Abortion Access for Incarcerated People: Incidence of Abortion and Policies at U.S. Prisons and Jails.

OBJECTIVE: To understand abortion incidence among incarcerated people and the relation to prison and jail pregnancy policies. METHODS: We collected abortion numbers and policy data from convenience sample of 22 state prison systems, all Federal Bureau of Prisons sites, and six county jails that voluntarily reported monthly, aggregate pregnancy outcomes for 12 months in 2016-2017. Sites also completed a baseline survey of institution characteristics and pregnancy policies, including abortion. We reported facility policies and abortion incidence according to state-level abortion characteristics. RESULTS: Only half of state prisons in the study allowed abortion in both the first and second trimesters, and 14% did not allow abortion at all. Of the 19 state prisons permitting abortion, two thirds required the incarcerated woman to pay. Four jails of the six study jails (67%) allowed abortions in the first and second trimesters, and 25% of those required the incarcerated woman to pay for the procedure. The three prisons and two jails that did not allow abortions were in states considered hostile to abortion access. In the state and federal prisons studied, 11 of the 816 pregnancies (1.3%) that ended during the study time period were abortions. Of the 224 pregnancies that ended at study jails, 33 were abortions (15%), with more than half of those (55%) occurring in the first trimester. The abortion ratio (proportion of pregnancies ending in abortion) was 1.4% for prisons and 18% for jails. CONCLUSION: Although some incarcerated individuals have abortions, many prisons and jails have restrictive policies surrounding abortion, either through self-payment requirements or explicit prohibition. Findings from this study should prompt further inquiry into abortion incidence in these settings and address interventions to ensure incarcerated people, in accordance with legal requirements and health equity, have access to abortion.

Pregnancy Prevalence and Outcomes in U.S. Jails.

OBJECTIVE: To describe the number of admissions of pregnant people to U.S. jails and the outcomes of pregnancies that end in custody. METHODS: We prospectively collected pregnancy data from six U.S. jails, including the five largest jails, on a monthly basis for 12 months. Jails reported de-identified, aggregate numbers of pregnant people admitted, births, preterm births, cesarean deliveries, miscarriages, induced abortions, ectopic pregnancies, and maternal and newborn deaths. RESULTS: There were 1,622 admissions of pregnant people in 12 months in the selected jails. The highest 1-day count of pregnant people at a single jail was 65. The majority of these admissions involved the release of a pregnant person. Of the 224 pregnancies that ended in jail, 144 (64%) were live births, 41 (18%) were miscarriages, 33 (15%) were induced abortions, and four were ectopic (1.8%). One third of the births were cesarean deliveries and 8% were preterm. There were two stillbirths, one newborn death, and no maternal deaths. CONCLUSION: About 3% of admissions of females to U.S. jails are of pregnant people; extrapolating study results to national female jail admission rates suggests nearly 55,000 pregnancy admissions in 1 year. It is feasible to track pregnancy statistics about this overlooked group.

Pregnancy Outcomes in US Prisons, 2016-2017.

OBJECTIVES: To collect national data on pregnancy frequencies and outcomes among women in US state and federal prisons. METHODS: From 2016 to 2017, we prospectively collected 12 months of pregnancy statistics from a geographically diverse sample of 22 state prison systems and the Federal Bureau of Prisons. Prisons reported numbers of pregnant women, births, miscarriages, abortions, and other outcomes. RESULTS: Overall, 1396 pregnant women were admitted to prisons; 3.8% of newly admitted women and 0.6% of all women were pregnant in December 2016. There were 753 live births (92% of outcomes), 46 miscarriages (6%), 11 abortions (1%), 4 stillbirths (0.5%), 3 newborn deaths, and no maternal deaths. Six percent of live births were preterm and 30% were cesarean deliveries. Distributions of outcomes varied by state. CONCLUSIONS: Our study showed that the majority of prison pregnancies ended in live births or miscarriages. Our findings can enable policymakers, researchers, and public health practitioners to optimize health outcomes for incarcerated pregnant women and their newborns, whose health has broad sociopolitical implications.

