Patterns of contraception utilization among reproductive-aged women with thyroid cancer undergoing radioiodine ablation: A study at Hasan Sadikin Hospital.

The incidence of new cases of thyroid cancer worldwide is around 10.1/100.000 in woman dan 3.1/100.000 in men. Women with thyroid cancer are advised to avoid pregnancy while undergoing radioablation due to teratogenicity. Therefore, it is crucial to utilize contraception to avoid pregnancy during treatment. The purpose of this study was to determine the characteristics of contraceptive use patterns in women with thyroid cancer of reproductive age who underwent radioablation at Hasan Sadikin Hospital Bandung.Cross-sectional study conducted at Hasan Sadikin Hospital Bandung in May 2023. The research sample was all female thyroid cancer of reproductive age who underwent radioablation at the Nuclear Medicine polyclinic of Dr. Hasan Sadikin Bandung in January-December 2022 by purposive sampling. Data obtained from patient medical records and primary data from patients. A total of 450 patients fulfilled inclusion criteria, but only 329 analyzed with complete data. Majority of the patient was in age group 35-49 years (58.1%), parity >1 (55.9%), last education high school (39.2%), married (81.8%), type of papillary thyroid carcinoma (79.9%), sources of information about contraception from doctors (71.7%), and 75.4% use contraception. The most widely used type of contraception was intrauterine device (IUD), accounting for 28.6% patients. Approximately 75.4% patient use contraception. The most widely used type of contraception is the IUD. Contraception counselling is important for increasing contraceptive use rates among women with thyroid cancer. Further research in the form of analytical research is needed to assess the factors that influence contraceptive use in women with thyroid cancer of reproductive age.

L'incidence des nouveaux cas de cancer de la thyroïde dans le monde est d'environ 10,1/100 000 chez la femme et 3,1/100 000 chez l'homme. Il est conseillé aux femmes atteintes d'un cancer de la thyroïde d'éviter une grossesse lorsqu'elles subissent une radioablation en raison de la tératogénicité. Il est donc crucial d'utiliser une contraception pour éviter une grossesse pendant le traitement. Le but de cette étude était de déterminer les caractéristiques des modes d'utilisation des contraceptifs chez les femmes atteintes d'un cancer de la thyroïde en âge de procréer qui ont subi une radioablation à l'hôpital Hasan Sadikin de Bandung. Étude transversale menée à l'hôpital Hasan Sadikin de Bandung en mai 2023. L'échantillon de recherche était entièrement cancer de la thyroïde chez la femme en âge de procréer qui a subi une radioablation à la polyclinique de médecine nucléaire du Dr Hasan Sadikin Bandung en janvier-décembre 2022 par échantillonnage raisonné. Données obtenues à partir des dossiers médicaux des patients et des données primaires des patients. Au total, 450 patients remplissaient les critères d'inclusion, mais seulement 329 ont été analysés avec des données complètes. La majorité des patients appartenaient à la tranche d'âge 35-49 ans (58,1%), parité >1 (55,9%), dernier diplôme d'études secondaires (39,2%), mariés (81,8%), type de carcinome papillaire de la thyroïde (79,9%), sources d'information sur la contraception auprès des médecins (71,7 %) et 75,4 % utilisent la contraception. Le type de contraception le plus utilisé était le dispositif intra-utérin (DIU), représentant 28,6 % des patientes. Environ 75,4 % des patientes utilisent une contraception. Le moyen de contraception le plus utilisé est le DIU. Les conseils en matière de contraception sont importants pour augmenter les taux d'utilisation des contraceptifs chez les femmes atteintes d'un cancer de la thyroïde. Des recherches supplémentaires sous forme de recherches analytiques sont nécessaires pour évaluer les facteurs qui influencent l'utilisation de la contraception chez les femmes atteintes d'un cancer de la thyroïde en âge de procréer.

Characterizing Family Planning Utilization in Adult Women and Adolescents in Pohnpei, Federerated States of Micronesia.

