Effect of Marital Status on Women's Quality of Life: A Cross-Sectional Study of Urban Women in Chengalpattu District, Tamil Nadu.

Background Quality of life (QoL), as defined by the World Health Organization, is a subjective evaluation influenced by cultural and environmental factors. It is a complex, multidimensional concept that encompasses various aspects of an individual's well-being. This study aimed to understand how marital status affects the QoL of women by comparing married and single women residing in the urban field practice area of a tertiary care Hospital. Methods This cross-sectional study includes 200 women, comprising 100 single and 100 married participants, aged 20-60 years. Data were collected using the WHO-QOL-BREF questionnaire, which assesses the following four domains of QoL: physical, psychological, social, and environmental. Demographic information was also gathered. Statistical analysis was performed using SPSS Version 25.0. Results Significant differences were found between single and married women in age distribution (p<0.0001), family type (p=0.002), presence of children (p=0.001), educational qualifications (p=0.02), and family income (p<0.0001). Married women reported higher median family incomes and better QoL scores in the social domain (p<0.0001), while single women were predominantly younger and more likely to live in nuclear families. No significant differences were observed in the physical, psychological, or environmental domains of QoL between the groups. Conclusion The study highlights the impact of marital status on various QoL aspects, with married women experiencing better social support and personal relationships. Despite this, the absence of significant disparities in other QoL domains suggests that marital status does not uniformly affect overall QoL.

Medically assisted reproduction (MAR) with sperm donation: Comparison of the profiles and medical pathways of unmarried women and women in heterosexual couples.

RESEARCH QUESTION: The legislation allowing unmarried women to undergo medically assisted reproduction (MAR) with sperm donation was adopted in France on August 2, 2021. This major advancement, and its impact on French society, led us to a closer examination of the requests made by unmarried women and the outcomes of ART attempts. DESIGN: A retrospective single center cohort study was conducted in a fertility center in Paris, France. All unmarried women and women in heterosexual couple seeking for MAR using sperm donation between September 2021 and October 2022 were included. Medical and socio-demographic data, as well as details and outcomes of MAR attempts were analyzed until October 31, 2023. RESULTS: Two hundred seventy-two unmarried women and 76 women in heterosexual couple were included. Results were compared between the two groups. Unmarried women were significantly older, with a significant decrease in anti-Müllerian hormone (AMH) and antral follicle count (AFC). They also exhibited a higher prevalence of gynecological pathologies associated with infertility, such as endometriosis. Unmarried women were more likely to work in intermediate occupations, whereas women in heterosexual couple more often had employee status. Among unmarried women who had undergone at least one MAR attempt by October 31, 2023, significantly lower cumulative early and ongoing pregnancy rates were observed. CONCLUSIONS: Female age appears to play a major role in the likehood of pregnancy and live birth. It is therefore crucial to inform women initiating the process of MAR with sperm donation that success is not guaranteed.

Trajectories of maternal parenting stress and adolescent behavioral symptoms in unmarried families: The role of family immigration status.

BACKGROUND: Maternal parenting stress during childhood may have important influences on offspring internalizing and externalizing behaviors during adolescence in unmarried households, but it is unclear whether effects differ across different trajectory patterns of maternal parenting stress and for native-born vs. immigrant families. METHODS: Using data from the Future of Families and Child Wellbeing Study, we identified trajectory patterns of maternal parenting stress from ages 1-9 years using semi-parametric group-based trajectory modeling. We used negative binomial regression models to estimate associations between maternal parenting stress trajectories and adolescent behavioral symptoms at age fifteen. RESULTS: Five maternal parenting stress trajectory groups were identified among the 1982 unmarried families included in this study, representing consistently low (9.2 %), consistently mild (54.2 %), moderate and decreasing (14.4 %), moderate and increasing (16.0 %) and consistently high (6.2 %) levels of maternal parenting stress. For adolescent internalizing symptoms, all maternal parenting stress trajectory groups exhibited higher symptoms compared to the consistently low group: IRR for consistently mild: 1.21 (95 % CI: 0.98-1.56); IRR for moderate/decreasing: 1.34 (95 % CI: 1.04-1.74); IRR for moderate/increasing: 1.62 (95 % CI: 1.28-2.13); and IRR for consistently high: 1.74 (95 % CI = 1.29-2.41). Similar results were observed for adolescent externalizing symptoms. Stronger effects of maternal parenting stress trajectories on adolescent externalizing symptoms were observed among native-born vs. immigrant families. LIMITATIONS: Differential attrition and same-source bias may lead to under- or over-estimation of the associations of interest. CONCLUSIONS: Interventions targeting unmarried families with elevated maternal parenting stress during childhood may reduce behavioral symptoms in adolescence.