Obesity and contraceptive use among women 20-44years of age in the United States: results from the 2011-15 National Survey of Family Growth (NSFG).

OBJECTIVE: Obesity has increased dramatically in the United States in recent decades. Our objective was to explore associations of contraceptive choices of US women, aged 20-44years, with body mass index (BMI) and relevant covariates. STUDY DESIGN: Data are based on interviews with a national sample of 11,300 women in the 2011-2015 National Survey of Family Growth. We analyzed women ages 20-44 at risk of unintended pregnancy. The primary dependent variable was BMI category. Covariates analyzed included age, parity, race/ethnicity, marital status, self-reported health and education. Data were analyzed via cross-tabulation and logistic regression. We determined unadjusted and adjusted odds ratios for three categories of contraceptive method: female sterilization, intrauterine device (IUD) and hormonal contraception. RESULTS: Obese women have higher odds of female sterilization (BMI 30.0-34.9 kg/m2: adjusted odds ratio (aOR)=1.96, 95% confidence interval (CI) 1.45-2.66; BMI 35.0 kg/m2 and higher: aOR=1.56, 95% CI 1.13-2.14) compared to women with normal BMI. Odds of IUD use are significantly higher among women with BMI >35 kg/m2 (aOR=1.64, 95% CI 1.20-2.25). Odds of hormonal contraceptive use are correspondingly reduced (aOR=0.78, 95% CI 0.62-0.98) for women in the highest BMI category. CONCLUSIONS: Contraceptive use varies by BMI category even after adjusting for usual correlates of use. Differences in contraceptive use by BMI category have implications for contraceptive counseling and provision. IMPLICATIONS: Findings that obese women are more likely to rely on female sterilization raise questions about how weight concerns and obesity affect contraceptive decision making. Future research could explore associations between obesity and contraceptive use in adolescent women.

Trends and determinants of IUD use in the USA, 2002-2012.

STUDY QUESTION: What factors and subgroups have propelled the recent increase in intrauterine device (IUD) use in the USA? SUMMARY ANSWER: The increase in IUD use, from 1.8 to 9.5% in the USA between 2002 and 2012, was driven primarily by a marked uptake among parous women who intended to have more children. WHAT IS KNOWN ALREADY: Recent data suggest an unprecedented increase in IUD use among women in the USA, yet less is known about how this increase has affected the overall proportion of women, at risk of unintended pregnancy, who are using contraception and which social and economic groups are involved. STUDY DESIGN, SIZE, DURATION: Data are drawn from the 2002 and 2011-2013 National Surveys of Family Growth. The surveys were based on cross-sectional, national samples of women of 15-44 years of age in the USA. Women responded to in-person interviews, which lasted an average of 80 min. The response rate was 80% in 2002 and 73% in 2011-2013. The sample included 7643 completed interviews in 2002 and 5601 interviews in 2011-2013. PARTICIPANTS/MATERIALS, SETTING, METHODS: This study was limited to women at risk of unintended pregnancy, i.e. women who were sexually active in the previous 3 months (using contraception or not); it excludes women who were sterile, currently pregnant or trying to conceive. Altogether, 5181 women were at risk in the 2002 sample and 3681 were at risk in the 2012 sample. We used descriptive statistics to investigate trends in contraceptive use patterns by women's sociodemographic characteristics between 2002 and 2012 and used logistic regression to identify current predictors of IUD use in 2012. MAIN RESULTS AND THE ROLE OF CHANCE: IUD use increased from 1.8% in 2002 to 9.5% in 2012 (P < 0.001). The surge was especially marked among parous women who intended to have more children (4.2% in 2002 to 19.3% in 2012; P < 0.001); it occurred to a lesser extent among parous women who did not intend to have more children (2.0-9.7% P < 0.001), suggesting that IUDs are more often used for spacing than for ending childbearing in the USA. The most important predictors of IUD use in 2012 were age, parity and intent to have children. Dissatisfaction with a previous method was also associated with IUD use (adjusted odds ratio = 1.89, P < 0.001). LIMITATIONS, REASONS FOR CAUTION: As with all cross-sectional studies, causal inference is limited. Data are self-reported, but the survey had a high response rate and rigorous quality controls. WIDER IMPLICATION OF THE FINDINGS: This study shows promising trends in the use of highly effective contraceptive methods in the USA, which may help to explain recently reported declines in unintended pregnancy in the USA. STUDY FUNDING/COMPETING INTERESTS: Caroline Moreau was supported by the William Robertson endowment funds. The work of Hannah Lantos and William Mosher on this analysis was supported by the Department of Population Family and Reproductive Health, The Johns Hopkins Bloomberg School of Public Health. The authors declare that no conflict of interest exists.