INTRODUCTION: Increasing family planning xutilization in low-income countries to improve health outcomes of women and children is a global priority. The Federated States of Micronesia (FSM) has poor maternal child health outcomes; therefore, this study aimed to examine family planning utilization in Pohnpei State, FSM. METHODS: This cross-sectional study sought to characterize family planning utilization in adult women of reproductive age and high school age adolescents in Pohnpei using representative survey data collected in 2019 (N = 570 and N = 1726, respectively). Chi-square tests were used to determine significant factors associated with family planning utilization. RESULTS: Among adult women of reproductive age (18-49 years old) not trying to get pregnant, 31.6% reported using contraception during last intercourse. Contraceptive use was significantly lower among younger women (18-24 years old) (21.7%, p = 0.021), unmarried women (18.6%, p < 0.001), those without health insurance (28.7%, p = 0.030), those who have never had a pap smear (20.5%, p < 0.001), and those who have never been pregnant (14.5%, p < 0.002). Among adolescents who reported being sexually active, 28.5% reported using any contraception at last intercourse and 22.6% reported using a condom at last intercourse. Condom use among sexually active adolescents was lowest among 12th graders (13.5%, p < 0.001) and girls (16.8%, p = 0.004). CONCLUSIONS: Our findings suggest that young, unmarried, never pregnant women face an unmet need for family planning. Additionally, women with lower access to and use of healthcare services have lower use of family planning.

Knowledge of non-contraceptive benefits of and willingness to consider taking oral contraceptive pills among a low-risk female population: a cross-sectional study.

BACKGROUND: In addition to its widely-appreciated contraceptive applications, the oral contraceptive pill (OCP) conveys both oncological and non-oncological benefits. Oncological benefits include a decreased risk of endometrial, ovarian, and colorectal cancer. Non-oncological benefits include reducing androgenic effects and alleviating menstruation-related problems. This study aimed to ascertain knowledge levels of non-contraceptive benefits and risks of OCP use among participants without contraindications to OCPs. This study also assessed factors associated with participants being more likely to consider taking OCPs. METHODS: 263 women aged 21 to 40 years old with no contraindications for OCP usage participated in this study. An anonymous questionnaire collected sociodemographic information and assessed participants' knowledge of the non-contraceptive benefits and risks associated with OCP use. Multivariate linear regression was used to assess factors associated with knowledge levels. Multivariate logistic regression was used to investigate factors associated with being more likely to consider taking OCPs among women who did not presently take them. RESULTS: Multivariate logistic regression revealed that participants who were more knowledgeable overall about the non-contraceptive benefits of OCPs were more likely to consider taking OCPs (coefficient = 0.184, p-value = 0.00). Knowledge of both oncological and non-oncological benefits of OCP use was relatively poor, especially among older women. Current OCP users were found to be more knowledgeable about their benefits. CONCLUSIONS: As women with greater knowledge of non-contraceptive benefits of OCPs are more likely to consider taking them, knowledge gaps regarding OCPs should be filled, so that more women may reap the non-contraceptive benefits of OCPs.

A sample of women with a low risk profile for oral contraceptive pills in Singapore demonstrated poor overall knowledge of their non-contraceptive benefits. Greater knowledge of the non-contraceptive benefits of oral contraceptive pills was associated with a greater willingness to consider taking oral contraceptive pills.

Uso de método anticonceptivo previo al embarazo, asesoramiento y preferencia posterior en puérperas del Hospital de Clínicas / Use of contraceptive method prior to pregnancy, counseling and subsequent preference in postpartum women at Hospital de Clínicas / Uso de método contraceptivo antes da gravidez, aconselhamento e posterior preferência em puérperas no Hospital de Clínicas