Evaluation of a child abuse prevention program for unmarried mothers in South Korea: a single-case experimental design.

PURPOSE: The purpose of this study is to apply and evaluate the effectiveness of a child abuse prevention program based on the Nursing Model of Resilience and Coping Skills Training Model for unmarried mothers during pregnancy and puerperium. METHODS: This study had a prospective single-case, AB design with four repeated self-questionnaire measures and three observational measures. Seven unmarried mothers were provided with 10 sessions child abuse prevention program through individual visits from 32 to 34 weeks of pregnancy to 6 weeks after childbirth. The questionnaire was composed related to resilience, maternal stress, maternal attitude, parent-child interaction, child abuse potential. The observation was measured by video recording (total 16 times) the interaction of parent-child during feeding and analyzing it by three experts. Data were analyzed by Wilcoxon signed-rank test and Friedman's test. RESULTS: Maternal attitude and parent-child interaction were statistically significantly improved after intervention compared to before intervention. However, maternal stress decreased after intervention compared to before intervention, but it was not statistically significant. Also, resilience and child abuse potential were not statistically significant. This program is partially effective in preventing child abuse by promoting parenting attitudes and parent-child interactions. CONCLUSION: This study focused on individual resilience and applied systematic intervention as coping skills training to prevent child abuse. This study is meaningful in that interventions were conducted through individual visits to unmarried mothers at high risk of child abuse, and the program was applied, including pregnancy and postpartum periods, to prevent child abuse early.

Factors influencing unintended pregnancy and abortion among unmarried young people in Nigeria: a scoping review.

BACKGROUND: Unintended pregnancies and abortions among unmarried adolescents in Nigeria are outcomes of the interplay of multifaceted factors. Abortion, a global public health and social issue, impacts both developed and developing countries. This scoping review explored the literature and mapped the risk factors for unintended pregnancies and abortions among unmarried female adolescents in Nigeria. METHODS: A scoping literature search was conducted across databases, including PubMed, Science Direct, Web of Science, EBSCOhost, JSTOR, African Index Medicus, and Scopus. Inclusion criteria encompassed peer-reviewed articles and reports in English, focusing on unmarried female adolescents. The range of interest included the past incidents of having sex, unintended pregnancies, contraceptive use, and abortions among this demographic. Studies categorized as grey literature were excluded to ensure the reliability and validity of the synthesized information. RESULTS: A total of 560 articles, 553 identified through databases and 7 through hand search, were subjected to a comprehensive full-text review, resulting in the inclusion of 22 studies that met the criteria for the final review. The scoping review shed light on the past incidents of having sex, unintended pregnancies, contraceptive use, and abortions among unmarried adolescents in Nigeria. The range of incidence for having sex varied from 57.2% to 82.7%, with the prevalence of unintended pregnancies ranging from 23.4% to 92.7%. Contraceptive use was notably low, with 21.5% reporting low usage, contributing to the high incidence of abortions, ranging from 20.2% to 51.0%. Factors influencing unintended pregnancies included a lack of awareness of modern contraceptives and limited access to sexual and reproductive health information. For induced abortions, factors such as the impact on educational career, childbearing outside wedlock and fear of expulsion from school were identified. CONCLUSION: This scoping review, through a systematic examination of existing literature, contributes to a more robust understanding of the factors influencing unintended pregnancies and abortions among unmarried adolescents in Nigeria. The findings inform future research directions and guide the development of targeted interventions to improve reproductive health outcomes for this vulnerable population.