Fathers' involvement with their children: United States, 2006-2010.

OBJECTIVE: This report measures fathers' involvement with their children. Father involvement is measured by how often a man participated in a set of activities in the last 4 weeks with children who were living with him and with children who were living apart from him. Involvement is measured separately for children aged 0-4 years and children aged 5-18 years. Increased involvement of fathers in their children's lives has been associated with a range of positive outcomes for the children. METHODS: The analyses presented in this report are based on a nationally representative sample of 10,403 men aged 15-44 years in the household population of the United States. The father-involvement measures are based on 2,200 fathers of children under age 5-1,790 who live with their children and 410 who live apart from their children, and on 3,166 fathers of children aged 5-18-2,091 who live with their children and 1,075 who live apart from their children. RESULTS: Statistics are presented on the frequency with which fathers took part in a set of age-specific activities in their children's lives. Differences in percent distributions are found by whether the father lives with or apart from his children, and by his demographic characteristics. In general, fathers living with their children participated in their children's lives to a greater degree than fathers who live apart from their children. Differences in fathers' involvement with their children were also found by the father's age, marital or cohabiting status, education, and Hispanic origin and race.

Responsive Design, Weighting, andVariance Estimation in the 2006-2010 National Survey of Family Growth.

Objective-The National Survey of Family Growth (NSFG) collects data on pregnancy, childbearing, men's and women's health, and parenting from a national sample of men and women aged 15-44 in the United States. The 2006-2010 NSFG design was a significant departure from the previous periodic design, used in 1973-2002. This report shows fieldwork results and weighting, imputation, and variance estimation procedures. The report should be useful to users of the 2006-2010 public-use data file and to survey methodologists wishing to learn how the NSFG was conducted. Methods-NSFG's new design is based on an independent national probability sample of men and women aged 15-44. The University of Michigan's Institute for Social Research conducted fieldwork under a contract with the National Center for Health Statistics. Professional female interviewers conducted in-person, face-to-face interviews using laptop computers. A responsive design approach was used in planning and managing the fieldwork for NSFG to control costs and reduce nonresponse bias. Results-The 2006-2010 NSFG is based on 22,682 completed interviews-10,403 interviews with men and 12,279 with women. Interviews with men lasted an average of 52 minutes, and for women, 71 minutes. Weighted response rates were 75% among men, 78% among women, and 77% overall. Analysis of NSFG data requires the use of sampling weights and estimation of sampling errors that account for the complex sample design and estimation features of the survey. Sampling weights are provided on the data files. The rate of missing data in the survey is generally low.

Contraceptive methods women have ever used: United States, 1982-2010.

OBJECTIVE: This report presents national estimates of the proportion of sexually experienced women aged 15-44 who have ever used various methods of contraception in the United States. Trends are shown since 1982, and results are shown by Hispanic origin and race, education, and religious affiliation. The number of methods ever used is also shown, along with reasons for stopping use of selected methods. METHODS: Data for 2006-2010 were collected through in-person interviews with 22,682 women and men aged 15-44 in the household population of the United States. Interviews were conducted by female interviewers in the homes of sampled persons. This report is based primarily on the sample of 12,279 women interviewed in 2006-2010 from the National Survey of Family Growth (NSFG). Data from earlier NSFGs are presented to show trends in method choice since 1982. RESULTS: Virtually all women of reproductive age in 2006-2010 who had ever had sexual intercourse have used at least one contraceptive method at some point in their lifetime (99%, or 53 million women aged 15-44), including 88% who have used a highly effective, reversible method such as birth control pills, an injectable method, a contraceptive patch, or an intrauterine device. In 2006-2010, the most common methods that women or their partners had ever used were: the male condom (93%), the pill (82%), withdrawal (60%), and the injectable, Depo-Provera (23%). Method use varied by race and Hispanic origin, nativity among Hispanics, education, and religious affiliation, with significant proportions of women in all categories having used one or more of the most effective methods. The median number of methods ever used by women was about three, but nearly 30% have used five or more methods. Side effects were the most common reason for discontinuing use of the pill, Depo-Provera, and the patch among women who had ever discontinued using these methods due to dissatisfaction.