Los derechos sexuales y reproductivos son derechos que todo individuo debe conocer. La planificación familiar se logra mediante la utilización de métodos anticonceptivos. Si bien se ofrece un amplio abanico de estos en el hospital, no todos reciben orientación, siendo el periodo grávido-puerperal una oportunidad única para realizar la consejería en anticoncepción. El objetivo es evaluar el uso de anticonceptivos previo al embarazo, el asesoramiento durante el puerperio y la elección de anticonceptivo posterior en una población de este hospital. Se realizó un estudio observacional descriptivo transversal realizado a partir de encuesta durante el puerperio de las puérperas del Hospital de Clínicas, en el periodo 01/02/2019 a 31/07/2019. Se evaluaron 220 pacientes. 79,5% de los embarazos no fue planificado. Del total de entrevistadas 35,5% no utilizaba método anticonceptivo previo al embarazo y 33% no habían tenido asesoramiento. Previo al embarazo, los anticonceptivos más usados fueron los anticonceptivos orales combinados (64,1%) y 50% refiere un uso no correcto. 81,6% recibió asesoramiento durante le puerperio. Los anticonceptivos que las pacientes refieren haber recibido mayor información durante el puerperio fueron: implante subdérmico (65,8%) y DIU (48%). 44,1% no recibió información de las contraindicaciones y efectos adversos. Los anticonceptivos más elegidos fueron: implante subdérmico (41,4%), ligadura tubaria (21,8%) y DIU (14,5%). La eficacia (60,1%) y facilidad de uso (43,9%) fueron los motivos más frecuentes de elección. La mayoría de los embarazos fueron no planificados y casi una tercera parte no utilizaba método anticonceptivo previo y nunca habían recibido asesoramiento. Durante el puerperio, la mayoría refiere haber sido asesorada en planificación familiar y optado por alguno de los métodos anticonceptivos siendo los más frecuentemente elegidos los métodos reversibles de larga duración por su facilidad de uso y eficacia.

Sexual and reproductive rights are rights that every individual must know. Family planning is achieved through the use of contraceptive methods. Although a wide range of these are offered in the hospital, not all of them receive counseling, and the pregnancy-puerperal period is a unique opportunity to carry out contraception counseling. The objective is to evaluate the use of contraceptives prior to pregnancy, counseling during the puerperium and the choice of later contraception in a population of this hospital. A cross-sectional descriptive study was carried out based on a survey during the puerperium of the puerperal women of the Hospital de Clínicas, in the period 01/02/2019 to 31/07/2019. 220 patients were evaluated. 79.5% of the pregnancies were unplanned. Of the total interviewed, 35.5% did not use contraception prior to pregnancy and 33% had not had counseling. Before pregnancy, the most used contraceptives were combined oral contraceptives (64.1%) and 50% reported incorrect use. 81.6% received counseling during the puerperium. The contraceptives that the patients reported having received more information during the puerperium were: subdermal implant (65.8%) and IUD (48%). 44.1% did not receive information on contraindications and adverse effects. The most chosen contraceptives were: subdermal implant (41.4%), tubal ligation (21.8%) and IUD (14.5%). Efficacy (60.1%) and ease of use (43.9%) were the most frequent reasons for choice. Most of the pregnancies were unplanned and almost a third were not using prior contraception and had never received counseling. During the puerperium, the majority reported having been counseled on family planning and opted for one of the contraceptive methods, the long-lasting reversible methods being the most frequently chosen for their ease of use and efficacy.

Os direitos sexuais e reprodutivos são direitos que todo indivíduo deve conhecer. O planejamento familiar é realizado por meio do uso de métodos anticoncepcionais. Embora muitos deles sejam oferecidos no hospital, nem todos recebem aconselhamento, e o período gravídico-puerperal é uma oportunidade única para realizar aconselhamento anticoncepcional. O objetivo é avaliar o uso de anticoncepcionais antes da gravidez, o aconselhamento durante o puerpério e a escolha da contracepção posterior em uma população deste hospital. Realizou-se estudo transversal descritivo com base em inquérito no puerpério das puérperas do Hospital de Clínicas, no período de 02/01/2019 a 31/07/2019. 220 pacientes foram avaliados. 79,5% das gestações não foram planejadas. Do total de entrevistadas, 35,5% não usavam anticoncepcionais antes da gravidez e 33% não haviam feito aconselhamento. Antes da gravidez, os anticoncepcionais mais usados eram os anticoncepcionais orais combinados (64,1%) e 50% relataram o uso incorreto. 81,6% receberam aconselhamento durante o puerpério. Os contraceptivos que as pacientes relataram ter recebido mais informações durante o puerpério foram: implante subdérmico (65,8%) e DIU (48%). 44,1% não receberam informações sobre contra-indicações e efeitos adversos. Os anticoncepcionais mais escolhidos foram: implante subdérmico (41,4%), laqueadura (21,8%) e DIU (14,5%). Eficácia (60,1%) e facilidade de uso (43,9%) foram os motivos de escolha mais frequentes. A maioria das gestações não foi planejada e quase um terço não estava usando anticoncepcionais anteriores e nunca havia recebido aconselhamento. No puerpério, a maioria relatou ter sido orientada sobre planejamento familiar e optado por um dos métodos contraceptivos, sendo os métodos reversíveis de longa duração os mais escolhidos pela facilidade de uso e eficácia.

