condom. Variables associated with pill use rather than condom use were age at first sex, race, family type, mother's education and school grades. CONCLUSIONS: Further efforts to understand contraceptive choice among adolescents should focus on relationship features. Research on the decision-making process surrounding contraceptive use may benefit from treating this as a partner decision and not just as a decision made by one member of the couple. Further research examining the qualities of the relationship may provide important clues for understanding adolescent contraceptive choice.     

569名未婚女性人工流产原因分析

目的:了解未婚人流女性特征,分析其人流原因。方法:采用分层整群多阶段抽样方法,以统一匿名调查表,由统一培训的专业医生对2004年10月~2005年5月在16个抽样单位行人流术的全部未婚女性进行调查。结果:569名调查对象平均年龄20.5岁,伴侣平均年龄23.8岁,月均性生活次数7.4次,33%的被调查者有既往怀孕史。本次人流原因主要为未避孕(71.7%),其原因主要是侥幸心理、不懂避孕和怕麻烦。避孕套是被调查者中知晓率和使用率最高的避孕方法。以百分制计算,被调查者避孕方法和知识的得分分别为60.4分和64.8分,其避孕知识主要来自媒体。结论:未婚女性性活跃、意外妊娠风险认识低、性和生殖健康知识贫乏,应加强未婚人群的性观念和性行为道德教育,根据其年龄和心理特征,提供相关的生殖健康知识和服务,并加强对媒体相关宣传的规范管理。     

Predicting contraceptive behavior among college students: The role of communication,knowledge, sexual anxiety,and self-esteem

Undergraduate students were surveyed about their sexual behavior and contraceptive behavior. In addition, measures of their self-esteem, knowledge about contraception, communication with their dating partners, communication about sexual matters with their sexual partners, and sexual anxiety were taken. Consistent with Byrne's (1983) model of effective contraception, it was found that general and sexual communication with one's partner were significant predictors of contraception use. Directional, but statistically weak, support was obtained for the predictions that knowledge about contraception and sexual anxiety would be related to contraception use. No support was found for the prediction that general self-esteem would be associated with contraceptive behaviorThis article is taken from the second author's Honor's Thesis, conducted under the supervision of the first author.     

人工流产少女的性行为及避孕现状调查

目的:了解人工流产少女的性行为和避孕现状,找出存在的问题并提出相关建议。方法:以成都市锦江区妇幼保健院作为研究现场,于2009年5月～2010年4月,采用自填式问卷的方法对年龄≤20岁的人工流产少女525例进行调查和统计分析。结果:本次妊娠的主要原因是未避孕(67.6%)和避孕失败(25.2%)。未避孕的最主要原因是认为偶尔无避孕性行为不会妊娠,导致避孕失败的方法依次为体外射精、避孕套、安全期和紧急避孕药。在过去6个月内,每次性行为都使用避孕措施的占4.2%,25.2%研究对象从未使用过任何避孕措施。研究对象与男伴同居的比例非本市户籍(58.1%)高于本市户籍(41.1%),农村(59.8%)高于城镇(47.9%)(P<0.05)。采用逐步回归方法分析影响重复性流产的因素,发现年龄和收入具有统计学意义(P=0.04和P<0.01)。结论:未婚同居、收入水平低、年龄小、避孕措施使用率低和方法低效是非意愿妊娠的主要原因。应加强避孕知识的宣传教育,提高避孕药具可及性及流产后服务水平和能力。     

A review on adolescent childbearing in Taiwan: its characteristics, outcomes and risks

In Taiwan, the age-specific fertility rate for adolescent girls aged 15-19 years has remained at 14-18/1,000 births during the past two decades, which is the highest among developed countries in Asia. There was a surprisingly high age-specific fertility rate for married women aged 15-19 years at 726 per 1,000 in 1994, much higher than that of the United States. Adolescent childbearing causes many adverse outcomes including unwanted and unstable marriage, repeated childbearing during adolescence, and increased risks of having low birth weight and preterm births and neonatal mortality. Studies in Taiwan showed that adolescent childbearing is associated with their poor knowledge but open attitude and behaviour on sexuality, the inadequate contraceptive services for the adolescents in need, some risk-taking behaviors, family dysfunction and low socioeconomic status of the adolescents' families. About two-thirds of the fathers of infants born to adolescent girls were adults, even old adults with a low education level Effective strategies for adolescent childbearing prevention range from sex education, the direct provision of contraceptive supplies, and to life options programmes, especially for the adolescents with high risk of adolescent pregnancy. Reducing the incidence of adolescent childbearing by active use of contraception is more important and practical than prohibiting adolescent sexual activity.     