First premarital cohabitation in the United States: 2006-2010 National Survey of Family Growth.

OBJECTIVE: This report provides an updated description of trends and patterns in first premarital cohabitations among women aged 15-44 in the United States using the National Survey of Family Growth (NSFG). Trends in pregnancies within first premarital cohabiting unions and differences by Hispanic origin and race, and education are also presented. METHODS: Data for 2006-2010 were collected through in-person interviews with 22,682 women and men aged 15-44 in the household population of the United States. This report is based primarily on the sample of 12,279 women interviewed in 2006-2010, and is supplemented by data from the 1995 and 2002 NSFGs. RESULTS: Forty-eight percent of women interviewed in 2006-2010 cohabited with a partner as a first union, compared with 34% of women in 1995. Between 1995 and 2006-2010, the percentage of women who cohabited as a first union increased for all Hispanic origin and race groups, except for Asian women. In 2006-2010, 70% of women with less than a high school diploma cohabited as a first union, compared with 47% of women with a bachelor's degree or higher. First premarital cohabitations were longest for foreign-born Hispanic women (33 months) and shortest for white women (19 months). In 2006-2010, 40% of first premarital cohabitations among women transitioned to marriage by 3 years, 32% remained intact, and 27% dissolved. Nearly 20% of women experienced a pregnancy in the first year of their first premarital cohabitation.

Intended and unintended births in the United States: 1982-2010.

OBJECTIVES: This report shows trends since 1982 in whether a woman wanted to get pregnant just before the pregnancy occurred. This is the most direct measure available of the extent to which women are able (or unable) to choose to have the number of births they want, when they want them. In this report, this is called the "standard measure of unintended pregnancy." METHODS: The data used in this report are primarily from the 2006-2010 National Survey of Family Growth (NSFG), conducted by the Centers for Disease Control and Prevention's National Center for Health Statistics. The 2006-2010 NSFG included in-person interviews with 12,279 women aged 15-44. Some data in the trend analyses are taken from NSFG surveys conducted in 1982, 1988, 1995, and 2002. RESULTS: About 37% of births in the United States were unintended at the time of conception. The overall proportion unintended has not declined significantly since 1982. The proportion unintended did decline significantly between 1982 and 2006-2010 among births to married, non-Hispanic white women. Large differences exist between groups in the percentage of births that are unintended. For example, unmarried women, black women, and women with less education or income are still much more likely to experience unintended births compared with married, white, college-educated, and high-income women. This report also describes some alternative measures of unintended births that give researchers an opportunity to study this topic in new ways.

First marriages in the United States: data from the 2006-2010 National Survey of Family Growth.

OBJECTIVES: This report shows trends and group differences in current marital status, with a focus on first marriages among women and men aged 15-44 years in the United States. Trends and group differences in the timing and duration of first marriages are also discussed. These data are based on the 2006-2010 National Survey of Family Growth (NSFG). National estimates of probabilities of first marriage by age and probabilities of separation and divorce for women and men's first marriages are presented by a variety of demographic characteristics. Data are compared with similar measures for 1982, 1995, and 2002. METHODS: The analyses presented in this report are based on a nationally representative sample of 12,279 women and 10,403 men aged 15-44 years in the household population of the United States. The overall response rate for the 2006-2010 NSFG was 77%-78% for women and 75% for men. RESULTS: The percentage of women who were currently cohabiting (living with a man in a sexual relationship) rose from 3.0% in 1982 to 11% in 2006-2010; it was higher in some groups, including Hispanic groups, and the less educated. In 2006-2010, women and men married for the first time at older ages than in previous years. The median age at first marriage was 25.8 for women and 28.3 for men. Premarital cohabitation contributed to the delay in first marriage for both women and men.