Contraceptive use and access among deployed US servicewomen: findings from an online survey.

BACKGROUND/INTRODUCTION: This study aimed to survey US servicewomen on their contraceptive access and use during deployment. METHODS: Between June 2016 and July 2017, we conducted a cross-sectional online survey among a convenience sample of current and former members of the US Military, National Guard and Reserves who had a deployment ending in 2010 or later. Participants were asked open-ended and closed-ended questions about their demographics and contraceptive use and access before and during their last deployment. Descriptive statistics were run on closed-ended questions and responses to open-ended questions were inductively coded. RESULTS: A total of 353 participants were included. Sixty-five per cent reported using contraception during all or part of their last deployment. Nearly half (49.3%) did not have or remember having a discussion with a military care provider about contraception prior to deployment. Both prior to and during deployment, the free or low cost of birth control and ability to get a full supply for deployment facilitated contraceptive use. Difficulty obtaining an appointment and the inability to get a full supply of birth control were barriers to contraception access both before and during deployment. Half (49.1%) of respondents who had to start or refill contraception during deployment said it was somewhat or very difficult to do so. CONCLUSIONS: For at least some servicewomen, there are barriers to contraceptive access and use prior to and during overseas deployment. Programmes to increase contraceptive access should be expanded and monitoring systems should be implemented to ensure all servicemembers receive predeployment contraceptive counselling.

Association between young women's physical and mental health and their method of contraception in a longitudinal, population-based study.

BACKGROUND: Women's physical and mental health are strongly inter-related and may influence patterns of contraceptive use. We examined the longitudinal associations between young women's physical and mental health and method of contraceptive use over a 5-year period. METHODS: Data from 4952 young women (≤27 years) participating in the Australian Longitudinal Study on Women's Health who completed four self-reported surveys between 2013 and 2017 were analysed. Women's contraceptive use was categorised as: contraceptive pill/oral contraceptives, long-acting reversible contraception (LARC), condom, other methods and none. Multinomial logistic regression was used to determine the longitudinal associations between women's physical and mental health and method of contraception. RESULTS: Over the 5-year period the percentage of pill users decreased from 60% (95% CI 58% to 61%) to 41% (95% CI 39% to 42%) and LARC users increased from 13% (95% CI 12% to 14%) to 21% (95% CI 20% to 22%) as did non-users from 9% (95% CI 8% to 9%) to 17% (95% CI 16% to 18%). Compared with women using the pill, women who used LARCs were more likely to be overweight (OR 1.34; 95% CI 1.17 to 1.53) and obese (OR 1.84; 95% CI 1.55 to 2.19), current smokers (OR 1.45; 95% CI 1.23 to 1.71) and reported fair or poor general health (OR 1.50; 95% CI 1.28 to 1.76) and very high levels of psychological distress (OR 1.47; 95% CI 1.24 to 1.76). Similar results were also found among women who used condoms or no contraception. CONCLUSIONS: Findings suggest that obesity, smoking and poor physical and mental health play an important role in young women's contraceptive use.

Evaluation of the frequency of coitus interruptus and the effect of contraception counselling on this frequency.

