上海市新婚夫妇的避孕动机及对避孕方法的评价

本文对来自上海市卢湾、虹口两区的7872对新婚夫妇婚后15个月内、生育前的避孕动机、对不同避孕方法的评价和可接受性等进行了分析。约半数的新婚夫妇婚后避孕,主要是“想暂时轻松”及“想工作学习”。近90%的使用者停用的主要原因为避孕失败及“想怀孕”。避孕方法较多选用安全期、避孕套,主要出发点是“方便”。更换避孕方法的主要原因是“影响性生活”和“效果不佳”(包括避孕失败)。有64%的对象不愿意使用口服药,主要原因是“怕影响健康”。妻子的受教育程度、职业、个性特征、夫妇的避孕知识、健康状况及家庭收入等因素影响了对口服药及针剂的可接受性。     

新婚夫妇选择避孕方法及其影响因素的动态研究

对上海市区７８１６对抽样新婚夫妇一年随访显示在３４１２对采取避孕夫妇中于初育前各时点以安全期为首选方法；婚礼前避孕夫妇有选用口服避孕药的倾向。婚礼后选用安全期、避孕套及两者配合的比例上升。领证时拟用安全期避孕的夫妇中８６％均于婚后实际采用了该方法。而拟服避孕药者仅１６％于婚后实际服药；这是由于她们担心服药会损害自身及胎儿健康，他们对避孕药的认识是不全面的。婚后一年时仍有６２％的避孕套使用者对使用方法未得到认真指导，而近一半的服避孕药及使用杀精剂者均由朋友处得到指导。各时点由计划生育人员主动提供药具的比例极低。多项分类Ｌｏｇｉｓｔｉｃ回归模型显示对避孕法的评价及认识是影响新婚夫妇选用避孕方法的主要因素；妻子的避孕知识及对避孕方法的可得性在一定程度上亦影响夫妇对避孕方法的选择。     

江苏农村育龄妇女避孕方法可接受性的研究

对1986年9月在中国江苏农村进行的“中国农村已婚育龄妇女使用避孕方法的变化”调查资料,应用单因素交叉表及多因素logistic回归分析江苏农村妇女的节育方法使用状况、副作用评价、满意程度及其原因。研究结果表明;江苏农村已婚妇女中,现用的节育方法主要是宫内节育器和女性绝育(分别占46.67%和36.39%)。妇女对各种节育方法的满意程度均较高,尤其对口服避孕药和宫内节育器更为满意。妇女对各种节育方法的评价不尽相同,宫内节育器、针剂、绝育和口服避孕药的优点较为突出,但副作用也较明显。避孕套虽然“使用简便”一项较差,但副作用小。不同特征妇女对各种节育方法的评价有所不同。     

中国育龄妇女紧急避孕知晓率及其影响因素分析

目的:探索可能影响紧急避孕知晓率的因素。方法:通过分层整群抽样方法,对全国1 041个点共39 586名育龄妇女进行面对面访问调查,问卷由经过严格培训的调查员填写。通过应用SAS统计软件包对资料进行单因素及二分类多元Logistic回归分析。结果:通过分析,发现育龄妇女年龄、受教育程度、理想子女数、居住地区、采用的避孕方法、丈夫的年龄和民族、是否与妻子讨论避孕方法和是否参加计划生育与生殖健康方面的培训活动、避孕药物的提供、宣传品是否免费以及是否读过和读懂宣传品、宣传品中是否有有关避孕节育和是否看过计划生育录像都是紧急避孕药物知晓率的影响因素。结论:加大宣教力度是提高紧急避孕知晓率最直接和有效的方法,在宣传教育方法的采用上要考虑到当地的经济和文化水平,提高紧急避孕方法的可及性和可利用性。     

