Validity of Partner Reports of Recent Condomless Sex.

BACKGROUND: Prostate-specific antigen (PSA), a biomarker of vaginal semen exposure, is less susceptible to bias than self-reported condom use behaviors. We examined the agreement of self-reported recent condomless sex (RCS) within couples and how these reports related to PSA detection. METHODS: We analyzed data from a study conducted in Vietnam, 2017 to 2020, of 500 different-sex couples using condoms and no other contraceptive method to prevent pregnancy for 6 months. We assessed enrollment and 6-month data from vaginal swabs and questionnaires from both partners. We calculated Prevalence-Adjusted Bias-Adjusted Kappa (PABAK) to evaluate agreement of men's and women's reports. Among couples with detected PSA, we assessed partner concordance of RCS reporting. RESULTS: At enrollment (n = 499), 79.8% of couples reported no RCS, 16.4% reported RCS, and 3.8% had partner-discordant reports (PABAK, 0.93; 95% confidence interval, 0.91-0.97). At 6 months (n = 472), 91.7% reported no RCS, 5.7% reported RCS, and 2.5% had partner-discordant reports (PABAK, 0.98; 95% confidence interval, 0.96-1.0). Among couples with detected PSA at baseline (11%, n = 55), 36% reported no RCS, 55% reported RCS, and 6% had discordant reports; at 6 months (6.6%, n = 31), 58% reported no RCS, 35% reported RCS, and 3% had discordant reports. CONCLUSIONS: We observed high agreement regarding condomless sex within couples in a population using condoms as contraception in Vietnam; however, a high proportion of couples with detected PSA had both partners reporting no RCS, indicating that concordant reporting of no RCS does not indicate lack of semen exposure.

Evolving Fertility Goals and Behaviors in Current U.S. Childbearing Cohorts.

In the post-Recession era, U.S. fertility rates have continued to fall. It is unclear if these declines are driven by shifts in fertility goals or growing difficulty in achieving goals. In this paper, we construct synthetic cohorts of men and women to examine both cross-cohort and within-cohort changes in fertility goals using multiple cycles of the National Survey of Family Growth. Although more recent cohorts exhibit lower achieved fertility at younger ages than earlier cohorts at the same age, intended parity remains around two children, and intentions to remain childless rarely exceed 15%. There is weak evidence of a growing fertility gap in the early 30s, suggesting more recent cohorts will need considerable childbearing in the 30s and early 40s to 'catch up' to earlier goals, yet low-parity women in their early 40s are decreasingly likely to have unfulfilled fertility desires or intentions to have children. Low-parity men in their early 40s, though, are increasingly likely to intend children. Declines in U.S. fertility thus seem to be largely driven not by changes in early-life fertility goals so much as either a decreasing likelihood of achieving earlier goals or, perhaps, shifts in the preferred timing of fertility that depress period measures.

Desired Fertility and Educational Aspirations: Adolescent Goals in Rapidly Changing Social Contexts.

Objective: This article analyzes the relationship between educational aspirations and fertility aspirations early in the life course in three different settings. Background: The negative relationship between women's educational attainment and childbearing is one of the most consistent associations in social science. Family scholars have a more limited understanding of the relationship between educational aspirations and fertility aspirations before childbearing or union formation. Method: The authors use data collected in Jalisco, Mexico; Gaza, Mozambique; and Chitwan Valley, Nepal as part of the Family Migration and Early Life Outcomes project. They estimate nested Poisson regressions to model the relationship between adolescent educational aspirations and desired family size, controlling for individual- and household-level sociodemographic variables as well as adolescent beliefs and values. Results: On average, adolescents who desire more education want fewer children in unadjusted models. In Mozambique and Nepal, this association is attenuated in models accounting for household characteristics. In Mexico, the association persists after incorporating these factors, but the inclusion of individual aspirations attenuates the relationship between educational aspirations and desired family size. In Mozambique, the association of educational aspirations with desired family size is moderated by gender. Conclusion: As young people enter adolescence, their desires for education and childbearing are inversely related, but the mechanisms driving this association vary across contexts. This variation may be related to linkages between education, social status, and family values.

Youth's Family and Non-Family Roles as Predictors of Subjective Adulthood in Three Low-Income Agricultural Settings.