In this prospective study, the aim was to determine the frequency and effectiveness of the coitus interruptus method, to compare the demographic characteristics of women using modern contraception methods and those using the coitus interruptus method and to demonstrate how effective contraceptive counselling is in choosing a contraception method. The researchers collected data from 1000 sexually active women in their reproductive period at the gynaecological clinic of a university hospital in Turkey. The researchers used an introductory information contraceptive counselling form, which they prepared for the data collection tool. The rate of the coitus interruptus method use among the interviewed women was 42.8%. There was a statistically significant difference between the coitus interruptus group and the group using modern contraceptive methods regarding mean age, educational status, smoking, awareness of last menstrual period, number of pads used during the menstrual period, and information sources. Following effective contraception counselling, the rate of switching to a modern and proven contraceptive method was found to be 73.8%.Impact statementWhat is already known on this subject? Although the traditional method of coitus interruptus has been used for many years, its incidence is not clearly known. What we know about the subject is based on ancient research. All the studies on the subject are very old and need to be updated.What do the results of this study add? With the help of the data obtained from this study, it is understood that withdrawal method is still widely used today, it is still not known that it is not a modern contraceptive method and the rate of transition to modern methods with effective contraception counselling is very high.What are the implications of these findings for clinical practice and/or further research? In the outpatient clinic conditions, even a very short period of time for contraception counselling will be very beneficial for women and will contribute to family planning and prevent unwanted pregnancies.

Gynecological Care and Contraception Considerations in Women with Cerebral Palsy.

The purpose of this literature review was to further explore gynecological care and contraceptive use in women with cerebral palsy. We address barriers to pelvic examinations for cervical cancer screenings and current contraceptive methods in severely debilitated patients with cerebral palsy.

Contraception Counseling and Use Among Adolescent and Young Adult Female Patients Undergoing Cancer Treatment: A Retrospective Analysis.

STUDY OBJECTIVE: Adolescent and young adult (AYA) women undergoing cancer treatment face unique reproductive health risks. This study aimed to assess the prevalence of sexual health counseling and contraception use in the oncology setting, and to identify patient factors associated with these outcomes. DESIGN: Retrospective chart review. SETTING: Yale New Haven Hospital from 2013 to 2018. PARTICIPANTS: Female patients 15-25 years of age receiving cancer treatment, excluding those treated with surgery only. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Outcomes of documented sexual health counseling and contraception use were assessed for frequency. Associations between patient factors and these outcomes were assessed using Pearson χ2 and Fisher exact tests, and multivariate logistic regression was used to identify predictors of these outcomes. RESULTS: In this cohort (n = 157), the median age was 20.5 years, and the most common diagnoses were hematologic (40.8%) and thyroid (31.2%) malignancies. Of the patients, 33.1% were documented as receiving sexual health counseling, and 48.4% used contraception. Younger patients (15-20 years of age) were less likely to receive counseling (OR 0.31, 95% CI 0.14-0.70, P = .005). Receiving counseling (OR 3.36, 95% CI 1.35-8.34, P = .009) and sexual activity (OR 4.18, 95% CI 1.80-9.68, P = .001) were significantly associated with contraception use. CONCLUSIONS: Sexual health counseling was documented infrequently during oncologic care for AYA women, especially for younger patients. However, such conversations were associated with a higher likelihood of contraception use. There is a need to improve rates of counseling in this high-risk setting, in which adolescents may be more vulnerable with regard to sexual health.

The socioeconomic and lifestyle determinants of contraceptive use among Chinese college students: a cross-sectional study.

