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。     

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。     

上海市已婚妇女初产后避孕方法的选择和转换

本文对上海市3701名已婚妇女初产后15个月内避孕方法的选择和转换进行了分析,分析结果表明：产后15个月内,95．46％的妇女采取过避孕方法。产后首次采取的避孕方法城市以避孕套（50．72％）和IUD（29．09％）为主,农村以IUD（56．65％）和避孕套（30．60％）为主,其它方法较少。首次避孕选择避孕套者,终止向IUD的转换率较高;而选用IUD者终止向其它方法的转换率较低。15个月随访时,94．54％的妇女正在使用某种避孕方法,其中60．76％的城市妇女71．07％的农村妇女正在使用IUD。多项分类Logistic回归分析结果表明不同特征的妇女对避孕方法的选择存在很大差异,城市、文化程度高的妇女倾向于选用避孕套和安全期,较少选用口服药;年龄大的妇女使用避孕套和安全期的人要多些;正在哺乳的妇女不愿用口服药;单位或计划生育部门对产后选用何种避孕方法有推荐意向的妇女使用IUD的比例较高。提示计划生育管理部门应根据妇女的不同特征耐心、细致、客观地向她们说明各种避孕方法的优点和缺点,需纠正社会上对一些避孕方法的偏见。应充分尊重妇女的避孕选择,使妇女自觉满意地实行计划生育。     

天津市18～49岁已婚者避孕情况的心理因素调查

本文调查了1211名18～49岁已婚成年人包括工人、干部和科技人员对避孕问题的心理活动。其中男性601人,女性610人。结果显示:80%已婚成年人至少知道五种避孕方法如避孕套、口服避孕药、宫内节育器、男性绝育和女性绝育。3.8%的人知道埋植和输卵管粘堵。只有0.7%的人对避孕方法一无所知,这些人多为新婚夫妇。研究还表明,最受欢迎的避孕方法是宫内节育器、避孕套和安全期。工人偏爱宫内节育器,科技人员偏爱避孕套。口服药是最不受欢迎的方法,多由于它的副作用影响。93.6%的被调查者对绝育持否定态度。仅6.4%的人主张这一方法,他们主要是科技人员和干部。     

婚前避孕措施使用状况及其影响因素分析

本文对上海市7872对新婚夫妇婚前,包括结婚登记前和结婚登记至办婚礼期间(简称举办婚礼前,下同)避孕措施的使用状况作了分析。结果表明,结婚登记前和婚礼前,分别有12.3%和15.4%的夫妇有过性行为,其中分别有35.2%和23.7%的夫妇使用过避孕措施。最常使用的避孕措施为安全期、避孕套和体外排精。避孕失败率分别为33.7%和18.0%。避孕失败的最重要原因是安全期计算失误和体外排精失控。结婚登记前不使用避孕措施的主要原因是缺乏避孕知识和无法获得药具。影响夫妇在结婚登记前和婚礼前使用避孕措施的因素有:妻子的避孕知识分数、与他人谈论避孕的能力、夫妇的晚育意愿,发生性行为距结婚登记或距办婚礼的时间间隔。本文对婚前使用的避孕药具的来源及对避孕知识的了解途径也作了分析。调查表明,加强对未婚青年(包括已领取结婚证但尚未办婚礼的夫妇)避孕知识的宣教和避孕药具的发放是必要的。     

上海市新婚夫妇避孕知识动态及影响因素的研究

对上海市两区于1987年8月到1988年8月间领证的7872对初婚夫妇婚后两次跟踪调查,显示上海市新婚夫妇对常用非永久性避孕措施的知识水平偏低。婚后15月时有增长但仍是低水平的。研究发现新婚夫妇普遍不愿服用口服避孕药,大部分妻子对口服药的知识不清晰,看法有偏倚。多元回归显示影响婚后妻子避孕知识水平的因素有:晚育意愿;妻子谈论避孕的能力及首先了解途径;婚前使用避孕措施;夫妇职业;妻子教育程度;丈夫单位所有制及夫妇月收入等。结果提示妻子婚龄及其母教育水平、恋爱时间与晚育意愿有内在关联而间接影响妻子避孕知识水平。初访后分娩或自流、“人流”是妻子避孕知识增长的主要影响因素。     