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。     

我国城乡居民对给未婚青少年提供避孕知识和避孕药具的态度

目的 探讨我国城乡居民对给未婚青少年提供避孕知识和药具的态度和提供避孕知识及避孕服务的可接受性和可行性。方法 取自2000年国家计生委组织开展的“预防艾滋病宣传教育项目基线调查”资料。在全国选择2个城市市区和5个农村乡镇采用分层随机抽样方法,调查15－49岁人群,包括已婚和未婚的男性和女性,结果 本次调查共获得7053份问卷,其中有效问卷7022份。调查结果显示,赞成向未婚青少年开展性教育和艾滋病教育的比例,城区和乡镇分别为83.9%、74.6%;89.2%、78.9%,认为在初中开始进行为宜占62.9%。赞成让未婚青少年了解避孕知识,城区占80.4%,乡镇占74.2%,女性赞成人数低于男性（P＝0.000）。对向未婚青少年提供避孕药具所持,人为应提供的城市和乡镇分别为41.7%和32.6%;认为视具体情况而定的分别为22.2%和9.6%,城市高于乡镇（P＝0.000）,男性高于女性（P＝0.000）,未婚高于已婚（P＝0.000）。结论 在我国应对未婚青少年进行避孕知识教育,并结合国情适时和适当地开展和提供相应服务。     

北京市大学生避孕知识、态度、行为现况调查

目的 了解北京市在校大学生避孕知识、态度、行为及影响因素.方法 采用定量研究方法,根据知情同意原则选择12 450名未婚大学生进行匿名问卷调查.结果 共回收12 129份有效问卷,其中女生的避孕相关知识知晓率高于男生,差异有统计学意义(P=0.000).赞成未婚同居及性解放的比率男生分别为81.9%和60.2%,女生分别为74.8%和54.3%;74.3%的男生和24.9%的女生有性自慰史,18.4%的男生和10.5%女生承认发生过婚前性行为;在有性行为的学生中,29.4%的男生曾导致性伴意外妊娠,23.1%的女生发生过意外妊娠;在对以上知识的态度和行为中男女生间的差异均有统计学意义(意外妊娠P=0.004,其余P=0.000).在首次性行为中使用避孕措施的男生和女生均为51.3%;没有使用避孕药具的主要原因是性行为没有计划而未备避孕药具,认为使用麻烦、影响情趣及认为偶尔性行为不会导致怀孕.结论 大学生未婚性行为发生率呈日益上升趋势,未婚性行为中避孕药具使用率低,意外妊娠发生率高,亟需在大学生中加强避孕知识的宣传.     

北京市大学生避孕知识、态度、行为现况调查

目的 了解北京市在校大学生避孕知识、态度、行为及影响因素.方法 采用定量研究方法,根据知情同意原则选择12 450名未婚大学生进行匿名问卷调查.结果 共回收12 129份有效问卷,其中女生的避孕相关知识知晓率高于男生,差异有统计学意义(P=0.000).赞成未婚同居及性解放的比率男生分别为81.9%和60.2%,女生分别为74.8%和54.3%;74.3%的男生和24.9%的女生有性自慰史,18.4%的男生和10.5%女生承认发生过婚前性行为;在有性行为的学生中,29.4%的男生曾导致性伴意外妊娠,23.1%的女生发生过意外妊娠;在对以上知识的态度和行为中男女生间的差异均有统计学意义(意外妊娠P=0.004,其余P=0.000).在首次性行为中使用避孕措施的男生和女生均为51.3%;没有使用避孕药具的主要原因是性行为没有计划而未备避孕药具,认为使用麻烦、影响情趣及认为偶尔性行为不会导致怀孕.结论 大学生未婚性行为发生率呈日益上升趋势,未婚性行为中避孕药具使用率低,意外妊娠发生率高,亟需在大学生中加强避孕知识的宣传.     