孕妇产后的避孕意愿及其影响因素

本文对上海市黄浦区、普陀区、青浦县、奉贤县 40 37名孕妇对产后避孕意愿及影响因素进行了分析。结果显示 :79.96 %的妇女考虑产后避孕。2 5～ 2 9岁的妇女较其它年龄段的妇女考虑产后避孕的比例要高。产后避孕意愿与本人文化程度及职业无关 ,而亲戚朋友的文化程度对产后避孕意愿有影响。工作单位要求在 1年内落实避孕措施、接受过有关避孕知识教育或为此进行咨询或查阅书籍的妇女考虑产后使用避孕方法的比例较高。单位或计划生育部门建议使用的避孕方法以宫内节育器最高 ,占 97.1 4% ,避孕套仅为 1 .0 2 % ;妇女自我选择的避孕方法中宫内节育器为多 ,占 82 .34% ;其次为避孕套 ,占 1 1 .2 1 %。 L ogistic回归分析表明 :年龄、文化程度、职业、家庭收入等对产后避孕意愿影响不大。产后愿意哺乳者、接受过避孕教育、咨询或查阅书籍者、了解避孕知识年龄较小者、知晓宫内节育器者对产后避孕意愿有正面作用。建议在计划生育服务中 ,今后需加强产后避孕教育 ,开展各种避孕方法知情选择的教育和咨询 ,指导妇女在产后选择最适合于自己的避孕方法 ,从而减少产后意外妊娠的发生     

影响育龄妇女避孕方法选择和避孕效果的影响因素

目的：调查影响育龄妇女避孕方法选择与避孕效果的各项因素,进而为妇女有效避孕提供建议。方法：逐村对近五年200例妇女避孕情况和避孕方法进行调查。结果：患者年龄、受教育程度、婚育情况以及避孕方法等有显著差异（P〈0．05）,具有统计学意义。结论：影响育龄妇女选择避孕措施的因素包括：缺乏避孕知识、心存侥幸、避孕方式不正确等,因此重视避孕、使用正确有效的避孕方式能够有效提升育龄期妇女的避孕有效率。     

人工流产妇女避孕知识、避孕方法使用现状及避孕失败原因初探

目的:了解人工流产妇女避孕知识及避孕方法使用现状。方法:对本院519例接受人工流产妇女进行横断面问卷调查。结果:64.9%的妇女本次妊娠是由于未采取避孕措施;35.1%的妇女本次妊娠是由于避孕失败。本次研究中,避孕套(92.7%)和避孕药(90.1%)的知晓率最高,知道避孕套如何正确使用的比率也最高(81.9%)。而避孕膜的知晓率(7.9%)和正确使用率(2.3%)均最低。在168例因避孕失败而导致本次妊娠的育龄女性中,最常用的避孕方法依次是避孕套(41.1%)、避孕药(19.1%)、紧急避孕药(14.3%)、安全期避孕(13.1%)。调查显示:婚姻状况、性伴学历、文化程度、职业、收入因素都对人工流产妇女的避孕知识和既往避孕行为产生不同程度的影响。结论:人工流产妇女对避孕知识的认知程度较低,对很多避孕方法的正确使用也知之甚少,应加强避孕知识的宣传教育,尤其是文化层次较低者和学生中,提高对意外妊娠风险的认识。     

新疆生产建设兵团育龄妇女紧急避孕知晓率及其影响因素分析

目的:了解兵团育龄妇女紧急避孕知晓率及其影响因素。方法:采取整群分层、四阶段、概率比例抽样方法随机抽样,共调查育龄妇女7533人;对影响紧急避孕知晓率的因素进行单因素分析和非条件Logistic逐步回归分析。结果:兵团育龄妇女的紧急避孕知晓率为47.1%,受教育程度、宣传教育状况、婚姻状况、工作性质是紧急避孕知晓率的影响因素;25.4%的对象听说过且了解紧急避孕内容。结论:应进一步加大宣传教育力度,重点关注未婚人群和少数民族妇女相关知识的获得,提高受教育程度是提高育龄妇女紧急避孕知晓率的根本途径。     

