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1.
Psychol Addict Behav ; 38(2): 193-196, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37707466

RESUMO

OBJECTIVE: The main reasons women in the general population seek abortion are financial, timing, and partner-related reasons. While women with opioid use disorder (OUD) appear to use abortion services more than women in the general population, reasons for abortion in this group have not been examined to our knowledge. METHOD: Female patients aged 18-50 years in OUD treatment at 22 randomly selected facilities in Michigan were surveyed. The survey included items assessing reproductive health history. Women who reported having one or more abortions were asked to think back to that time and their reasons for choosing abortion. Twenty potential reasons and a write-in option were offered; women could endorse as many as applied. RESULTS: Of 260 women surveyed, 84 reported having an abortion. Of these, most (77.4%) reported multiple reasons for having an abortion. The most common reasons for having an abortion were not having money to take care of a baby (54.8%), feeling too young to have a child and not feeling ready to be a mother (both 42.9%), not loving the father and other partner-related concerns (25.0%-32.1%), and having concerns about the effects of their drug use (28.6%). No combination of reasons for abortion emerged as more prevalent than any other. CONCLUSIONS: Like women in the general population, women in treatment for OUD had not only abortions because of financial, timing, and partner-related reasons but also concerns about the effects of their drug use. These results underscore the multiple and often interrelated reasons that lead women to seek abortion. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Assuntos
Aborto Induzido , Transtornos Relacionados ao Uso de Opioides , Feminino , Humanos , Gravidez , Tomada de Decisões , Transtornos Relacionados ao Uso de Opioides/terapia , Inquéritos e Questionários , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade
2.
J Contin Educ Nurs ; 55(1): 21-25, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37971229

RESUMO

BACKGROUND: There is a gap in the availability of continuing education opportunities for labor and delivery nurses regarding trauma-informed perinatal care. METHOD: A continuing education module on trauma-informed pain management in labor was created and distributed to 17 nurses in an intrapartum unit at a hospital in the Midwestern United States. Changes in knowledge, attitudes, skills, and intent to use trauma-informed principles were assessed using a pretest-posttest design and paired t test analyses. RESULTS: Change in knowledge (p = .043) and skills (p = .011) was statistically significant. There were no statistically significant changes in attitudes. CONCLUSION: Continuing education opportunities in trauma-informed perinatal care are needed for health care team members who provide care to trauma survivors in labor. Further research on the effectiveness of trauma-informed pain management in labor and birth is necessary to provide additional resources and recommendations for labor and delivery nurses. [J Contin Educ Nurs. 2024;55(1):21-25.].


Assuntos
Recursos Humanos de Enfermagem Hospitalar , Manejo da Dor , Humanos , Educação Continuada em Enfermagem , Recursos Humanos de Enfermagem Hospitalar/educação , Conhecimentos, Atitudes e Prática em Saúde , Competência Clínica , Dor
3.
J Interpers Violence ; 39(11-12): 2526-2551, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38158747

RESUMO

Depressive symptoms and delinquent behaviors that emerge during adolescence pose both short- and long-term negative outcomes. Though there is growing evidence that exposure to teen dating violence is also associated with a greater likelihood of depressive symptoms and delinquent behaviors such as engaging in peer violence and substance use, less is known about the effects of specific forms of electronic dating violence (i.e., electronic harassment, electronic coercion, and electronic monitoring) across adolescence on depressive symptoms and delinquent behaviors. Data were drawn from a 4-year prospective longitudinal study of two cohorts of youth followed from age 12 to 15 (n = 526, 52% female) and age 15 to 18 (n = 592, 53% female). Two mixed-effects models (stratified by cohort) were employed to evaluate depressive symptoms and delinquent behavior outcomes by exposure to electronic harassment, electronic coercion, and electronic monitoring, while accounting for verbal dating violence, physical dating violence, sexual dating violence, exposure to threat-based adverse childhood experiences, exposure to deprivation-based adverse childhood experiences, and gender across all four waves of data collection. Higher exposure to electronic sexual coercion was predictive of increased depression (ß = .015, p = .018). Increased exposure to electronic sexual coercion (ß = .007, p = .004) and electronic monitoring (ß = .008, p = .045) were both predictive of more delinquency across adolescence. By delineating the effects of in-person verbal, physical, and sexual dating violence with unique electronic domains, we found unique additional risk from domains of electronic dating violence, which was particularly pronounced for youth who reported electronic sexual coercion. Electronic sexual coercion heightens the risk of depressive symptoms and delinquent behaviors in males and females beyond the risk presented by in-person forms of dating violence and should be accounted for in prevention and intervention programs. Future research should explore the effect of perceived normativity on the prevalence of electronic harassment and subsequent influence on outcomes.