无痛人工流产者避孕知识与行为的调查

目的:了解无痛人工流产者对避孕知识的知晓程度与实际使用情况及影响因素。方法:采用横断面调查的方法,对因非意愿妊娠而自愿要求无痛人工流产者进行面对面的问卷调查,探究她们对于避孕方法的知与行的异同及其原因,并采用单因素和多因素非条件Logistic回归法分析每种避孕方法使用情况的影响因素。结果:在609名无痛人工流产者中,平均年龄为28.3±5.2岁,重复人工流产率为50.1%,首次性生活年龄为22.0±2.8岁。知道≥3种避孕方法者占95%以上。对某种避孕方法,使用者与知晓者的比例总体上从高到低顺序为避孕套(91.0%)、紧急避孕药(71.2%)、安全期(63.3%)、体外排精(58.8%)、杀精剂(21.1%)、口服避孕药(OC)(19.2%)、宫内节育器(IUD)(8.9%);目前使用者与曾经使用者的比例总体上从高到低顺序为安全期(83.4%)、避孕套(79.0%)、体外排精(71.2%)、杀精剂(50.0%)、紧急避孕药(36.1%)、IUD(11.4%)、OC(10.0%)。IUD和OC的停用和不愿使用的比例较高,主要原因是顾虑其副作用。未婚无分娩史者对安全期、体外排精、IUD和OC的知晓率较低,有分娩史者使用安全期、避孕套和IUD的比例最高,使用OC的比例最低;年龄、收入、流产次数对未婚无分娩史者选用避孕方法的影响比较大。结论:妇女对避孕方法的知晓度较高,但多未使用高效的避孕方法,避孕失误多,应加强流产后服务及避孕知情选择工作,指导妇女正确地选择和使用避孕方法,提高避孕效率。     

对人工流产者术前避孕情况的调查

<正> 1985年在石河子医学院附属医院门诊调查443例人工流产受术者的术前避孕情况。其中有44%根本未避孕。在避孕者中有19%合用两种或两种以上避孕方法。使用的方法比例依次为口服药、避孕套、外用药膜、IUD等。失败时间:一年内占46%、两年内占72%。除绝育外,IUD节育失败率最低。失败主要原因:采     

国产女用避孕套的临床可接受性试验

24对已婚夫妇、234次性生活使用国产女用避孕套（简称阴道套），以询问表的形式进行可接受性评估。从总结性询问表分析结果显示，78．3％的夫妇认为阴道套可以接受，并是一种好的避孕器具；91．3％认为使用方便；65．2％认为使用阴道套的性快感与平时一样或增强；但与阴茎套相比，仅35．3％更喜欢阴道套。研究还从征募的前12对与后12对夫妇以及每对前5次与后5次应用时对阴道套进行对照评估。试验结果提示，如果阴道套上市，有一定比例的育龄夫妇愿选用阴道套作为避孕方法；作为一种新的避孕器具，阴道套有一个被人们逐渐认识和接受的过程。     

上海市长宁区未婚流动人口的避孕措施使用状况及其影响因素

目的:了解未婚流动人口的避孕措施使用状况及其影响因素。方法:采用结构式匿名问卷对上海市长宁区新泾镇1092名15～24周岁未婚流动人口的性与生殖健康知识、态度、行为和避孕措施使用状况等进行调查。结果:有22.6%的对象自我报告有性经历,男女性经历比例分别为34.8%和12.7%。9.4%的对象曾经怀孕或使其性伴怀孕,男女分别为13.7%和6.0%。其中,1/3的对象或其性伴有过2次及2次以上的妊娠。怀孕的主要原因为未避孕(54.4%)。仅7.3%的对象坚持每次性生活都使用避孕措施,21.1%的对象从未使用过避孕措施。59.8%的对象首次性行为时未使用避孕措施。使用最多的避孕方法为避孕套(76.4%),其次是口服避孕药(34.4%)、安全期(33.3%)和体外排精(30.3%)。避孕药具主要来源于药店(60.5%)。不避孕或未坚持使用避孕的主要原因是因为“偶尔的性生活不会怀孕(36.7%)”、“通常性生活是在无思想准备情况下发生(24.0%)”“不懂得避孕(17.5%)”及“不好意思买/要避孕药具(16.2%)”等。多因素分析结果提示,月平均收入较高、在上海居住时间较短、避孕知识得分较高者避孕使用频率较高;文化程度较高、服务行业职工、避孕知识得分较高、与媒体接触较多者避孕套使用比例较高。结论:未婚流动人口的避孕措施使用率低,提高他们的避孕知识水?     