Cooperative coparenting and the associations with adolescent behavioral problems and delinquency in unmarried families.

INTRODUCTION: Coparenting in unmarried families is a protective factor for positive adolescent adjustment. Although the relations between coparenting and adolescent outcomes have been investigated, it remains unclear whether the specific patterns of maternal and paternal coparenting are associated with adolescent behavioral outcomes. METHODS: The present study includs a longitudinal cohort of 1143 triads of unmarried parents and their adolescents to examine the associations between different patterns of coparenting and adolescent behavioral problems and delinquency. The data were drawn from the Future of Families and Child Wellbeing Study in the United States. Our study used six waves of publicly available data at children's birth, ages 1, 3, 5, 9, and 15. RESULTS: The latent profile analyses identified four coparenting profiles of maternal and paternal coparenting perceived by the other unmarried parent. Comparing average levels of coparenting between mothers and fathers, the profiles were entitled Low Mom-Low Dad, High Mom-Medium Dad, Low Mom-Medium Dad, and High Mom-High Dad. Parents characteristics, such as cohabitation and marital status, predicted the likelihood of being in cooperative coparenting profiles. Furthermore, all the identified coparenting profiles predicted adolescent externalizing behavioral problems; only the high mom cooperative coparenting profiles predicted adolescent internalizing behavioral problems; none of the coparenting profiles predicted adolescent delinquency. CONCLUSIONS: Our study adds empirical evidence for coparenting research by revealing that coparenting patterns vary in unmarried families and that cooperative coparenting benefits child behavioral outcomes. The findings encourage introducing different coparenting training programs targeting unmarried parents' diverse needs, thus promoting positive adolescent adjustment.

Unmarried status effect on stage at presentation and treatment patterns in primary urethral carcinoma patients.

BACKGROUND: Unmarried status has been associated with advanced stage at presentation and lower treatment dose intensification rates in several urological and non-urological malignancies. However, no previous investigators focused of the association of unmarried status with locally advanced stage (T3-4N0-2) at presentation and lower bi-/trimodal therapy rates in primary urethral carcinoma (PUC) patients. To address these knowledge gaps, we relied on the Surveillance, Epidemiology, and End Results (SEER) database. METHODS: Within the SEER database 2000 to 2020, all non-metastatic PUC patients were identified. Logistic regression models (LRMs) tested for differences in stage at presentation and treatment modality in the overall cohort and then in a sex-specific fashion, according to marital status (married vs unmarried). RESULTS: Of all 1,430 non-metastatic PUC patients, 1,004 (70%) were male vs 426 (30%) were female. Of 1,004 male PUC patients, 272 (27%) were unmarried. Of all 426 female PUC patients, 239 (56%) were unmarried. In multivariable LRMs predicting T3-4N0-2, unmarried status was independently associated with an increased risk of locally advanced stage at presentation in the overall cohort (odds ratio [OR]:1.31; P = 0.03) and in female patients (OR:1.62; P = 0.02), but not in male PUC patients (P = 0.6). In multivariable LRMs predicting bi-/trimodal therapy, unmarried status was an independent predictor of lower bi-/trimodal therapy rates in the overall cohort (OR:0.73; P = 0.02) and in male patients (OR:0.60; P = 0.007), but not in female PUC patients (P = 0.6). CONCLUSIONS: Unmarried female PUC patients more likely harbored locally advanced stage at presentation. Conversely, unmarried male PUC patients are less likely to benefit from bi-/trimodal therapy.

'I have to pretend that I don't care': Stigma management among unmarried young mothers in South-Western Nigeria.