未婚青少年避孕知识状况及其影响因素分析

目的:了解上海市15～24岁未婚青少年避孕知识状况及其影响因素。方法:本研究为横断面调查,于2006.05～2007.01采用多阶段抽样方法共调查15～24岁未婚青少年6 023名。调查采用匿名电子问卷,其中基本情况由调查员问填,敏感信息由青少年自填。调查内容包括对象人口学特征和避孕相关知识等。结果:在所调查的10种避孕方法中,男性知晓率较高的为避孕套(85.7%)、口服避孕药(71.3%)和紧急避孕药(45.4%);女性为避孕套(88.9%)、口服避孕药(77.9%)和手术节育(49.6%)。在男、女对象认为有效的避孕方法中,前3位依次为避孕套(男:90.9%,女:82.2%)、口服避孕药(男:58.9%,女:57.7%)和手术节育(男:46.5%,女:49.3%)。男性对象的避孕知识得分(40.9分)高于女性对象(37.3分),差别有统计学意义(P<0.05)。多因素分析结果显示,无论男性还是女性,年龄较大、在校学生、文化程度较高、有性经历、从男/女朋友、朋友/同伴、广播/电视、书籍、网络等途径了解过避孕相关知识、避孕知识来源途径较多的以及从较为有效的知识来源获取避孕知识的对象其避孕知识水平较高。结论:上海市未婚青少年的避孕知识水平仍有待提高,在未婚青少年性行为不断增多的情况下,应向他们提供适宜的避孕知识教育。     

Contraception news

Although contraception is widely available in France, contraceptive failure remains high. However a number of modifications in contraceptive methods have been developed and should help reduce contraceptive failure. Among those, information and improvement of access to contraception are very important. Recent advances in contraceptive practice have also contributed to improve clinical tolerance and subsequently compliance. Finally, emergency contraception has evolved as well.     

Intrauterine Contraception Continuation in Adolescents and Young Women: A Systematic Review

Study ObjectiveAdolescents are at high risk for unintended pregnancies. Although intrauterine devices (IUDs), long-acting reversible contraceptives (LARCs), are known to be highly effective in preventing pregnancy, little is known about IUD adherence in adolescents. In this systematic review (SR) we examined IUD continuation rates compared with other forms of contraception in young women aged 25 years and younger.Design, Setting, Participants, Interventions, and Main Outcome MeasuresA systematic search of Ovid Medline, Cochrane Library, and Embase was conducted for the years 1946-2015. Included studies examined IUD use in women 25 years of age and younger, compared IUD use with another form of contraception, and measured continuation rates at 12 months. The quality of each study was appraised using the Downs and Black criteria, and 12-month continuation rates among studies were pooled and analyzed according to contraceptive type.ResultsOf 3597 articles retrieved, 9 studies met criteria for SR. Synthesized across studies, 12-month continuation was significantly higher for IUD users (86.5%, 12,761/14,747) compared with oral contraceptives (39.6%, 1931/4873), Depo-Provera (Pfizer Inc, New York, NY) hormonal injection (39.8%, 510/1282), vaginal ring (48.9%, 196/401), and transdermal patch (39.8%, 37/93; all P values < .001). There was no statistically significant difference in 12-month continuation between the IUD and another LARC method, the subdermal etonogestrel implant (85.3%, 4671/5474).ConclusionFindings of this SR suggest that continuation rates for IUDs are generally higher compared with other contraceptive methods for women aged 25 years and younger. In a population with high rates of unintended pregnancies, generally low adherence, and imperfect use with other non-LARCs, IUD use should be encouraged.     