Subjective adulthood, or feeling like an adult, captures identity development relative to the local context that shapes life course processes. Most research on this topic is conducted in wealthy developed countries. Instead, we draw on household-based survey data from the Family Migration and Early Life Outcomes project (FAMELO) to estimate ordinal logistic regression models predicting how often adolescents aged 11-17 in Jalisco, Mexico (n = 1,567); Gaza Province, Mozambique (n = 1,368); and the Chitwan Valley, Nepal (n = 1,898), identify as adults. The relationships between adult roles, family capital, youth characteristics, and youth's adult identities vary substantially across the sites. The findings highlight how the transition to adulthood reflects the cultural and structural conditions of adult identities.

When leaving is normal and staying is novel: Men's labor migration and women's employment in rural Mozambique.

Considerable cross-national research has examined the impact of international labor migration on livelihoods in sending households and communities. Although findings vary across contexts, the general underlying assumption of this research is that migration represents a novel income-generating alternative to local employment. While engaging with this assumption, we also argue that in many sending communities where labor migration has been going on for generations, it is the decision not to migrate and instead to pursue local livelihood opportunities that might constitute a true departure from the expected behavior. Importantly, both the decisions to migrate and not to migrate are part of a household strategy shaped by gendered negotiation and bargaining. Building on these propositions, we use rich survey data from rural Mozambique, a typical setting of long-established large-scale international male labor out-migration, to examine married women's gainful employment outside subsistence agriculture as it relates to their husbands' migration or local work. We find a somewhat lower likelihood of employment among migrants' wives, compared with nonmigrants' wives, and this pattern strengthens with increased duration of migration. However, we also find substantial differences among nonmigrants' wives: women married to locally employed men have themselves by far the highest probability of employment, while wives of nonemployed men are no different from migrants' wives, net of other factors. These findings are discussed in light of interconnected gendered complexities of both migration-related and local labor market constraints and choices.

Gender Differences in Adolescents' Work and Family Orientations in the United States.

We use the Education Longitudinal Study: 2002 to compare the perceived importance of work and family achievement among young women and men. We apply latent class analysis to identify distinct configurations of values, then examine associations between latent classes and educational and occupational expectations. Results show high ambitions for both work and family among both young women and men. Although young women are more likely than young men to report that marriage and family relationships are very important, differences are small. Young women are also more likely to value work-related outcomes and to hold high educational and occupational expectations.

Black-White Differences in Pregnancy Desire During the Transition to Adulthood.

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.

Bridewealth Marriage in the 21st Century: A Case Study from Rural Mozambique.

OBJECTIVE: This study examines trends over several decades in bridewealth marriage and analyzes the association of bridewealth with women's experiences in marriage in a rural sub-Saharan setting. BACKGROUND: Bridewealth - payments from the groom's to the bride's family as part of the marriage process - has long been a central element of kinship and marriage systems in patrilineal sub-Saharan Africa. This payment, which symbolizes the transfer of sexual and reproductive rights from the wife's to the husband's family, is grounded in a collectivist-oriented family system that closely ties women's status and value to their reproductive capacity. METHOD: The study draws on population-based longitudinal survey data collected in 2006, 2009, and 2011 from 1,552 women in rural Mozambique. We use multivariable regression to investigate whether year of marriage predicts being in a bridewealth marriage and whether bridewealth status predicts marital dissolution, women's decision-making autonomy, women's work outside of subsistence agriculture, or modern contraceptive use. RESULTS: The proportion of marriages involving bridewealth payment has declined over time. While no difference by bridewealth status exists in women's autonomy levels or modern contraceptive use, women in bridewealth marriages are less likely to divorce over a five-year period and less likely to work outside of subsistence agriculture, net of other factors. CONCLUSION: These findings reflect the complexity of a modernizing marriage system. With the decline of bridewealth marriage, its meaning has evolved, becoming increasingly indicative of individual wealth and status rather than family control.

Adolescent reproductive attitudes and knowledge effects on early adult unintended and nonmarital fertility across gender.

Theory and evidence suggest strong short-term effects of attitudes toward, and knowledge about, reproduction on women's fertility. Adolescent attitudes and knowledge may also have longer-term implications about the contexts women perceive as appropriate for childbearing and their capacity to manage their preferences. Although previous research on men's fertility is limited, theory would suggest the links between adolescent attitudes and knowledge and subsequent fertility would also exist for men (though perhaps in different ways given the gendered meanings of sex, contraception, and reproduction). We analyze the relationship between reproductive attitudes and knowledge in adolescence and unintended and nonmarital first and second births in early adulthood, using the National Longitudinal Study of Adolescent to Adult Health (N = 9,431). Adolescent reproductive attitudes, especially life course consequences of early childbearing, predict the intendedness and marital status of first and second births. Adolescent reproductive knowledge is more often linked to the context of second births than first births. These associations vary by gender, but the overall results suggest that fertility schemas developed during adolescence predict behavior into early adulthood.