Assuntos
Comportamento do Adolescente , Depressão , Violência por Parceiro Íntimo , Delinquência Juvenil , Humanos , Adolescente , Feminino , Masculino , Depressão/psicologia , Depressão/epidemiologia , Violência por Parceiro Íntimo/psicologia , Violência por Parceiro Íntimo/estatística & dados numéricos , Estudos Longitudinais , Delinquência Juvenil/psicologia , Comportamento do Adolescente/psicologia , Criança , Estudos Prospectivos
4.
J Interpers Violence ; 38(3-4): 3344-3372, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-35658568

RESUMO

Despite the fact that intimate partner violence (IPV) occurs within intimate relationships, we know relatively little about the characteristics of those intimate relationships, and even less about how IPV changes across time within different relationships. We use the Relationship Dynamics and Social Life (RDSL) study, based on a random sample of 1003 18-19-year-old women residing in a Michigan county. Women were interviewed weekly for 2.5 years, resulting in an age range of 18 through 22. We estimate hybrid "within-between" regression models, which allows us to directly compare the same woman's risk of experiencing IPV across her different relationships, varied in terms of resources, balance of power, conflict, childbearing, relationship type, and duration. Our analyses demonstrate that power imbalance in intimate relationships, non-monogamous and unstable relationships, relationships with men who are not the father of a woman's existing children, and serious relationships (especially stayover and cohabiting) place young women in their late teens and early twenties at particularly high risk of multiple dimensions of IPV. Our fixed-effects modeling strategy isolated the increase in IPV risk that is due to these characteristics and experiences within intimate relationships from the risk due to young women being at high risk of IPV for other reasons who might tend to choose these types of relationships. The elevated risk of IPV in relationships with these characteristics and experiences supports a causal link between them. Our research supports the potential efficacy of interventions that reduce conflict, equalize power within relationships, and encourage women-especially young mothers-to delay serious relationships.


Assuntos
Vítimas de Crime , Violência por Parceiro Íntimo , Masculino , Adolescente , Criança , Humanos , Feminino , Comportamento Sexual , Parceiros Sexuais , Fatores de Risco
5.
Soc Probl ; 69(4): 1068-1091, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36249958

RESUMO

While research has demonstrated that high residential mobility has negative consequences for an array of outcomes, particularly among women and young adults, the mechanisms underlying these associations are unclear. The consequences of high residential mobility may be comprised solely of a series of short-term disruptions surrounding individual moves, or there may also be long-term, cumulative effects from repeated moves. High residential mobility may diminish access to resources as individuals move to different neighborhoods, impose a cognitive burden that impairs their ability to plan ahead, or decrease the relative power they have in their relationships to limit exposure to risk behaviors. We adjudicate between these possibilities by predicting the effects of high residential mobility on sexual intercourse and contraceptive use, the proximate determinants of pregnancy, during women's transition to adulthood. Using 2.5 years of monthly address data for 882 respondents in the Relationship Dynamics and Social Life study-a random sample of young women in Genesee County, Michigan-we find that high residential mobility is associated with long-term decreases in contraceptive use. These long-term consequences are independent of the short-term effects of individual moves and attributable to diminished contraceptive access. We disentangle the effects of home-leaving, which is distinct from subsequent moves.