Contraceptive failure in the United States: the impact of social economic and demographic factors (author's transl)

With the use of a relatively new multivariate life table technique, 1st year contraceptive use failure rates are calculated for currently married U.S. women, based on data from the 1973 and 1976 National Surveys of Family Growth, conducted by the National Center for Health Statistics. When, in order to delay or prevent a subsequent pregnancy, age and family income are controlled for simultaneously, the pill is considered the most effective method with a 1 year standardized failure rate of 2.4%, next is the IUD with 4.6%, the condom (9.6%), spermicides (17.9%), diaphragm (18.6%), and natural family planning (NFP) or rhythm (23.7%). Including other variables, such as parity, education, age at marriage, religion, and race, does not result in any significant improvement in the ability to predict contraceptive use effectiveness beyond that obtained by using method, intention, age, and income. Previous studies, which did not employ multivariate techniques found that women who sought to prevent another pregnancy were less likely to experience contraceptive failure than were those who sought only to delay conception, presumably because preventers are more highly motivated to avoid conception. This analysis, however, shows that among those 25 and younger, preventers have higher failure rates for each method than delayers. The most likely explanation for this phenomenon is that women who had all the children they wanted at an early age have probaly already had previous contraceptive failures, while those who are still spacing at older ages are more likely to have been successful in postponing pregnancy until the desired time. Among preventers, failures for all methods decline with increasing age. By contrast, among delayers, failure rates (except for those among condom users) are lowest for women ages 22-25 and differ little among older and younger women. It is notable that failure rates among pill users are generally very low for women in all age, income, and intention groups. The highest failure rate for pill users (8% for women under age 22 seeking to prevent an unwanted pregnancy and who have annual family incomes of under $10,000) is the same as the lowest failure rate for women who depend on NFP methods (those seeking to avoid an unwanted pregnancy who have incomes of over $15,000 and are age 30 or older). For women under age 22, the diaphragm is associated with extremely high failure rates, but diaphragm use improves at older ages. Among women age 30 and older, the condom is associated with lower failure rates than any method except the pill. Failure rates shown are based on those experienced in actual use and reflect failures due to the method itself as well as to incorrect use. If theoretical method effectiveness is measured as the lowest failure rate seen by any subgroup of women under age 30, rates for each method are: pill--1.2%, IUD--2.3%, condom--5.7%, spermicides--9.4%, diaphragm--9.7%, and rhythm--12.6%. For each method, the lowest rates are obtained by preventers with annual family incomes of over $15,000 and ages 26-29. (author's modified)     

Do they, don't they, or why haven't they?. Contraceptive use patterns among inner-city sexually active female adolescents

Background: Female adolescents frequently practice unprotected vaginal intercourse leading to nearly 1 million unintended pregnancies and 3 million sexually transmitted diseases (STDs) a year. Qualitative reasons for three contraceptive use patterns were explored. Contraceptive use patterns were quantified and correlated with gynecologic history.Methods: A total of 146 predominantly non-white (81%) sexually active female adolescents with a mean age of 17.2 +/- 1.9 years (13-21 years), completed a 45-minute self-administered, computerized questionnaire as part of a larger project. The questionnaire assessed sexual, contraceptive, gynecologic and obstetric history. Nearly a third (32%) had ever been pregnant and 32% had ever had a STD. Subjects were asked to describe their contraceptive use patterns for condoms, pills, and Depo-Provera as either "never used," "have used, but stopped," or "used before and am still using." Adolescents typed in their qualitative reasons for never using, stopping, or still using each of the three methods of contraception.Results:None of the three condom use patterns were significantly correlated with ever having a STD or being pregnant. Of those who had ever been pregnant, 70% had stopped using Depo-Provera as compared to 38% who were still using Depo-Provera, p < 0.02; 47% had stopped using pills as compared to 25% who were still using pills, p = 0.04; 47% had stopped using pills as compared to 22% who had never used pills, p < 0.01. "Using another contraceptive" was the reason why one-third of subjects never used condoms. The most common reasons for never using pills were "on Depo-Provera," "would forget," and not liking to take pills. Reasons for never using Depo-Provera included using another contraceptive, not liking shots and "might make me fat." The top four reasons for discontinuing condom use were being in a trusting, monogamous relationship, using another form of contraception, abstinence, and "don't like the way condoms feel." Two of the main reasons for stopping pills and Depo-Provera were weight gain and altered menses. However, those subjects who stopped taking the pill reported "kept forgetting" and "they made me sick" as other reasons for stopping. "Prevent pregnancy" was by far the most common reason for still using pills and Depo-Provera, while for condoms "prevent STDs" was cited with equal frequency to "prevent pregnancy." Having regular or no periods were frequent reasons for ongoing use of pills and Depo-Provera, respectively. Depo-Provera users also reported "don't have to worry about missing a pill" as a major reason for continuing use.Conclusions: Understanding the reasons why adolescents never use, stop using, or continue to use a particular method of contraception may provide a focus for more effective counseling.     