Young mothers often encounter stigma and discrimination, affecting their lives and that of their children. This paper explores stigma management strategies and their effectiveness for young mothers in rural Nigeria. Ten key informants and 24 young mothers were recruited from Ife-East in South-Western Nigeria. Data from semi-structured interviews showed that societal disapproval of pregnant teenagers and young mothers were common experiences. Women used a range of strategies to actively cope with stigma including: belief in predestination, avoidance, concealment, and cohabitation. These strategies could be seen as tools to mitigate negative stereotypes and discrimination. However, they also had the unintended consequences of compounding many young women's difficult circumstances and exposing them to adverse outcomes, including gender-based violence, repeat pregnancies, poor mental health, and low uptake of services. The results show the need for policy frameworks to actively combat stigma by addressing the negative framing of early pregnancy and motherhood and promoting supportive environments for young mothers. Health professionals need to be trained to offer de-stigmatising services to encourage young mothers to seek help and reduce pre-existing inequities in access to services, and policies need to include measures that address the rights of young mothers and protect them from violence and abuse.

Induced abortions among Chinese adolescent girls.

BACKGROUND: Induced abortion among adolescent girls is a global public health issue and a serious challenge in China, but still remains under-examined. We aimed to examine the overall trend and characteristics of induced abortions among Chinese adolescent girls and to investigate the factors associated with induced abortion. STUDY DESIGN: Based on the 2017 China Fertility Survey, this study examined the trend and characteristics of induced abortions among adolescent girls with statistical analysis and multiple indicators of descriptive statistics from period and cohort perspectives, including induced abortion proportion and rate, age-specific cumulative proportion, and age-specific cumulative number of induced abortions in adolescent girls. RESULTS: Between 1996 and 2016, the proportion and rate of adolescent induced abortions first increased and then decreased, and the mean age at the time of induced abortions among adolescent girls declined. The cumulative proportion of women who had experienced induced abortion at the age of 15-19 in a cohort is less than 2.5% but shows an upward trend. Over 70% of all adolescent induced abortions are premarital. The proportion of women with unintended pregnancy experiences increased and is higher among rural, less educated, and ethnic minority women. Similarly, the prevalence of induced abortion is higher among adolescent girls who live in rural areas, are less educated, and come from ethnic minorities. The cumulative number of induced abortions and premarital abortions increased with later cohorts. CONCLUSIONS: This study shows an upward trend in adolescent-induced abortion and a decline in the age at the time of the induced abortion. Women in later birth cohort have a higher proportion of having experienced adolescent induced abortion. Adolescent girls who live in rural areas, who are less educated, or who are from ethnic minorities, are more likely to undergo induced abortions at the age of 15-19. More appropriate educational efforts and interventions are urgently needed to reduce the incidence of adolescent induced abortions.

Unmarried Women and Unintended Pregnancy: An Indonesian Cross-Sectional Study.

Background: Indonesia has moral norms consider pregnancy among unmarried women a disgrace. The study analyzes the factors influencing unintended pregnancies among unmarried women in Indonesia. Material and Methods: The study examined 1,050 women. The author analyzed unintended pregnancy and six other variables (residence, age, education, employment, wealth, and parity). Multivariate analysis used binary logistic regression. Results: 15.5% of unmarried women in Indonesia have experienced an unintended pregnancy. Women living in urban areas are more likely to experience unintended pregnancies than women in rural areas. The 15-19 have the highest chance of experiencing an unintended pregnancy. Education is a protective factor from unintended pregnancy. Employed women are 1.938 times more likely than unemployed. Poverty is a risk factor for experiencing an unintended pregnancy. Multiparous is 4.095 times more likely than primiparous. Conclusion: The study identified six variables that affect unintended pregnancy among unmarried women in Indonesia: residence, age, education, employment, wealth, and parity.

Intimate partner violence among unmarried young women (18-24 years) in urban communities, Ibadan, Nigeria.