6.
Womens Health Issues ; 32(6): 595-601, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35821183

RESUMO

OBJECTIVE: We aimed to examine the role of perceived and direct stigma on access to reproductive health services among women in treatment for substance use disorders in Michigan. METHODS: We draw on self-interview data from a cross-sectional study of female patients aged 18-50 years who accessed substance use disorder treatment at 22 randomly selected facilities in Michigan from December 2015 to May 2017. We conducted logistic regressions to examine associations between perceived stigma and access to three types of reproductive health services (screening exams, birth control, and prenatal care), as well as direct stigma and access to birth control. RESULTS: The final sample included 260 women. A notable percentage of women reported inability to access reproductive health services (24% for screening exams, 14% for birth control, and 12% for prenatal care). Women with higher levels of perceived stigma because of substance use were significantly more likely to report inability to access screening exams (odds ratio [OR]: 2.14; confidence interval [CI]: 1.43-3.20) and birth control (OR: 2.17; CI: 1.36-3.77). Women reporting higher levels of direct stigma were also significantly more likely to report inability to access birth control (OR: 3.87; CI: 2.29-6.53), even after accounting for perceived stigma. CONCLUSION: Perceived and direct stigma because of substance use may be significant barriers to seeking and accessing reproductive health services for women. Health professionals should reduce stigma in health care in order to increase access to necessary services for this population.


Assuntos
Serviços de Saúde Reprodutiva , Transtornos Relacionados ao Uso de Substâncias , Gravidez , Feminino , Humanos , Estudos Transversais , Acessibilidade aos Serviços de Saúde , Estigma Social , Transtornos Relacionados ao Uso de Substâncias/terapia
7.
J Youth Adolesc ; 51(1): 45-61, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34647192

RESUMO

Electronic dating violence is a form of violence perpetrated through electronics between dating partners and is associated with worse mental health, greater risk of substance use, and increased risk of in-person forms of dating violence. Though prevalent and seeming to increase in occurrence across adolescence, little is known about trajectories of electronic dating violence throughout adolescence and both risk and protective factors predicting a given trajectory. Latent growth models were used to evaluate change over time in three specific domains of electronic dating violence: harassment, coercion, and monitoring. Data are drawn from two cohorts who were surveyed annually for four years (2013-2017) from age 12 to 15 (n = 543; 48.3% female) and 15 to 18 (n = 597, 46.6% female), respectively. For all three domains of electronic dating violence, a quadratic model fit best. In general, electronic dating violence increased from early adolescence until a peak around age 16 or 17, and then leveled off. Threat-based adverse childhood experiences (i.e., exposure to physical child abuse, parental intimate partner violence, etc.) and earlier engagement in dating behaviors increased long-term risk for both age cohorts. Protective factors such as parental monitoring decreased risk but seemed to only have protective influence at developmentally-specific periods (i.e., during the developmental period of early adolescence). A better understanding of the risk and protective factors that affect the increase of electronic dating violence during adolescence is necessary to develop effective age-appropriate prevention and intervention strategies for youth.


Assuntos
Comportamento do Adolescente , Vítimas de Crime , Violência por Parceiro Íntimo , Adolescente , Criança , Eletrônica , Feminino , Humanos , Masculino , Violência
8.
Violence Against Women ; 28(10): 2286-2311, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-34636717

RESUMO

Few studies explore how intimate partner violence (IPV) affects Arab Americans. Through focus groups with stakeholders from an Arab-centered health organization and semistructured interviews with Arab-American female clients (18-65 years), we explore how IPV affects Arab-American women and factors that impede and facilitate their access to support services. We find that IPV is a critical concern among Arab Americans and that generational status, educational attainment, and support from family, friends, or religious leaders were perceived to influence access to IPV support services. This study has implications for developing culturally sensitive IPV interventions for Arab-American women.