北京市大学生避孕知识、态度、行为现况调查

目的 了解北京市在校大学生避孕知识、态度、行为及影响因素.方法 采用定量研究方法,根据知情同意原则选择12 450名未婚大学生进行匿名问卷调查.结果 共回收12 129份有效问卷,其中女生的避孕相关知识知晓率高于男生,差异有统计学意义(P=0.000).赞成未婚同居及性解放的比率男生分别为81.9%和60.2%,女生分别为74.8%和54.3%;74.3%的男生和24.9%的女生有性自慰史,18.4%的男生和10.5%女生承认发生过婚前性行为;在有性行为的学生中,29.4%的男生曾导致性伴意外妊娠,23.1%的女生发生过意外妊娠;在对以上知识的态度和行为中男女生间的差异均有统计学意义(意外妊娠P=0.004,其余P=0.000).在首次性行为中使用避孕措施的男生和女生均为51.3%;没有使用避孕药具的主要原因是性行为没有计划而未备避孕药具,认为使用麻烦、影响情趣及认为偶尔性行为不会导致怀孕.结论 大学生未婚性行为发生率呈日益上升趋势,未婚性行为中避孕药具使用率低,意外妊娠发生率高,亟需在大学生中加强避孕知识的宣传.     

北京市大学生避孕知识、态度、行为现况调查

目的 了解北京市在校大学生避孕知识、态度、行为及影响因素.方法 采用定量研究方法,根据知情同意原则选择12 450名未婚大学生进行匿名问卷调查.结果 共回收12 129份有效问卷,其中女生的避孕相关知识知晓率高于男生,差异有统计学意义(P=0.000).赞成未婚同居及性解放的比率男生分别为81.9%和60.2%,女生分别为74.8%和54.3%;74.3%的男生和24.9%的女生有性自慰史,18.4%的男生和10.5%女生承认发生过婚前性行为;在有性行为的学生中,29.4%的男生曾导致性伴意外妊娠,23.1%的女生发生过意外妊娠;在对以上知识的态度和行为中男女生间的差异均有统计学意义(意外妊娠P=0.004,其余P=0.000).在首次性行为中使用避孕措施的男生和女生均为51.3%;没有使用避孕药具的主要原因是性行为没有计划而未备避孕药具,认为使用麻烦、影响情趣及认为偶尔性行为不会导致怀孕.结论 大学生未婚性行为发生率呈日益上升趋势,未婚性行为中避孕药具使用率低,意外妊娠发生率高,亟需在大学生中加强避孕知识的宣传.     

北京市大学生避孕知识、态度、行为现况调查

目的 了解北京市在校大学生避孕知识、态度、行为及影响因素.方法 采用定量研究方法,根据知情同意原则选择12 450名未婚大学生进行匿名问卷调查.结果 共回收12 129份有效问卷,其中女生的避孕相关知识知晓率高于男生,差异有统计学意义(P=0.000).赞成未婚同居及性解放的比率男生分别为81.9%和60.2%,女生分别为74.8%和54.3%;74.3%的男生和24.9%的女生有性自慰史,18.4%的男生和10.5%女生承认发生过婚前性行为;在有性行为的学生中,29.4%的男生曾导致性伴意外妊娠,23.1%的女生发生过意外妊娠;在对以上知识的态度和行为中男女生间的差异均有统计学意义(意外妊娠P=0.004,其余P=0.000).在首次性行为中使用避孕措施的男生和女生均为51.3%;没有使用避孕药具的主要原因是性行为没有计划而未备避孕药具,认为使用麻烦、影响情趣及认为偶尔性行为不会导致怀孕.结论 大学生未婚性行为发生率呈日益上升趋势,未婚性行为中避孕药具使用率低,意外妊娠发生率高,亟需在大学生中加强避孕知识的宣传.     

北京市大学生避孕知识、态度、行为现况调查

目的 了解北京市在校大学生避孕知识、态度、行为及影响因素.方法 采用定量研究方法,根据知情同意原则选择12 450名未婚大学生进行匿名问卷调查.结果 共回收12 129份有效问卷,其中女生的避孕相关知识知晓率高于男生,差异有统计学意义(P=0.000).赞成未婚同居及性解放的比率男生分别为81.9%和60.2%,女生分别为74.8%和54.3%;74.3%的男生和24.9%的女生有性自慰史,18.4%的男生和10.5%女生承认发生过婚前性行为;在有性行为的学生中,29.4%的男生曾导致性伴意外妊娠,23.1%的女生发生过意外妊娠;在对以上知识的态度和行为中男女生间的差异均有统计学意义(意外妊娠P=0.004,其余P=0.000).在首次性行为中使用避孕措施的男生和女生均为51.3%;没有使用避孕药具的主要原因是性行为没有计划而未备避孕药具,认为使用麻烦、影响情趣及认为偶尔性行为不会导致怀孕.结论 大学生未婚性行为发生率呈日益上升趋势,未婚性行为中避孕药具使用率低,意外妊娠发生率高,亟需在大学生中加强避孕知识的宣传.     