Sexual behavior, sexual attraction, and sexual identity in the United States: data from the 2006-2008 National Survey of Family Growth.

OBJECTIVE: This report presents national estimates of several measures of sexual behavior, sexual attraction, and sexual identity among males and females aged 15-44 years in the United States, based on the 2006-2008 National Survey of Family Growth (NSFG). These data are relevant to demographic and public health concerns, including fertility and sexually transmitted infections among teenagers and adults. Data from the 2006-2008 NSFG are compared with data from the 2002 NSFG and other national surveys. METHODS: Data for 2006-2008 were collected through in-person interviews with a national sample of 13,495 males and females in the household population of the United States. The measures presented in this report were collected using audio computer-assisted self interviewing (ACASI), in which the respondent enters his or her own answers into the computer without telling them to an interviewer. The overall response rate for the 2006-2008 NSFG was 75%. RESULTS: Sexual behaviors among males and females aged 15-44 based on the 2006-2008 NSFG were generally similar to those reported based on the 2002 NSFG. Among adults aged 25-44, about 98% of women and 97% of men ever had vaginal intercourse, 89% of women and 90% of men ever had oral sex with an opposite-sex partner, and 36% of women and 44% of men ever had anal sex with an opposite-sex partner. Twice as many women aged 25-44 (12%) reported any same-sex contact in their lifetimes compared with men (5.8%). Among teenagers aged 15-19, 7% of females and 9% of males have had oral sex with an opposite-sex partner, but no vaginal intercourse. Sexual attraction and identity correlates closely but not completely with reports of sexual behavior. Sexual behaviors, attraction, and identity vary by age, marital or cohabiting status, education, and race and Hispanic origin.

Use of contraception in the United States: 1982-2008.

OBJECTIVE: This report presents national estimates of contraceptive use and method choice based on the 1982, 1995, 2002, and 2006-2008 National Surveys of Family Growth (NSFG). METHODS: Data for 2006-2008 were collected through in-person interviews with 13,495 men and women 15-44 years of age in the household population of the United States. This report is based on the sample of 7,356 women interviewed in 2006-2008. The response rate for women in the 2006-2008 survey was about 76%. RESULTS: More than 99% of women 15-44 years of age who have ever had sexual intercourse with a male (referred to as "sexually experienced women") have used at least one contraceptive method. The percentage of women who have ever used emergency contraception, the contraceptive patch, and the contraceptive ring increased between 2002 and 2006-2008. Looking at contraceptive use in the month of interview, or current use, the leading method of contraception in the United States during 2006-2008 was the oral contraceptive pill, used by 10.7 million women; the second leading method was female sterilization, used by 10.3 million women. While contraceptive use is virtually universal in the United States, women with different characteristics make different choices of methods--for example, college educated women are much more likely to use the pill and less likely to use female sterilization than less educated women. Age, parity, marital status, and income are also closely related to the choice of method. These method choices are related to the risk of unintended pregnancy in these groups.

The 2006-2010 National Survey of Family Growth: sample design and analysis of a continuous survey.

OBJECTIVE: The National Survey of Family Growth (NSFG) collects data on pregnancy, childbearing, men's and women's health, and parenting from a national sample of women and men 15-44 years of age in the United States. This report describes the sample design for the NSFG's new continuous design and the effects of that design on weighting and variance estimation procedures. A working knowledge of this information is important for researchers who wish to use the data. Two data files are being released--the first covering 2.5 years (30 months) of data collection and the second after all data have been collected. This report is being released with the first data file. A later report in this Series will include specific results of the weighting, imputation, and variance estimation. METHODS: The NSFG's new design is based on an independent, national probability sample of women and men 15-44 years of age. Fieldwork was carried out by the University of Michigan's Institute for Social Research (ISR) under a contract with the National Center for Health Statistics (NCHS). In-person, face-to-face interviews were conducted by professional female interviewers using laptop computers. RESULTS: Analysis of NSFG data requires the use of sampling weights and estimation of sampling errors that account for the complex sample design and estimation features of the survey. Sampling weights are provided on the data files. The rate of missing data in the survey is generally low. However, missing data were imputed for about 600 key variables (called "recodes") that are used for most analyses of the survey. Imputation was accomplished using a multiple regression procedure with software called IVEware, available from the University of Michigan website.