Assuntos
Árabes , Violência por Parceiro Íntimo , Feminino , Grupos Focais , Humanos , Michigan , Pesquisa Qualitativa
9.
Women Health ; 61(5): 461-469, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33938402

RESUMO

Discrimination has historically contributed to coercive contraceptive in the United States. We investigated associations between perceived discrimination, or the perception of unequal treatment in everyday life, and contraceptive method use among U.S. women. We analyzed population-based data from a 2013 study of U.S. women who were premenopausal, age 18-50, sexually active with a male partner in the last year and were not attempting pregnancy. Perceived discrimination was measured using the Everyday Discrimination Scale. Contraceptive method use was categorized into five method categories: permanent, highly effective reversible, moderately effective, barrier and no method. We analyzed relationships between perceived discrimination and contraceptive method use with several regression models, controlling for covariates. Among 539 women in our analytic sample, those with high perceived discrimination had lower incomes, less educational attainment and were less likely to be insured. Perceived discrimination was associated with a reduced odds of using any contraceptive method (aOR 0.43, CI 0.21-0.87, p < .001). Contraceptive method users with high perceived discrimination had an increased odds of using highly effective reversible methods versus moderately effective methods (aOR 5.28, CI 1.63-17.07 p = < .001). Women who perceived discrimination were at risk for contraceptive nonuse; however, among contraceptive users, perceived discrimination was associated with the use of more effective reversible methods.


Assuntos
Anticoncepção , Discriminação Percebida , Adolescente , Adulto , Comportamento Contraceptivo , Anticoncepcionais , Atenção à Saúde , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Gravidez , Estados Unidos , Adulto Jovem
10.
Demography ; 58(2): 603-630, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33834223

RESUMO

This article explores race differences in the desire to avoid pregnancy or become pregnant using survey data from a random sample of 914 young women (ages 18-22) living in a Michigan county and semi-structured interviews with a subsample of 60 of the women. In the survey data, desire for pregnancy, indifference, and ambivalence are very rare but are more prevalent among Black women than White women. In the semi-structured interviews, although few women described fatalistic beliefs or lack of planning for future pregnancies, Black and White women did so equally often. Women more often described fatalistic beliefs and lack of planning when retrospectively describing their past than when prospectively describing their future. Using the survey data to compare prospective desires for a future pregnancy with women's recollections of those desires after they conceived, more Black women shifted positive than shifted negative, and Black women were more likely to shift positive than White women-that is, Black women do not differentially retrospectively overreport prospectively desired pregnancies as having been undesired before conception. Young women's consistent (over repeated interviews) prospective expression of strong desire to avoid pregnancy and correspondingly weak desire for pregnancy, along with the similarity of Black and White women's pregnancy plans, lead us to conclude that a "planning paradigm"-in which young women are encouraged and supported in implementing their pregnancy desires-is probably appropriate for the vast majority of young women and, most importantly, is similarly appropriate for Black and White young women.


Assuntos
População Negra , Comportamento Contraceptivo , Adolescente , Adulto , Feminino , Humanos , Michigan , Gravidez , Estudos Prospectivos , Estudos Retrospectivos , Adulto Jovem
11.
J Interpers Violence ; 36(23-24): NP13162-NP13184, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-32054385

RESUMO

Within a lifetime, one in four women and more than one in 10 men will experience intimate partner violence (IPV). Researchers have begun to examine physical and social neighborhood risk factors of IPV, often using cross-sectional data. Most studies focus on risk or promotive factors. Often, neighborhood factors are studied through the lens of social disorganization theory, which focuses on how a neighborhood slips into a violent and crime-ridden place. Busy streets theory provides an alternative perspective, focusing on how building up community assets and resources may help create a safe and vibrant neighborhood. A conceptual approach that utilizes risk and promotive neighborhood variables may help develop new conceptual frameworks for understanding how context may decrease risk for, or moderate, the negative consequences of IPV. Using five waves of data from a 24-year longitudinal study, we employ multilevel linear regression models to examine the trajectory of IPV experiences in relation to positive perceptions of neighborhood, neighborhood cohesion, and informal social control in individuals aged 28 to 33 years. We control for the neighborhood and individual-level risk factors of alcohol consumption, drug use, observed neighborhood violence, and demographic factors of age, race, sex, and socioeconomic status. We found that positive perceptions of neighborhood, alcohol consumption, drug use, economic need, and observed neighborhood violence are associated with IPV. Levels of IPV risk were relatively constant within individuals across waves, but varied significantly between individuals. The measure of positive perceptions of neighborhood is derived from busy streets theory, which may be a useful conceptual framework for understanding how neighborhoods may contribute to positive social contexts that can protect residents from IPV experiences, and potentially other violent behavior. Additional research examining promotive social neighborhood features derived from busy streets theory may help expand our understanding of contextual factors that affect IPV.