BACKGROUND: Chinese youth have become more sexually active over the years, yet their behaviours of contraceptive use are influenced by socioeconomic and lifestyle factors. This study aimed to investigate the socioeconomic and lifestyle determinants of contraceptive use among Chinese college students, and to investigate quantitatively their reasons for choosing different contraceptive methods. METHODS: The study used the data from a cross-sectional survey, which was conducted in 2015 among 17,517 students from 130 colleges and professional schools in mainland China. Chi-square tests were performed to test the differences in the awareness and uses of contraceptives between male and female students. Multivariable logistic regression models were used to analyse the associations between socioeconomic and lifestyle factors and contraceptive uses. RESULTS: Condoms (95%), oral contraceptives (91%) and emergency contraceptives (71%) were the most commonly known contraceptive methods among the sample of Chinese youth that were surveyed. Among male participants, high monthly expenditure (OR = 1.37, 95%CI: 1.07-1.75), light alcohol consumption (OR = 1.47, 95%CI: 1.03-2.11), and high sexual knowledge (OR = 1.96, 95%CI: 1.57-2.45) were positively associated with contraceptive uses, while tobacco use (OR = 0.47, 95%CI: 0.23-0.95) showed a negative association with contraceptive uses. Among female students, suburban residency (OR = 1.38, 95%CI: 1.03-1.83), high level of parental education (OR = 1.96, 95%CI: 1.19-3.22), moderate alcohol consumption (OR = 2.66, 95%CI: 1.05-6.77), and high sexual knowledge (OR = 1.50, 95%CI: 1.18-1.91) were positively associated with contraceptive uses, while tobacco use (OR = 0.60, 95%CI: 0.36-0.99) showed a negative association. CONCLUSIONS: A series of socioeconomic and lifestyle factors were associated with contraceptive choices among Chinese college students. Targeted sexual education programs are in demand to improve the awareness and the use of contraceptives in this population.

A Population-Based Study of Factors Associated with Postpartum Contraceptive Use by Birth Interval Length.

OBJECTIVE: The purpose of this study was to evaluate factors associated with postpartum contraceptive use among women with short and moderate-to-long birth intervals using population-based data from the Pregnancy Risk Assessment and Monitoring System. METHODS: Because only Mississippi and Tennessee include a question about birth interval length on their Pregnancy Risk Assessment and Monitoring System survey, this analysis was limited to women from those states who reported information on this variable (N = 2198). Demographic, lifestyle, and reproductive data, including information on postpartum contraceptive use, were obtained from surveys and birth certificates. Logistic regression was used to obtain odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: Nearly 90% of women reported currently using a form of contraception during the postpartum period. In the unadjusted model, among women with short birth intervals, there was no association between alcohol consumption during pregnancy and postpartum contraceptive use (OR 1.03, 95% CI 0.15-7.31); however, smoking during pregnancy was associated with a decreased odds of postpartum contraceptive use (OR 0.70, 95% CI 0.25-1.96). Among women with moderate-to-long birth intervals, alcohol use during pregnancy was associated with a decreased odds (OR 0.71, 95% CI 0.28-1.80) and smoking during pregnancy was associated with an increased odds (OR 1.18, 95% CI 0.60-2.30) of postpartum contraceptive use. Regardless of birth interval length, women with no health insurance had a decreased odds of postpartum contraceptive use when compared with women with health insurance (short birth interval: OR 0.89, 95% CI 0.32-2.49 and moderate-to-long birth interval: OR 0.85, 95% CI 0.52-1.39). Among women with short birth intervals, non-Hispanic black women had a decreased odds of postpartum contraceptive use (OR 0.14, 95% CI 0.03-0.64) and women who were unmarried or had a history of preterm delivery had an increased odds of postpartum contraceptive use (unmarried: OR 5.81, 95% CI 1.26-26.69 and preterm delivery: OR 4.19, 95% CI 1.42-12.37, respectively) after adjustment for confounders. Among women with moderate-to-long birth intervals, individuals who identified as Hispanic/mixed race/other had a statistically significant decreased odds of postpartum contraceptive use after adjustment (OR 0.43, 95% CI 0.18-0.99). CONCLUSIONS: Findings underscore the importance of postpartum medical visits for all women, regardless of birth interval length. Certain groups of women may need additional counseling regarding the importance of using contraceptives to prevent another closely spaced or unintended pregnancy.