Do Adolescent Sexual and Reproductive Attitudes and Knowledge Predict Men and Women's Adult Sexual Partnerships?

PURPOSE: Adolescence is a key stage for forming knowledge and attitudes about sex and reproduction that may have long-term implications for adult sexual behaviors. Gender differences in experiences and socialization processes may affect the links between adolescent characteristics and adult behaviors. METHODS: By following adolescent virgins aged 15 years and older from wave I through wave IV of the National Longitudinal Study of Adolescent to Adult Health (n = 4,152), we test whether adolescent boys' and girls' knowledge about, and attitudes toward, sex and reproduction influence the number of lifetime different-sex sexual partners and the likelihood of having concurrent sexual partners in adulthood, using negative binomial regression and logistic regression, respectively. Models are run separately by gender. RESULTS: Men and women who reported greater physical benefits of sex as adolescents reported more lifetime different-sex sexual partners and were more likely to have concurrent sexual partners in adulthood. For women, adolescent perceptions of more social costs to sex were linked to fewer lifetime sexual partners, whereas greater birth control confidence was linked to more sexual partners. Women who more strongly felt that avoiding sexually transmitted infections was a hassle during adolescence were less likely to have concurrent sexual partners as adults, and men who were more knowledgeable about condoms during adolescence were more likely to have concurrent sexual partners. CONCLUSIONS: Adolescent knowledge and attitudes about sex, contraception, and reproduction have implications for adult sexual behavior, but different aspects emerge as salient for men and women.

Men's migration and women's mortality in rural Mozambique.

Labor migration is widespread and growing across the world. As migration grows, the economic outcomes of migration increasingly diversify, and so do its consequences for the well-being and health of both migrants and non-migrating household members. A considerable body of scholarship has examined the effects of migration on the physical and mental health of 'left-behind' household members. The impact of migration on mortality, particularly of non-migrating marital partners, is less well understood. Addressing this gap, we use data from a longitudinal survey of married women conducted over twelve years in rural Mozambique to examine the association between men's labor out-migration and their non-migrating wives' mortality. The analyses detect no significant differences when comparing non-migrants' wives to migrants' wives in the aggregate but point to instructive variation among migrants' wives according to the economic success of migration, as measured by the effects of migration on the household's material well-being. Specifically, women married to less successful migrants had higher mortality risks over the project span than women married to more successful migrants, regardless of other individual and household-level factors. Importantly for this setting with high HIV prevalence, the advantage of wives of more successful migrants is significant for HIV/AIDS-unrelated deaths but not for HIV/AIDS-related deaths. We situate these findings within the cross-national scholarship on migration and health.

Preferences, Partners, and Parenthood: Linking Early Fertility Desires, Marriage Timing, and Achieved Fertility.

In the United States, underachieving fertility desires is more common among women with higher levels of education and those who delay first marriage beyond their mid-20s. However, the relationship between these patterns, and particularly the degree to which marriage postponement explains lower fertility among the highly educated, is not well understood. We use data from the National Longitudinal Survey of Youth 1979 cohort to analyze differences in parenthood and achieved parity for men and women, focusing on the role of marriage timing in achieving fertility goals over the life course. We expand on previous research by distinguishing between entry into parenthood and average parity among parents as pathways to underachieving, by considering variation in the impact of marriage timing by education and by stage of the life course, and by comparing results for men and women. We find that women with a bachelor's degree who desired three or more children are less likely to become mothers relative to women with the same desired family size who did not attend college. Conditional on becoming mothers, however, women with at least a bachelor's degree do not have lower completed family size. No comparable fatherhood difference by desired family size is present. Postponing marriage beyond age 30 is associated with lower proportions of parenthood but not with lower parity among parents. Age patterns are similar for women and men, pointing at social rather than biological factors driving the underachievement of fertility goals.

Abortion Access in Ohio's Changing Legislative Context, 2010-2018.