Assuntos
Violência por Parceiro Íntimo , Estudos Transversais , Feminino , Humanos , Estudos Longitudinais , Masculino , Análise Multinível , Características de Residência , Fatores de Risco
12.
J Interpers Violence ; 36(21-22): NP11577-NP11592, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-31771392

RESUMO

"Stealthing" is a form of sexual violence wherein a sexual partner purposefully removes a condom during penetration without the receptive partner's knowledge. Given the role of substance use in sexual violence broadly, we examined demographic and substance use correlates of stealthing perpetration (SP) and victimization (SV) among emerging adults. Participants comprised 2,550 18- to 25-year-olds (M age = 20.8, SD = 2.3), recruited via social media (48% female; 53.9% non-Hispanic White; 46.0% had another racial/ethnic identity; 67.4% heterosexual; 85.3% had some college education). Unadjusted analyses (t tests, χ2 analysis) and adjusted logistic regression analyses examined associations between demographics (age, education, race/ethnicity, sexual orientation) and substance use (binge drinking, marijuana use, other illegal drug use, and prescription drug misuse) with male SP and male and female SV. Five percent of males and 18.9% of females reported SV; 6.1% of males reported SP. In adjusted analyses, significant correlates of SP were: non-Hispanic White race/ethnicity (odds ratio [OR] = 0.39), binge drinking (OR = 1.39), cannabis use (OR = 1.37), and other drug use (OR = 1.43). Significant correlates of male SV were: non-Hispanic White race/ethnicity (OR = 0.28), non-heterosexual orientation (OR = 0.24), binge drinking (OR = 1.49), and other illegal drug use (OR = 1.79). Significant correlates of female SV were: older age (OR = 1.13), non-Hispanic White race/ethnicity (OR = 0.57), binge drinking (OR = 1.28), cannabis use (OR = 1.29), and other drug use (OR = 1.22). Consistent with literature linking alcohol to sexual violence, binge drinking correlated with both SV and SP, with other substance use also playing a role. Data are needed to explore these relationships using longitudinal, event-level assessments to investigate the influence of acute intoxication. Interventions to reduce sexually transmitted infections, unintended pregnancy, and sexual assault should include content on stealthing and substance use.


Assuntos
Bullying , Vítimas de Crime , Delitos Sexuais , Adulto , Idoso , Feminino , Humanos , Masculino , Gravidez , Prevalência , Comportamento Sexual , Adulto Jovem
13.
Demography ; 57(6): 2003-2034, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32901407

RESUMO

We investigate the immediate social context of contraceptive behaviors: specifically, the intimate relationship. We use the Relationship Dynamics and Social Life (RDSL) study (2008-2012), based on a random sample of 1,003 women ages 18-19 residing in a Michigan county. Women were interviewed weekly for 2.5 years, resulting in an age range of 18-22. We test three sets of hypotheses about change over time within a relationship, using relationship-level within-between models, which compare a couple's contraceptive behaviors across different times in the relationship. First, we find that a couple is less likely to use contraception when the relationship is more intimate and/or committed and that a couple becomes less likely to use contraception over time, regardless of intimacy and commitment. Second, we find that a couple using contraception becomes increasingly likely to choose hormonal over coital methods, but this change occurs as a relationship endures and is unrelated to intimacy and/or commitment. Third, we find that a condom-using couple's consistency does not decline when there is conflict; rather, consistency of condom use declines over time regardless of the relationship's characteristics. We also demonstrate that conflict and power imbalance increase reliance on hormonal methods among those using contraception; conflict decreases consistency among withdrawal (but not condom) users; and nonmonogamy increases reliance on condoms and decreases withdrawal consistency. The strong and consistent link between duration and contraceptive behaviors-regardless of intimacy, commitment, conflict, or power imbalance-suggests that the continual vigilance required for long-term contraceptive use is difficult during early emerging adulthood.