OBJECTIVES: Intimate partner violence (IPV) is a global health problem that affects more than one-third of women globally. Young women who experience IPV face the same consequences as older women. Previous studies on IPV have not studies young women exclusively, thus, we aimed to report the prevalence of IPV and predictors among young women in Ibadan, Nigeria. METHODS: A community-based cross-sectional survey, using multistage cluster technique was conducted to determine the past-year prevalence of IPV among unmarried young women (n=736) from 20 communities in five Local Government Areas in Ibadan, Nigeria. The independent variables were respondents and their partners' background information. Dependent variables were experience of physical, sexual, psychological and any IPV. Data were analysed using descriptive statistics and binary logistic regression (α0.05). RESULTS: Psychological IPV was the most prevalent form of IPV (50.1 %). Prevalence of any IPV was 56.3 %. At the bivariate level, having children, acceptance of IPV, ever had sex, age at first sex, experience at sexual debut, partners being with other women while being with the respondents, partners alcohol use, and partners witness of abuse as a child were significantly associated with IPV. However, only acceptance of IPV, experience at sexual debut, and partners being with other women while being with the respondents remained significant at the multivariate level. CONCLUSIONS: IPV is a common occurrence among young women. Both individual and partners characteristics, especially acceptance of IPV contribute significantly to experience of IPV among young women. Hence, interventions targeted at reduction of IPV acceptance will greatly reduce the prevalence of IPV.

Perceived Marriage Squeeze and Subjective Well-Being Among Unmarried Rural Men in China: The Mediating Role of Sense of Coherence.

The marriage-squeeze unmarried rural men perceive during their daily life is one of the main stressors severely affecting their subjective well-being under the universal marriage culture. The mechanism of this relationship is still unknown. Based on the Stress Process Model, using data from the "Survey on Rural Family Martial Status," this study examines the relationship between perceived marriage squeeze (PMS) and subjective well-being (SWB) and the mediating effect of sense of coherence (SOC). A sample of 417 Chinese unmarried rural men with an average age of 28.88 years was enrolled in this cross-sectional. Ordinary least square regressions and Bootstrap-mediated effect analysis methods were used to examine the association between PMS, SWB, and SOC. The results show that PMS has significant negative effects on both SWB and SOC of unmarried rural men, and SOC has a significant positive impact on SWB; the more perceived marriage squeeze they have, the lower SWB and SOC they have. The mediated analysis shows that SOC plays a mediating role in the influence of PMS on the SWB of unmarried rural men. This is to say, SOC can mitigate PMS's negative effects on the SWB of unmarried rural men. Our findings highlight the importance of SOC in protecting the SWB of unmarried rural men. Considering the propounding influence of the marriage squeeze, policies that enhance the level of SOC should be implemented to relieve the influence of PMS on vulnerable unmarried rural men's SWB.

Restrictions on contraceptive services for unmarried youth: a qualitative study of providers' beliefs and attitudes in India.

Sexual and reproductive health (SRH) of unmarried youth is an important issue, particularly in Indian society, where premarital sex is socially restricted. It is an uncomfortable subject for most people, including healthcare providers, who are responsible for catering to the reproductive health needs of youth. This is because of the prevailing social norms, where sex outside marriage is discouraged and stigmatised. These social norms give importance to virginity, and children outside marriage are not welcome. The present qualitative study was conducted in public health facilities (primary and secondary) to explore the attitudes of healthcare providers in providing contraceptive services to unmarried youth. In-depth interviews were conducted with family planning (FP) service providers (frontline healthcare workers [ASHAs] nurses and FP counsellors) between October 2017 and September 2018. Almost a quarter of the providers were either hesitant or against providing contraceptives to unmarried youth. Providers stated that they preferred emergency contraceptive pills for unmarried girls if they had already engaged in unprotected sex. Providers expressed strong personal views against premarital sex because they believed it was against existing social norms. Some providers were concerned about the possible negative reactions of the community if they recommended any contraceptive to unmarried youth. A few providers even considered it illegal to provide contraceptives to unmarried youth, though there is no such law in the country. Findings further indicated that though the country had launched programmes for improving adolescents and youth SRH, service providers were still conflicted between medical eligibility and social beliefs.

Parents' intention toward early marriage of their adolescent girls in eastern Ethiopia: A community-based cross-sectional study from a social norms perspective.