Increasing the effectiveness of contraceptive usage in university students

Prevention of pregnancy requires correct and consistent use of an effective method of contraception and knowledge alone is not sufficient to ensure such use, as many complex social and behavioral factors influence contraceptive behavior. Women are particularly likely to change their contraceptive method after a contraceptive 'shock'. In this study, the change in contraceptive behavior of a group of university students who presented for emergency contraception is studied. Each student participated in a single individualized educational session. A total of 465 women requested emergency contraception in a 3.5-year period at a large student health center. Of these, 24% had not previously used contraception, 50% had previously used condoms and 25% had taken the pill (COC). Of those who usually used condoms, 79% had had a condom accident and 21% had not used them at the last intercourse. Only 30% of COC users had had a problem with the pill and the remaining 70% were not taking it at the time of last intercourse, for social rather than medical reasons. Follow-up is available for 309 (66.5%). Paired-sample analysis of these women shows a decrease in the number using no contraception (22% to 8%), and an increase in the number using COCs (33% to 66%). These changes reached statistical significance (p < 0.0001). University students, despite their intelligence, exhibit a high degree of risk-taking behavior but become more effective contraceptive users after an interactive counselling session following a contraceptive scare.     

上海市妇女婚后初育前的避孕措施

本调查应用流行病学方法 ,对上海 4 0 3 7名妇女婚后初育前的避孕情况进行了调查。了解婚后初育前避孕知识的来源和避孕的实施状况。调查表明 :1 ) 76 .9%的妇女在婚后初育前了解避孕套的使用方法 ,2 7.6 %的妇女使用过避孕套 ;50 .1 %的妇女了解安全期避孕 ;3 4.5%曾使用过安全期避孕 ;72 .4 %的妇女了解口服避孕药方法 ;1 3 .9%的人初育前口服过避孕药 ;3 1 .2 %的妇女知道体外排精法 ;1 0 .4 %的妇女在婚后初育前使用过该法 ;89.8%的妇女知道 IUD;但仅有 1 4.7%的妇女在婚后初育前采用过 IUD方法。避孕知识的主要来源是书刊杂志。2 )多元 L ogistic回归分析表明 :影响婚后初育前避孕的主要因素是 :夫妻文化程度、职业及其户口性质。3 )值得注意的是 :初育前 ,3 8.2 %的人曾有过 1次妊娠 ,7.7%的人有过 2次妊娠。其中 ,第 1次妊娠的主要原因 70 .2 %是没有采取避孕措施 70 .% ,7.0 %是避孕失败 ;第 2次妊娠的主要原因同样是没有采取任何避孕措施和避孕失败 ,分别是 4 5.7%和 2 0 .6 %。结果提示 :今后应加强避孕知识宣教 ,增加妇女避孕知识的深度和广度 ,制订和完善婚前、婚后的计划生育常规服务 ,使广大妇女真正做到知情选择 ,尽早落实可行的避孕方法 ,从而减少非意愿妊娠和人工流产。     

Repeat induced abortions and contraceptive practices among unmarried young women seeking an abortion in China.

OBJECTIVE: To determine the rates of repeated abortion and contraceptive use among unmarried young women seeking an abortion in China. METHODS: We used an anonymous self-administered questionnaire at abortion clinics in Beijing, Changsha, and Dalian from January to September 2000. RESULTS: Of 4547 unmarried young women seeking an abortion, 33.0% reported having had one previous induced abortion. Of those who had had more than one abortion, only 29.7% used a contraceptive method at their first sexual intercourse after the procedure; and of the 446 women who chose contraception, 41.3% used the traditional methods of withdrawal or rhythm. Although 65.0% of the young women had used condoms at least once, only 9.6% did so consistently and correctly; 47.7% of the current pregnancies were associated with nonuse of any contraceptive, and 52.3% were related to contraceptive failure. CONCLUSION: The rate of unmarried young women seeking repeated abortions was high in China on 2000. The rate of consistent condom use was low, and the rate of contraceptive failure was higher.