Assuntos
Comportamento Contraceptivo/estatística & dados numéricos , Comportamento Sexual/estatística & dados numéricos , Adolescente , Feminino , Humanos , Relações Interpessoais , Michigan , Fatores de Tempo , Adulto Jovem
14.
Perspect Sex Reprod Health ; 52(2): 129-138, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32666672

RESUMO

CONTEXT: Sexual concurrency among women is associated with increased risks of STD transmission, unintended pregnancy and sexual health disparities. Understanding the prevalence of concurrency-overlapping sexual partnerships-is imperative to reducing these disparities. METHODS: Weekly, population-representative panel data from 757 women aged 18-22, collected from 2008 to 2012 in Michigan, were drawn from the Relationship Dynamics and Social Life study. Univariate analyses assessed the prevalence of two forms of sexual concurrency. Multivariate logistic regression models investigated associations between women's social-ecological characteristics and concurrency. RESULTS: Twenty percent of women had vaginal intercourse with two partners in one week; 14% had intercourse with a second partner during an ongoing relationship. In both cases, the majority of individuals had intercourse with the second partner in one to three weeks in total. The likelihood of both types of concurrency was elevated among women who believed they should have sex with men after seeing them for a while (log-odds, 0.27 and 0.23, respectively) and among those who were Black (0.58 and 1.02, respectively); the likelihood was reduced among women who were more willing to refuse unwanted sex (-0.10 and -0.13, respectively) and who were in exclusive, cohabiting, or married or engaged relationships (-1.82 to -2.64). Having intercourse with multiple partners in one week was also associated with receiving sex education from parents, the degree that parents and friends approved of sex, and having had early intercourse without contraception. CONCLUSIONS: Sexual concurrency among young women is prevalent but intermittent, and interventions that address individuals' social-ecological contexts are needed to reduce negative health outcomes.


Assuntos
Comportamento Sexual/estatística & dados numéricos , Meio Social , Adolescente , Feminino , Humanos , Modelos Logísticos , Michigan/epidemiologia , Prevalência , Fatores de Risco , Adulto Jovem
15.
Obstet Gynecol ; 135(2): 361-369, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31923070

RESUMO

OBJECTIVE: To evaluate the sexual and reproductive health characteristics of women in treatment for opioid use disorder in Michigan and explore services provided and desired. METHODS: We conducted a cross-sectional study of female patients aged 18-50 years who accessed opioid use disorder treatment at 22 randomly selected facilities in Michigan from December 2015 to May 2017. Computer-assisted self-interviews were completed using online survey management software to assess prior substance use and use disorder treatment, sexual and reproductive health history, and sexual and reproductive health services received in the previous 12 months through a treatment program, and desire for and barriers to sexual and reproductive health services within substance use disorder treatment. Descriptive statistics were calculated. RESULTS: The final sample consisted of 260 participants. About half (51.5%) had ever had an abnormal Pap test result, and 57.3% had ever tested positive for a sexually transmitted infection. Unintended pregnancy was common (61.2%), as was substance use during pregnancy (74.2%). Nearly half (46.5%) were not currently using a method of contraception, and only 28.5% were using a highly effective method. Common barriers to accessing reproductive health services included fear of being treated poorly or judged because of substance use, fear of child protective services, and structural barriers such as cost and lack of transportation. Most participants (80.4%) indicated interest in receiving sexual and reproductive health services on site or by referral from their substance use disorder treatment programs. CONCLUSION: Women in treatment for opioid use disorder in Michigan have high rates of adverse sexual and reproductive health experiences and face barriers to accessing care.


Assuntos
Acessibilidade aos Serviços de Saúde/economia , Serviços de Saúde Reprodutiva/estatística & dados numéricos , Saúde Reprodutiva , Infecções Sexualmente Transmissíveis/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/terapia , Adulto , Anticoncepção , Estudos Transversais , Feminino , Humanos , Michigan/epidemiologia , Pessoa de Meia-Idade , Gravidez , Gravidez não Planejada , Infecções Sexualmente Transmissíveis/prevenção & controle , Adulto Jovem
16.
Subst Use Misuse ; 55(1): 95-107, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31455128