Background: Strong social norms around early marriage put pressure on parents to marry off their adolescent girls at an early age. Early marriage is widely practiced in many parts of Ethiopia. However, early marriage studies rarely address the role of social norms. This study aims to examine the role of social norms on parents' intention to marry off adolescent girls early in Eastern Ethiopia. Method: A community-based cross-sectional study was conducted from September to November 2019. A multistage sampling procedure was applied to select the study participants. Factors related to parents' intention for early marriage were assessed through the lens of the Theory of Planned Behavior (TPB). Adjusted Prevalence Ratio (PR) was calculated using a log-binomial model to identify factors associated with intention toward early marriage. Results: A total of 859 mothers and 859 fathers of unmarried girls were included in the study. The prevalence of intention to marry off their daughter early among mothers was 39.70% (95% CI = 36.4-43.0%) and 43.54% (95%CI = 40.2-47.1%) among fathers of adolescent girls [chi2(1) = 41.8; P < 0.001]. The intention for an early marriage was higher among mothers and fathers with favorable attitude towards early marriage, in those who believe that most people in their reference group conform to early marriage norms (empirical expectation), in those who believe that most people in their reference group expect them to conform to early marriage norms (normative expectation) and among fathers who did not know the legal age of marriage for adolescent girls and those who did not know the health consequences of early marriage. The prevalence of intention toward early marriage was lower among mothers (APR = 0.49; 95% CI: 0.36-0.65) and fathers (APR = 0.62; 95% CI: 0.49-0.78) in urban areas; and among mothers (APR = 0.41; 95% CI: 0.27-0.62) and fathers (APR = 0.50; 95% CI: 0.38-0.67) with higher educational level. Conclusion: The social norms that promote intention for early marriage are still high among parents, especially among those living in rural areas and uneducated. Hence, interventions that aim to reduce early marriage need to address locally relevant social norms.

Individual and Social Level Factors Influencing Repeated Pregnancy among Unmarried Adolescent Mothers in Katavi Region-Tanzania: A Qualitative Study.

Adolescents' pregnancy rates are still high in Tanzania, despite the efforts made by the national campaign. Within two years after the first pregnancy, adolescent mothers are more at risk of repeat conception. Repeated pregnancies are associated with increased maternal and perinatal outcomes. Katavi is a leading region in the country, with 45% adolescent pregnancy. Studies are scarce on factors influencing repeated pregnancy among unmarried adolescent mothers in the region. Therefore, this study explored the individual and social level factors influencing repeated pregnancy among unmarried adolescent mothers in the Katavi Region. An exploratory qualitative study, using key informant interviews (KIIs) was adopted for 16 participants. The study participants were unmarried adolescent mothers, aged 15-19 years, who were purposively sampled. Thematic analysis was used to analyze qualitative data. QSR Nvivo version 14 was used to analyze these data. The study established the individual factors influencing repeated pregnancy, which were inadequate sexuality knowledge, individually perceived barriers to contraceptive use, and the guarantee for marriage. Furthermore, the social factors identified were the power of decision-making, peer pressure, and the parent-child relationship. Inadequate education on sexuality is observed as a crucial factor influencing repeated pregnancy. Parents as primary educators should be encouraged to talk with their children, especially adolescent girls about sexual education.

Wealth Accumulation and the Gender Wealth Gap Across Couples' Legal Statuses and Matrimonial Property Regimes in France.

This paper examines wealth accumulation among couple-headed households and investigates changes in within-household inequality over time and across couple statuses. Going beyond previous research that mostly studies wealth accumulation within marriages by comparing married with unmarried individuals, we consider the legal statuses of couples (cohabitation, civil union, and marriage) and property regimes (community and separate property). We apply multivariate regression analysis to high-quality longitudinal data from the French wealth survey (2015-2018) and find no differences in net worth accumulation between couples' legal statuses when property regimes are not accounted for. However, couples with a separate property regime accumulate more wealth than couples with a community property regime, and married couples with a separate property regime drive this association. Our results show that the gender wealth gap is larger for couples with a separate property regime, but it is partially compensated by accumulated wealth. Our results highlight the importance of legal statuses and property regimes in explaining the dynamics of between- and within-household inequality in France, specifically within a context of increasingly diversified marital trajectories. Supplementary Information: The online version contains supplementary material available at 10.1007/s10680-022-09632-5.

Unmarried Sri Lankan youth: sexual behaviour and contraceptive use.