Prevalence Rates of Sexual Behaviors,Condom Use,and Contraception Among Australian Heterosexual Adolescents

BackgroundThe development of effective health promotion practices and education programs to reduce rates of sexually transmitted infections and unintended pregnancy requires accurate, up-to-date information about young people's sexual behaviors.AimsTo provide prevalence rates on sexual behaviors and condom and contraceptive use for Australian year 10–12 heterosexual students in a nationally representative sample.MethodsA nationally representative sample of 2,301 male and 2,055 female year 10 through 12 heterosexual students were recruited to an online survey about their lifetime sexual behaviors and condom and contraceptive use. Means and 95% confidence intervals of weighted data, based on the national census, were reported.OutcomesThe main outcomes of this study were prevalence of sexual behaviors by gender (excluding trans and gender diverse) and prevalence of contraception and condom use among sexually active students by gender.ResultsThe most common sexual behavior was masturbation (96.3% of male students, 78.9% of female students), and the least common behavior was anal or vaginal sex (43.7% of male students, 48.5% of female students). Of the sexually active students, condoms were used by 78.1% of male students and 77.5% of female students at first sexual experience and by 65.1% of male students and 56.8% of female students at their most recent sexual experience, whereas 91.6% of male students and 92.3% of female students used some form of contraception at most recent sexual experience.Clinical TranslationResults provide up-to-date information on the practices clinicians who are likely to encounter with heterosexual cisgender adolescent populations in Australia.Strengths & LimitaitonsThe study represents the largest representative cohort of adolescents in Australia to date. However, comparisons with previous representative studies were limited owing to differing samples by age and culture.ConclusionsCompared with earlier Australian studies, young heterosexual cisgender people today engage in slightly less oral and penetrative sexual behaviors, with the exception of more women receiving oral sex, and are generally consistent in condom and contraceptive use.Fisher CM, Kauer S, Mikolajczak G, et al. Prevalence Rates of Sexual Behaviors, Condom Use, and Contraception Among Australian Heterosexual Adolescents. J Sex Med 2020;17:2313–2321.     

A Contraception Quality Improvement Initiative with Detained Young Women: Counseling,Initiation, and Utilization

Study Objective

To assess the effect of providing standardized counseling to improve the rates of contraception initiation and utilization among detained young women. This was a quality improvement (QI) project conducted at a large urban juvenile short-term detention center.

Practices and Perceptions among Pediatricians regarding Adolescent Contraception with Emphasis on Intrauterine Contraception

Study ObjectiveThis study was conducted to characterize pediatricians' current practice patterns and perceived barriers related to adolescent contraception counseling with an emphasis on intrauterine contraception (IUC).DesignWe performed a mailed survey study to 400 general pediatricians.SettingSurveys were mailed to pediatricians at their individual office locations.ParticipantsGeneral pediatricians belonging to the Massachusetts Pediatric Society were included in the study.InterventionsThe survey instrument assessed current practice patterns and perspectives as related to contraception counseling for adolescents.Main Outcome MeasuresUse of contraception among adolescent patients, policy to recommend IUC to adolescents in various clinical scenarios, and barriers to adolescent contraceptive counseling.ResultsOver 50% of pediatricians considered abstinence their favored method of contraception for adolescents, while fewer than 20% reported discussing IUC as an option. Female pediatricians were more likely to discuss IUC (25% vs 8%, P = .01), as were younger pediatricians (28% vs 14%, P = .13). Given 8 clinical scenarios suitable for IUC use, less than 25% of pediatricians would offer IUC to a teen unless she had a history of a vaginal delivery or abortion. Seventy percent of pediatricians reported lack of training with IUC, and more than 30% reported legal, fertility and parental concerns as barriers to discussing IUC with adolescents.ConclusionsEfforts are warranted to improve the education of pediatricians regarding the most current guidelines for proper IUC use in adolescents with the goal to increase the frequency with which this effective contraceptive method is discussed with this vulnerable population.     

Incidence of Discontinuation of Long-Acting Reversible Contraception among Adolescent and Young Adult Women Served by an Urban Primary Care Clinic

Study Objective

To estimate long-acting reversible contraception (LARC) discontinuation rates. Secondary aims were to determine risk factors for discontinuation, describe reasons for discontinuation, evaluate complications related to placement, and estimate pregnancy rates after discontinuation.