Marriage and cohabitation in the United States: A statistical portrait based on cycle 6 (2002) of the National Survey of Family Growth.

OBJECTIVE: This report provides an overview of marital and cohabiting relationships in the United States among men and women aged 15-44 in 2002, by a variety of characteristics. National estimates are provided that highlight formal and informal marital status, previous experience with marriage and cohabitation, the sequencing of marriage and cohabitation, and the stability of cohabitations and marriages. METHODS: The analyses presented in this report are based on a nationally representative sample of 12,571 men and women aged 15-44 living in households in the United States in 2002, based on the National Survey of Family Growth, Cycle 6. RESULTS: Over 40% of men and women aged 15-44 were currently married at the date of interview, compared with about 9% who were currently cohabiting. Men and women were, however, likely to cohabit prior to becoming married. Marriages were longer lasting than cohabiting unions; about 78% of marriages lasted 5 years or more, compared with less than 30% of cohabitations. Cohabitations were shorter-lived than marriages in part because about half of cohabitations transitioned to marriage within 3 years. Variations--often large variations-in marital and cohabiting relationships and durations were found by race and Hispanic origin, education, family background, and other factors.

Estimated pregnancy rates for the United States, 1990-2005: an update.

OBJECTIVES: This report presents detailed pregnancy rates for 1990-2005, updating a national series of rates extending since 1976. METHODS: Tabular data on pregnancy rates by age, race and Hispanic origin, and by marital status are presented and briefly described. RESULTS: in 2005, an estimated 6,408,000 pregnancies resulted in 4.14 million live births, 1.21 million induced abortions, and 1.06 million fetal losses. The 2005 pregnancy rate of 103.2 pregnancies per 1000 women aged 15-44 years is 11 percent below the 1990 peak of 115.8. The teenage pregnancy rate dropped 40 percent from 1990 to 2005, reaching an historic low of 70.6 per 1000 women aged 15-19 years. Rates fell much more for younger than for older teenagers.

Planning and development of the continuous National Survey of Family Growth.

OBJECTIVES: This report describes how the continuous National Survey of Family Growth (NSFG) (begun in 2006) was designed, planned, and implemented. The NSFG is a continuous national survey of men and women 15-44 years of age designed to provide national estimates of factors affecting pregnancy and birth rates; men's and women's health; and parenting. METHODS: The survey used in-person, face-to-face interviews conducted by trained female interviewers. One person per household was interviewed from a national area probability sample. The data collection used computer-assisted personal interviewing (CAPI). Separate questionnaires were used for male and female respondents. The last section of the questionnaires used a self-administered technique called audio computer-assisted self-interviewing or ACASI. Each data collection period lasted 12 weeks-10 weeks for "Phase 1," the main data collection protocol, and 2 weeks for "Phase 2," an intensive attempt to locate and interview nonrespondents. RESULTS: Each year, about 5,000 persons were interviewed in about 33 areas, called primary sampling units (PSUs). Over a 4-year period, 110 PSUs will be used. This report gives an overview of the procedures used in the conduct of the continuous NSFG. A later report will describe response rates and other results of the data collection, but the early fieldwork has gone well.

Estimated pregnancy rates by outcome for the United States, 1990-2004.