Objectives. To examine abortion utilization in Ohio from 2010 to 2018, a period when more than 15 abortion-related laws became effective.Methods. We evaluated changes in abortion rates and ratios examining gestation, geographic distribution, and abortion method in Ohio from 2010 to 2018. We used data from Ohio's Office of Vital Statistics, the Centers for Disease Control and Prevention's Abortion Surveillance Reports, the American Community Survey, and Ohio's Public Health Data Warehouse.Results. During 2010 through 2018, abortion rates declined similarly in Ohio, the Midwest, and the United States. In Ohio, the proportion of early first trimester abortions decreased; the proportion of abortions increased in nearly every later gestation category. Abortion ratios decreased sharply in most rural counties. When clinics closed, abortion ratios dropped in nearby counties.Conclusions. More Ohioans had abortions later in the first trimester, compared with national patterns, suggesting delays to care. Steeper decreases in abortion ratios in rural versus urban counties suggest geographic inequity in abortion access.Public Health Implications. Policies restricting abortion access in Ohio co-occur with delays to care and increasing geographic inequities. Restrictive policies do not improve reproductive health.

Changing Educational Differentials in Female Sterilization.

CONTEXT: Female surgical sterilization is widely used in the United States. Educational differentials in sterilization are large, but poorly understood. Improved understanding of these differences is important to ensure that all women have access to the full range of contraceptive methods. METHODS: Data from the National Survey of Family Growth (1973-2015) from 8,100 women aged 40-44 were used to describe trends in sterilization and other contraceptive methods by educational attainment. Demographic standardization was employed to examine how compositional changes in marital status and age at first birth contribute to aggregate changes in sterilization prevalence. RESULTS: In 1982, women with a high school diploma and those with at least a bachelor's degree reported similar levels of sterilization use (38% and 32%, respectively), but by 2011-2015, prevalence had declined to 19% among college-educated women and had increased to 44% among those with a diploma. The trend among college graduates was largely attributable to delayed fertility; all other things being equal, if their age at first birth had not increased, the prevalence of sterilization would have declined by approximately 3% instead of 14% between 1982 and 2002. Increased use of sterilization among women with a high school diploma was only weakly related to changes in birth timing and marital status. CONCLUSIONS: Among women with a high school diploma, elements other than childbearing and marital status-such as contraceptive preferences and access-appeared to influence their contraceptive behavior. Sterilization differentials between high school and college graduates may reflect or exacerbate other socioeconomic disparities that affect women's health and well-being.

Community gender systems and a daughter's risk of female genital mutilation/cutting: Multilevel findings from Egypt.

We tested a feminist social-ecological model to understand community influences on daughters' experience of female genital mutilation/cutting (FGMC) in Egypt, where over 90% of women ages 15-49 are cut. FGMC has potential adverse effects on demographic and health outcomes and has been defined as a human-rights violation. However, an integrated multilevel-level framework is lacking. We theorized that a more favorable community-level gender system, including stronger gender norms opposing FGMC and expanded extra-familial opportunities for women in the village or neighborhood, would be associated with a daughter's lower risk of FGMC and would strengthen the negative association of a mother's opposition to FGMC with her daughter's risk of cutting. Using a national sample of 14,171 mother-daughter dyads from the 2014 Egypt Demographic and Health Survey, we estimated multilevel discrete-time hazard models to test these relationships. Community gender norms opposing FGMC had significant direct, negative associations with the hazard that a daughter was cut, but women's opportunities outside the family did not. Maternal opposition to FGMC was negatively associated with cutting a daughter, and these associations were stronger where community opposition to FGMC and opportunities for women were greater. Results provided good support for a gender-systems framework of the multilevel influences on FGMC. Integrated, multilevel interventions that address gender norms about FGMC and structural opportunities for women in the community, as well as beliefs about the practice among the mothers of at-risk daughters, may be needed for sustainable declines in the practice.

Community Influences on Female Genital Mutilation/Cutting: A Comparison of Four Francophone West African Countries.

Despite long-term efforts to encourage abandonment of female genital mutilation/cutting (FGMC), the practice remains widespread globally. FGMC is situated in specific social and historical contexts, and both prevalence and rates of decline vary widely across practicing countries. However, cross-national comparative research on the determinants of FGMC is sparse. This paper adds to the limited body of rigorous, theoretically grounded quantitative studies of FGMC and takes a step toward advancing cross-national comparative research. We apply an integrated theoretical framework that brings together norms-based and gender-based explanations of community-level influences on FGMC. We test this framework in four francophone West African countries, drawing on comparable nationally representative data from the Demographic and Health Surveys in Burkina Faso (2010), Côte d'Ivoire (2011-2012), Guinea (2012), and Mali (2012-2013). Results show that community-level FGMC norms and community-level gendered opportunities are associated with girls' risk of FGMC, but that the direct and moderating associations vary qualitatively across countries. Our findings highlight the contribution of context-specific social and institutional processes to the decline or persistence of FGMC.