BACKGROUND: Youth are at high risk for casual and unprotected sexual activities even before marriage. The objective of the study is to describe the sexual behavior, and contraceptive use among unmarried youth of Sri Lanka and to assess the factors associated with sexual behaviour. METHODS: An observational descriptive cross-sectional study was conducted in three selected districts in Sri Lanka from 1st March 2019 to 31st January 2020 among 1057 never-married youth using a self-administered questionnaire. Both stratified cluster sampling and snowball sampling were used to select the eligible never-married youth. Factors associated with sexual intercourse were assessed using logistic regression. RESULTS: Compared to boys (26%), more girls (35%) were engaged in unprotected sexual intercourse. Among sexually active unmarried youth aged less than 20 years, 10% had sexual intercourse with an unknown person. Unmarried Tamil and estate sector youth displayed significantly lower chances of sexual intercourse compared to Sinhala and urban counterparts (OR = 0.390, CI = 0.213-0.715, p = 0.002 and OR = 0.807, CI = 0.709-0.978, p = 0.020 respectively). Youth in the rural (69.5%) and urban sectors (87.3%) tend to use contraceptives during intercourse compared to the youth in the Estate sector (51.1%). CONCLUSIONS: A significant portion of youth are exposed to sexual risk behavior including unprotected sexual intercourse even before marriage which can contribute to many social and health consequences. Focus interventions are needed to address the issue.

With early puberty and late marriage, Sri Lankan youth are more susceptible to unprotected and casual sex. The physical, psychological, and sociocultural impact of resulting pregnancies and Sexually Transmitted Diseases including HIV could be detrimental. In Sri Lanka, significant variation in sexual intercourse and concurrent use of contraceptive use was observed among different ethnic groups and sectors. Increased popularity for emergency contraceptive pills was observed among never-married female youth. Younger youth (teenagers) tend to engage in more unprotected sexual intercourse compared to older youth in Sri Lanka. Concentrating on reducing barriers to contractive access for younger youth in Sri Lanka is important. To prevent unwanted pregnancies, and Sexually Transmitted Diseases including HIV, targeted interventions are required especially for Tamil ethnic groups and estate sector youth populations in Sri Lanka.

Association between poor self-reported health and unmarried status among adults: examining the hypothesis of marriage protection and marriage selection in the Indian context.

BACKGROUND: The link between marital status and health differences has long been a topic of debate. The substantial research on marriage and health has been conducted under two important hypotheses: marital protection and marriage selection. While the majority of evidence on the marriage-health relationship using these hypotheses comes from developed countries, there is a lack of evidence from Asia, particularly from India. OBJECTIVES: The current study examines theoretical frameworks of marriage i.e., marital protection and marriage selection in the Indian setting concurrently, bringing substantial empirical evidence to explore the link between marriage and health, considering this subject in the context of self-reported health (SRH). Secondly, this study will aid in investigating age and gender differences in marriage and health. METHODS: Using the Study on Global AGEing and Adult Health (SAGE), a cohort study of individuals aged 50 years and older with a small section of individuals aged 18 to 49 for comparative reasons, the present study population was 25 years and above individuals with complete marital information. Logistic regressions were employed to explore the connection between marital status and self-reported health. In the marriage protection hypothesis, the follow-up poor SRH was the dependent variable, whereas the initial unmarried status was the independent variable. For the marriage selection effects, initial poor SRH as the independent variable and follow-up unmarried status as the dependent variable had considered. RESULTS: Examining the marital protection hypothesis, the initial unmarried status (OR: 2.14; CI at 95%: 1.17, 3.92) was associated with the followed-up SRH transition from good to poor between 2007 and 2015 for young men, while initial unmarried status was linked with a lower likelihood of stable good SRH and a higher likelihood of stable poor SRH status across all age categories among women. Focusing on the marriage selection hypothesis, among young men, a significant association exists between the initial poor SRH and departure in marital status from married to unmarried. Young women with initial poor SRH (OR: 0.68; CI at 95%: 0.40, 1.00) had lower odds of stable married. In comparison, women with initially poor SRH, irrespective of age, were more likely to have higher odds of being stably unmarried. CONCLUSION: Marriage indeed protects health. There are also shreds of evidence on health-selected marital status in India. Taken together, the aspect of marital protection or marriage selection is gender and age-specific in India. The findings contribute to a more comprehensive understanding of the relationship between marriage and health, which may have significant implications for health-related public policies aimed at unmarried women.