OBJECTIVES: This report presents detailed pregnancy rates for 1990-2004, updating a national series of rates extending since 1976. Data from the National Survey of Family Growth (NSFG) are used to interpret trends in teenage pregnancy and in total pregnancy and fertility rates. METHODS: Tabular and graphical data on pregnancy rates by age, race and Hispanic origin, and by marital status are presented and described. Birth data are from the birth registration system for all births registered in the United States and reported by state health departments to the National Center for Health Statistics; abortion data are from the Guttmacher Institute and the National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention; and fetal loss estimates are from pregnancy history information collected by the NSFG. RESULTS: In 2004 an estimated 6,390,000 pregnancies resulted in 4.11 million live births, 1.22 million induced abortions, and 1.06 million fetal losses. The estimated pregnancy rate for 2004 was 103.0; the rate varied little between 1995 and 2004. The teenage pregnancy rate dropped 38 percent during 1990-2004, reaching an historic low of 72.2 pregnancies per 1,000 women aged 15-19 years. Rates for younger teenagers declined relatively more than for older teenagers.

Measuring HIV risk in the U.S. population aged 15-44: results from Cycle 6 of the National Survey of Family Growth.

OBJECTIVE: This report presents national estimates of the percentage and number of persons in the U.S. population aged 15-44 who report behaviors that place them at increased risk for acquiring or transmitting human immunodeficiency virus, or HIV. The report also contains data on condom use and HIV testing by persons who report risk behaviors. In addition, estimates of self-reported risk for HIV from the Cycle 6 National Survey of Family Growth (NSFG) are compared with data from other recent national surveys. METHODS: Data from the NSFG Cycle 6, conducted by the Centers for Disease Control and Prevention's (CDC) National Center for Health Statistics (NCHS), are based on interviews with a national sample of the household population of the United States. In-person, face-to-face interviews were conducted in the homes of 12,571 males and females 15-44 years of age in 2002. Most of the data were collected by Computer-Assisted Personal Interviewing (CAPI), in which a laptop computer is used to select and present the questions, which an interviewer reads to the respondent. The more sensitive data, including the risk behavior items on which this report is based, were collected by Audio Computer-Assisted Self-Interviewing (ACASI), in which the respondent listens to a recording of each question and enters his or her own answers into the computer without involving an interviewer. RESULTS: Overall, 8.9 percent of persons 15-44 years of age had engaged in sexual behaviors in the past year that put them at increased risk of HIV, and 1.5 percent had engaged in drug use behaviors that put them at risk. In all, an estimated 9.9 percent engaged in either drug use or sexual behavior that placed them at increased risk for HIV. Including those who were treated for a sexually transmitted disease (STD) in the past year, 11.9 percent of persons 15-44 years of age--13.0 percent males and 10.8 percent of females+-were at risk of HIV in 2002. The 11.9 percent at risk is equivalent to an estimated 14.4 million persons aged 15-44 at higher risk of HIV through drug use, sexual behavior, or having been treated for an STD in the past year. Persons who were at increased risk reported greater condom use and higher rates of HIV testing, but among those at risk, 33.6 percent had never been tested for HIV and 60.4 percent did not use condoms at last sex.

National Survey of Family Growth, Cycle 6: sample design, weighting, imputation, and variance estimation.

OBJECTIVES: Cycle 6 of the National Survey of Family Growth (NSFG) was conducted by the National Center for Health Statistics in 2002 and early 2003. This report describes how the sample was designed, shows response rates for various subgroups of men and women, describes how the sample weights were computed to make national estimates possible, shows how missing data were imputed for a limited set of key variables, and describes the proper ways to estimate sampling errors from the NSFG. The report includes both nontechnical summaries for readers who need only general information and more technical detail for readers who need an in-depth understanding of these topics. METHODS: The NSFG Cycle 6 was based on an independent, national probability sample of men and women 15-44 years of age. It was the first NSFG ever to include a national sample of men 15-44 as well as a sample of women. Fieldwork was carried out by the University of Michigan's Institute for Social Research (ISR) under a contract with NCHS. In-person, face-to-face interviews were conducted by professional female interviewers using laptop computers. In all, 12,571 women and men-7,643 females and 4,928 males-were interviewed, the largest NSFG ever done. RESULTS: Analysis of NSFG Cycle 6 data requires the use of sampling weights and estimation of sampling errors that accounts for the complex sample design and estimation features of the survey. Examples of how to use several available software packages that incorporate complex design features in estimation, such as SAS, SUDAAN, and STATA, are presented.