RESUMO

Background: Women with substance use disorders have high rates of adverse sexual and reproductive health (SRH) outcomes, including unintended pregnancy, sexually transmitted infections, and contraceptive nonuse. Little research has explored barriers and facilitators to accessing SRH services experienced by women with substance use disorders. Objectives: To investigate barriers and facilitators to accessing SRH services experienced by women with substance use disorders. To assess perspectives on integration of SRH services into substance use treatment. Methods: Twenty-nine semi-structured interviews were conducted with female patients (N = 17) and providers (N = 12) at four substance use treatment facilities in Michigan between October 2015 and January 2016. Respondents were asked about experiences accessing SRH services and perspectives on integration of SRH services into substance use treatment. Data were analyzed using the constant comparative method. Results: Patients and providers discussed barriers to accessing SRH services, including competing priorities, structural barriers, lack of knowledge on SRH services and substance use, fear of Child Protective Services and law enforcement, and stigma. Facilitators included reprioritization of SRH, accessible transportation, insurance coverage and funding for SRH services, and education and training on SRH. Finally, participants expressed support for integration of SRH services into substance use treatment. Conclusions/Importance: Understanding the barriers to accessing SRH services is essential to reducing the adverse SRH outcomes experienced by women with substance use disorders. Substance use treatment is a critical time to offer SRH services. Integration of care is a potential model for improving the SRH of women with substance use disorders.


Assuntos
Acessibilidade aos Serviços de Saúde , Serviços de Saúde Reprodutiva , Comportamento Sexual , Estigma Social , Transtornos Relacionados ao Uso de Substâncias/terapia , Adulto , Atitude do Pessoal de Saúde , Feminino , Humanos , Michigan , Pessoa de Meia-Idade , Gravidez , Infecções Sexualmente Transmissíveis/prevenção & controle
17.
Demogr Res ; 42: 933-984, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-38249422

RESUMO

OBJECTIVE: We identify common patterns of joint relationship, sex, and contraceptive trajectories in young adulthood and assess how selection into these trajectories differs across socioeconomic and demographic groups and varies with earlier sexual and reproductive experiences and attitudes. METHODS: We draw on a weekly panel of 581 young adult women in the United States that includes granular data on sexual and contraceptive behaviors. We use sequence analysis to describe joint relationship, sex, and contraceptive trajectories over the course of a year and multinomial logistic regression to examine how these trajectories are associated with socioeconomic disadvantage and minority racial status. RESULTS: We identify six trajectories characterized by differences in relationship stability, sexual regularity, and contraceptive efficacy. Many women report no romantic relationships over the year. Among those who do, instability in relationships, sex, and contraception is common. Less advantaged women are more likely to be on trajectories marked by frequent relationship transitions, coresidence, and less effective contraception. These socioeconomic differences are largely explained by earlier experiences and attitudes. Black women are the most likely to be on a trajectory characterized by simultaneous relationship, sex, and contraceptive instability, and this holds net of earlier experiences and attitudes. CONTRIBUTION: We provide a novel way of understanding how women's relationship, sexual, and contraceptive trajectories co-evolve and vary by sociodemographic characteristics. Results highlight that instability is common in the young adult years but that differences in how trajectories unfold suggest greater risk of unintended pregnancies for socially disadvantaged and black women.

18.
Perspect Sex Reprod Health ; 51(3): 143-152, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31518052

RESUMO

CONTEXT: Although substantial research has focused on unintended pregnancy among young women, less is known about the circumstances under which pregnancy is desired. Whether a young woman's pregnancy desire changes across her different relationships, or over time within a relationship, has not been directly assessed. METHODS: Data on intimate relationships and pregnancy desire were assessed weekly for 895 women aged 18-22 who participated in the Relationship Dynamics and Social Life study in a county in Michigan (2008-2012). Within-between logistic regression models were used to examine within-cluster and between-cluster differences-comparisons of a woman's pregnancy desire within a relationship over time as well as across a woman's different relationships. RESULTS: Young women were more likely to desire pregnancy if they were in any relationship more intimate and committed than a casual relationship (odds ratios, 1.6-9.2); the odds of desiring pregnancy were also higher in long-term relationships rather than in short-term ones (2.1). In general, pregnancy desire increased over time as a relationship endured and became more serious. The odds of desiring pregnancy were lower among women with less educated, rather than equally educated, partners (0.7), while the odds were higher in nonmonogamous or violent relationships than in monogamous or nonviolent relationships (1.6 and 1.9, respectively). CONCLUSIONS: Young women's pregnancy desire changes depending on their intimate relationship context, across the range of relationships they experience during the transition to adulthood.