Barriers to Long-Acting Reversible Contraceptive Uptake Among Homeless Young Women

Study ObjectiveTo identify barriers to long-acting reversible contraception (LARC) uptake among homeless young women.DesignIn this mixed methods study surveys and guided interviews were used to explore women's contraceptive and reproductive experiences, interactions with the health care system, and their histories of homelessness.SettingAll surveys and interviews were conducted at a homeless drop-in center or shelter.ParticipantsFifteen women between 18 and 24 years of age with a past year history of homelessness.InterventionsNone.Main Outcome MeasuresPerceived barriers to contraceptive use, including knowledge and access barriers and interactions with the health care system around reproductive health.ResultsConfusion about the possibility of early termination of LARC, and the perception that providers deliberately withhold selective information about contraceptive options to bias contraceptive decision-making, were 2 key new findings. Women also reported interest in visual aids accompanying verbal contraceptive counseling. Pregnancy attitudes and history of reproductive and sexual coercion also influenced contraceptive decision-making and reported interest in LARC methods.ConclusionComprehensive counseling about all contraceptive options, including LARC, are important for targeting the perceived gaps in contraceptive education and care among homeless young women.     

1955例武汉市农村妇女HPV感染状况与危险因素分析

目的:探讨武汉市农村妇女HPV在宫颈炎、宫颈上皮内瘤变(CIN)、宫颈癌中的感染分布情况及HPV感染危险因素。方法:在2011年武汉市20万农村妇女宫颈癌初筛阳性患者中随机抽取1955例,采用飞行时间质谱检测法对宫颈刷片进行HPV分型测定,分析HPV在宫颈炎、CIN、宫颈癌中的感染情况。结果:1955例宫颈刷片标本中发现HPV感染1115例,感染率为57.03%。HPV在不同宫颈疾病中的感染率不同,HPV在宫颈炎中的感染率为40.72%,CIN中为89.64%,宫颈癌中为92.86%,差异有统计学意义(P<0.01);HPV感染患者中,单纯高危型及单纯低危型HPV感染所占比例分别为92.74%、3.23%,差异有统计学意义(P<0.01)。1955例患者中HPV 16型感染率最高(18.16%),其次是HPV 58型(13.35%)、HPV52型(11.00%)、HPV 33型(5.68%)。1955例患者中单一亚型感染率为41.43%,双重及多重感染率为15.60%。不同初婚年龄、临床症状、宫颈癌家族史及是否熬夜等患者HPV感染率比较,差异有统计学意义(P<0.05)。结论:武汉市农村妇女高危型HPV感染是宫颈癌及CIN发生的必要因素。初婚年龄较早、有宫颈癌家族史、经常熬夜等为HPV感染的危险因素。     

Contraception prior to counselling for termination of pregnancy

Objective This study investigates the methods of contraception used by women attending for pregnancy counselling at the time of an unintended pregnancy.

Method Women attending three pregnancy counselling clinics in Birmingham were asked to fill in a questionnaire which was designed to obtain demographic data and history of women's methods of contraception, prior to attending for termination of pregnancy.

Results The contraceptive methods used most widely by women presenting for termination of pregnancy were the condom (n= 188; 43%) and the oral contraceptive pill (n = 96; 22%). A proportion of women did not use any contraception (n = 117; 27%). Women who had undergone a previous termination of pregnancy (29%) had similar contraceptive patterns to those with no history of termination of pregnancy. Women aged 19 and under were less likely to be using contraception (non-users 30/90; 33%) compared with women aged 20 and over (non-users 82/324; 25%), but this difference was not statistically significant. Forty per cent (n = 31) of Afro-Caribbeans did not use any contraception; this was statistically significant when compared with the percentage of Caucasians not using contraception. Only 30% of those eligible had actually presented for post-coital emergency contraception. However, the uptake of emergency contraception was similar in the different age groups.

Conclusion Effective contraception is important in the prevention of unwanted pregnancies and, although it will not prevent all conceptions, it will contribute significantly to a reduction in unintended pregnancies. This study indicates that there is a need to consider and be sensitive to the different cultural needs of ethnic groups in the development and presentation of future contraceptives.