北京市大学生避孕知识、态度、行为现况调查

目的 了解北京市在校大学生避孕知识、态度、行为及影响因素.方法 采用定量研究方法,根据知情同意原则选择12 450名未婚大学生进行匿名问卷调查.结果 共回收12 129份有效问卷,其中女生的避孕相关知识知晓率高于男生,差异有统计学意义(P=0.000).赞成未婚同居及性解放的比率男生分别为81.9%和60.2%,女生分别为74.8%和54.3%;74.3%的男生和24.9%的女生有性自慰史,18.4%的男生和10.5%女生承认发生过婚前性行为;在有性行为的学生中,29.4%的男生曾导致性伴意外妊娠,23.1%的女生发生过意外妊娠;在对以上知识的态度和行为中男女生间的差异均有统计学意义(意外妊娠P=0.004,其余P=0.000).在首次性行为中使用避孕措施的男生和女生均为51.3%;没有使用避孕药具的主要原因是性行为没有计划而未备避孕药具,认为使用麻烦、影响情趣及认为偶尔性行为不会导致怀孕.结论 大学生未婚性行为发生率呈日益上升趋势,未婚性行为中避孕药具使用率低,意外妊娠发生率高,亟需在大学生中加强避孕知识的宣传.     

北京市大学生避孕知识、态度、行为现况调查

目的 了解北京市在校大学生避孕知识、态度、行为及影响因素.方法 采用定量研究方法,根据知情同意原则选择12 450名未婚大学生进行匿名问卷调查.结果 共回收12 129份有效问卷,其中女生的避孕相关知识知晓率高于男生,差异有统计学意义(P=0.000).赞成未婚同居及性解放的比率男生分别为81.9%和60.2%,女生分别为74.8%和54.3%;74.3%的男生和24.9%的女生有性自慰史,18.4%的男生和10.5%女生承认发生过婚前性行为;在有性行为的学生中,29.4%的男生曾导致性伴意外妊娠,23.1%的女生发生过意外妊娠;在对以上知识的态度和行为中男女生间的差异均有统计学意义(意外妊娠P=0.004,其余P=0.000).在首次性行为中使用避孕措施的男生和女生均为51.3%;没有使用避孕药具的主要原因是性行为没有计划而未备避孕药具,认为使用麻烦、影响情趣及认为偶尔性行为不会导致怀孕.结论 大学生未婚性行为发生率呈日益上升趋势,未婚性行为中避孕药具使用率低,意外妊娠发生率高,亟需在大学生中加强避孕知识的宣传.     

Disparities in Sexually Transmitted Infection/HIV Testing,Contraception, and Emergency Contraception Care Among Adolescent Sexual Minority Women Who Are Racial/Ethnic Minorities

PurposeSexual minority women and racial/ethnic minority women in the United States are at increased risk for sexually transmitted infections (STIs) and unintended pregnancy. Yet, we know little about STI/HIV testing and contraceptive care among women who have sex with women only and women who have sex with both women and men, and who are racial/ethnic minorities. This study examined receipt of STI/HIV testing and contraceptive care among sexually active adolescent women by sex of sexual contact(s) and race/ethnicity.MethodsOur sample included 2,149 sexually active adolescent women from the National Survey of Family Growth (2011–2019). We examined receipt of sexual and reproductive health (SRH) services by sex of sexual contact(s) and race/ethnicity: STI and HIV testing, contraceptive counseling, contraceptive method, emergency contraception (EC) counseling, and EC method.ResultsService receipt was low for all adolescent women, with disparities by sex of sexual contact(s) and by race/ethnicity. Women who have sex with women only had the lowest rates across all services; women who have sex with both women and men had higher rates of STI and HIV testing and EC counseling than women who have sex with men only. Non-Hispanic Black women had higher rates of STI and HIV testing than non-Hispanic White peers, and non-Hispanic Black and Hispanic women had lower rates of contraception method receipt than their non-Hispanic White peers. Racial/ethnic disparities persisted when results were stratified by sex of sexual contact(s).DiscussionThere is an unmet need for improved SRH service delivery for all adolescent women and for services that are not biased by sex of sexual contact(s) and race/ethnicity.