Assuntos
Relações Interpessoais , Gravidez não Planejada/psicologia , Comportamento Sexual/psicologia , Parceiros Sexuais/psicologia , Adolescente , Análise por Conglomerados , Características da Família , Feminino , Humanos , Modelos Logísticos , Michigan , Razão de Chances , Gravidez , Fatores de Tempo , Adulto Jovem
19.
Contraception ; 100(6): 484-491, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31484058

RESUMO

OBJECTIVE: We examined whether women's experiences across and within their intimate relationships affect their expected level of control over sex and contraceptive use. STUDY DESIGN: We used data from 648 women ages 18-20 in the Relationship Dynamics and Social Life (RDSL) study, which interviewed a random, population-based sample in a Michigan county. We used ordered logistic regression with fixed-effects to control for individual- and relationship-level characteristics. RESULTS: We found a u-shaped relationship between intimacy/commitment and expected control, with the lowest expected control in the least intimate/committed and the most intimate/committed relationships, and the highest expected control in the intermediate relationships. Women expected more control in their long-term compared to short-term relationships, and expected control increases over time in a specific relationship. Women also expected less control in their conflictual and/or asymmetric relationships - those with older and/or violent partners, and expected control decreases after experiencing violence or a partner's non-monogamy. CONCLUSIONS: Our results are consistent with cross-sectional research suggesting that women in violent relationships experience more reproductive coercion than women in non-violent relationships, but we also found that other aspects of intimate relationships are important determinants of expected control over sex and contraception. IMPLICATIONS: Intervention strategies should consider a wider range of intimate relationship characteristics - beyond violence - to improve women's control of their reproductive behaviors.


Assuntos
Comportamento Contraceptivo/psicologia , Anticoncepção/psicologia , Identidade de Gênero , Adolescente , Feminino , Humanos , Violência por Parceiro Íntimo/psicologia , Inquéritos e Questionários , Adulto Jovem
20.
J Womens Health (Larchmt) ; 28(8): 1060-1067, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31166827

RESUMO

Background: Intimate partner violence (IPV) and psychological distress (PD) are major public health concerns among emerging adult women. Emerging adulthood presents a complex set of new experiences and challenges that pose a risk to normative development. In particular, an increased prevalence of IPV and PD during this time period may lead to long-term health consequences. Methods: Data from the Relationship Dynamics and Social Life study, a longitudinal study of a racially and socioeconomically diverse population-representative random sample of 726 partnered women, aged 18-19, residing in a Michigan county, and followed for 2.5 years, were used to investigate the relationship between IPV and PD. Logistic regression models predicted each measure of PD (depression, stress, loneliness, self-esteem) as a function of past IPV (none, psychological violence only, any physical violence), and multinomial logistic regression models predicted subsequent weekly IPV as a function of each measure of PD. Results: PD and IPV were prevalent among emerging adult women. Past psychological IPV was associated with experiencing all four distress measures. Past physical IPV was also associated with depression, stress, and loneliness, but not self-esteem. Women with each PD were more likely to subsequently experience psychological violence, and women who reported stress were more likely to subsequently experience any physical violence. Conclusions: The IPV-PD relationship is bidirectional. Women who experienced past IPV were more likely to report PD. Conversely, women who experienced PD were at a greater risk of subsequent IPV.


Assuntos
Violência por Parceiro Íntimo/estatística & dados numéricos , Angústia Psicológica , Parceiros Sexuais/psicologia , Adolescente , Estudos Transversais , Feminino , Humanos , Violência por Parceiro Íntimo/psicologia , Masculino , Michigan/epidemiologia , Prevalência , Fatores de Risco , Adulto Jovem
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