Association of marital status with cognitive function in Chinese hypertensive patients: a cross-sectional study.

PURPOSE: The aim of this study was to evaluate the association of marital status with cognitive function and to examine the potential effect modifiers in Chinese hypertensive populations. METHODS: A total of 9,525 adult Chinese hypertensive patients were enrolled in this cross-sectional study. Cognitive function, as the dependent variable in our study, was assessed by the Chinese version of the Mini-Mental State Examination (MMSE). We adjusted for potential confounding factors in multiple linear regression models to examine the relationship of marital status with cognitive function. In addition, we divided the population according to sex to explore whether there were sex-specific differences. RESULTS: Among the 9,525 study participants, the mean (SD) age for men was 63.5 (10.3) years, and the mean MMSE score was 24.9 ± 5.0, whereas for women, the mean (SD) age was 63.8 (9.3) years, and the mean MMSE score was 19.4 ± 6.4. Unmarried persons had lower scores on the MMSE and lower subscores in each of the cognitive domains. A stronger correlation between marital status and a lower MMSE score was statistically significant in men (unmarried men: ß = -1.55; 95% CI: -1.89, -1.21) but not women (unmarried women: ß = -0.22; 95% CI: -0.56, 0.12; p interaction = 0.006). Compared to men who were widowed or divorced, never married men were more likely to have lower MMSE scores (ß = -2.30, 95% CI -3.10,-1.50; p < 0.001). CONCLUSIONS: Our study demonstrated that being unmarried is an extremely important but neglected social risk factor for cognitive function. Sex was a strong effect modifier: being unmarried was correlated with a higher risk of cognitive decline than being married in Chinese hypertensive men, especially among older men, but this correlation was not observed among women. Moreover, never married men showed poorer cognitive function than those who were divorced or widowed.

The experience of unmarried mothers raising their children in residential facilities: a phenomenological qualitative study.

BACKGROUND: Birth outside of marriage has been gradually increasing in Korea. However, social perception of unmarried mothers is still negative, and a number of them are not accepted by their family. Therefore, the Korean government has implemented a policy to provide financial aid and communal residence to unmarried mothers who cannot raise children with their family, or afford residence. Unmarried young mothers who rely on this government policy have low economic independence and social adaptation skills. Additionally, they have a high chance of encountering numerous challenges in raising children due to their living conditions in residential facilities and social prejudice. This study was conducted to gain an in-depth understanding of the lived experience of unmarried mothers raising children in residential facilities. METHODS: Data were collected through in-depth interviews with nine unmarried mothers living in residential facilities with their children. An interpretative phenomenological analysis was conducted to analyze the data. RESULTS: The findings revealed that unmarried mothers struggled with various difficulties given the limitations of living in the facility, but attempted to navigate their uncertain future with the determination to be good mothers. Three main themes and eight sub-themes emerged: (1) adaptation to the identity of "unmarried mother", (2) willingly undertaking the heavy burden of childrearing, (3) indispensable but insufficient supports from facilities. Participants had childrearing responsibilities, and tried to be good mothers for their children while struggling to adapt to their new identities. However, their self-doubt as a "good mother" and the absence of the child's father made them feel sorry for their child. Their daily experiences raising children and simultaneously preparing for their own independence were exhausting. The supports from the facilities were helpful but unsatisfactory and led to various psychosocial difficulties such as anxiety, depression, fear, guilty, and anger in unmarried mothers. CONCLUSIONS: Besides information and resources for parenting and independence, active approaches are needed to improve the psychological stability of unmarried mothers raising their children in facilities, and sustain a long-term socioeconomic support system. Thoughtful services tailored to mothers and children are also needed, instead of standardized services.