Pathways to Parenthood in Social and Family Context: Decade in Review, 2020.

OBJECTIVE: This article reviews research from the past decade on patterns, trends, and differentials in the pathway to parenthood. BACKGROUND: Whether, and under what circumstances, people become parents has implications for individual identity, family relationships, the well-being of adults and children, and population growth and age structure. Understanding the factors that influence pathways to parenthood is central to the study of families and can inform policies aimed at changing childbearing behaviors. METHOD: This review summarizes recent trends in fertility as well as research on the predictors and correlates of childbearing, with a focus on the United States and on research most relevant to family scholars. We document fertility differentials and prevailing explanations for variation across sub-groups and discuss alternative pathways to parenthood, such as adoption. The article suggests avenues for future research, outlines emerging theoretical developments, and concludes with a discussion of fertility policy. RESULTS: U.S. fertility has declined in recent years; whether fertility rates will increase is unclear. Elements of the broader social context such as the Great Recession and increasing economic inequality have impacted pathways to parenthood, and there is growing divergence in behaviors across social class. Scholars of childbearing have developed theories to better understand how childbearing is shaped by life course processes and social context. CONCLUSION: Future research on the pathways to parenthood should continue to study group differentials, refine measurement and theories, and better integrate men and couples. Childbearing research is relevant for social policy, but ideological factors impact the application of research to policy.

Adolescent Fertility Attitudes and Childbearing in Early Adulthood.

Teens' attitudes about adolescent childbearing predict childbearing in the short term. If these attitudes reflect persistent goals and values, they may also be linked to later outcomes. To test long-term linkages, we analyze the association of adolescent fertility attitudes with actual and prospective fertility in adulthood using Waves I (1994-95) and IV (2007-08) of the National Longitudinal Study of Adolescent to Adult Health and focusing on men (N = 4,275) and women (N=4,418) without a teen birth. For women, we find that more negative teen attitudes predict lower hazards of a first birth up to around age 30 but that teens' attitudes are unrelated to planned childlessness among those who have not yet had children. Men's adolescent attitudes are unrelated to actual fertility or prospective intentions. For both men and women, more advantaged individuals are less likely to have had a child by around age 30; socioeconomic advantage is also related to postponement of childbearing rather than planned childlessness, though more so for women than men. We interpret the findings as evidence that, for girls, teens' attitudes toward adolescent childbearing capture an internalization of social schema about childbearing, childrearing, and sequencing with other life outcomes but do not reflect overall preferences about having children. More work is needed to understand the psychosocial factors that influence men's fertility.

Intimate Relationship Dynamics and Changing Desire for Pregnancy Among Young Women.

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.

Teen Girls' Reproductive Attitudes and the Timing and Sequencing of Sexual Behaviors.

PURPOSE: Teen girls consider not only health outcomes, such as pregnancy or contracting a sexually transmitted infection (STI), but also social outcomes, such as guilt or embarrassment, when making decisions about sexual behaviors. METHODS: Following a sample of female virgins aged 15-18 years from wave I through wave IV of the National Longitudinal Study of Adolescent to Adult Health (N = 2,376), we tested whether adolescent girls' attitudes toward sex, contraception, pregnancy, and STIs influence the timing of coital debut, using discrete time event history logistic regression, and whether oral sex precedes coital debut, using logistic regression. RESULTS: Concerns about negative social consequences of sex were associated with later coital debut (adjusted odds ratio [AOR]=.79, p = .000), whereas perceived physical benefits of sex and positive attitudes toward contraception were associated with earlier coital debut (AOR = 1.09, p = .049 and AOR = 1.17, p = .002, respectively). Worries about pregnancy were not associated with the timing of coital debut but did predict having oral sex before vaginal sex (AOR = 1.33, p = .007). Favorable birth control attitudes and positive attitudes toward sex also increased the odds of oral sex before vaginal sex (AOR = 1.38, p = .008 and AOR = 1.47, p = .000, respectively). CONCLUSIONS: Teen girls' worries about the emotional and social consequences of sex may be a more salient predictor of the timing of coital debut than concerns about the risk of pregnancy or STIs. Teen girls' fears coexist with positive views about sex and contraception, which are associated with earlier sex and sexual sequencing.