Factores socioeducativos asociados al no uso de métodos anticonceptivos en universitarias de cuatro países de Latinoamérica / Socio-educational factors associated with the non-use of contraceptive methods in university students from four Latin American countries

INTRODUCCIÓN: El cuidado anticonceptivo es importante una vez que se inicia la vida sexual, pero esto no ha sido medido en distintas realidades de Latinoamérica. OBJETIVO: Determinar los factores socio-educativos asociados al no uso de métodos anticonceptivos en universitarias de cuatro países de Latinoamérica. METODOLOGÍA: Estudio transversal analítico, se encuestó a estudiantes mujeres que ya habían iniciado su vida sexual, se le preguntó por el uso de condón (preservativo), método del ritmo, anticoncepción oral y anticoncepción oral de emergencia. Estas fueron descritas y asociadas a variables socio-educativas. RESULTADOS: El 7% (47) no usaba ninguno de los 4 métodos anticonceptivos; al realizar el análisis multivariado, no hubo diferencias estadísticamente significativas según el país, el año de estudios o si eran católicas/cristianas (todos los valores p>0,05), en cambio, las de universidades particulares tuvieron un mayor porcentaje de ausencia de uso de los 4 métodos anticonceptivos (RPa: 2,52; IC95%: 1,24-5,14; valor p=0,010). Según el uso de alguno de los 4 métodos, el país donde se encuestó tuvo muchas diferencias entre el uso de uno u otro método; el año de la carrera no estuvo asociado al no uso de alguno de los cuatro métodos; las que fueron católicas o cristianas usaron menos la anticoncepción oral (p<0,001) y las que estudiaban en universidades particulares usaron más el método del ritmo (p<0,05). CONCLUSIONES: Un porcentaje importante no usó ninguno de los cuatro métodos anticonceptivos más comunes, estando esto asociado al tipo de universidad.

INTRODUCTION: The care of contraception is important once you start the sex lives, but this hasn't been measured in different realities of Latin-America. OBJECTIVE: To determine the socio-educational factors associated with non-use of contraceptive methods in universities in four Latin American countries. METHODOLOGY: Cross-sectional study. Surveyed women students, who have started their sexual lives. They were asked about the use of condoms, rhythm method, birth control pills and next day pill. These're described and associated to variables socio-educational. RESULTS: 7% (47) did not use any of the 4 contraceptive methods; when performing the multivariate analysis, there were no statistically significant differences by country, the year of study or if they were Catholic/Christian (all values p>0.05), on the other hand, those of particular universities had a higher percentage of non- take care of yourself with one of the 4 methods (RPa: 2,52; IC95%: 1,24-5,14; value p=0,010). According to the use of one of the 4 methods, the country where it was surveyed had many differences between the use of one or the other method; the year of the degree was not associated with the non-use of any of the four methods; those who were Catholic or Christian used less oral contraception (p <0.001) and those who studied at private universities used the rhythm method more (p <0.05). CONCLUSIONS: A significant percentage did not use any of the four most common contraceptive methods, this being associated with the type of university.

Emergency contraceptive pill use among women in Denmark, Norway and Sweden: Population-based survey.

INTRODUCTION: Emergency contraceptive pill (ECP) use is reported to have increased in several countries over time. In this multi-country population-based questionnaire study, we aimed to describe the patterns of ECP use and identify factors associated with its use. MATERIAL AND METHODS: In 2011-2012, women aged 18-45 years were randomly selected from national registers in Denmark, Norway and Sweden and invited to respond to questions related to lifestyle and contraceptive use. We used generalized logistic models to estimate odds ratios (ORs) and 95% confidence intervals (CI) comparing women who had used ECP with women who had never used ECP. RESULTS: Of the 45 445 women, 33.9% (Denmark = 32.3%, Norway = 35.1%, Sweden = 34.6%) had used ECP at least once in their lifetime. Among ECP users, 15.8% had used ECP within the last year and 50.0% had used ECP more than once in their life. After adjusting for country, age at response and response type, ECP use was associated with higher education (OR 2.09, 95% CI 1.54-2.84) and being single, divorced or widowed (OR 3.17, 95% CI 2.87-3.49). Binge drinking and smoking increased the odds of ECP use. Furthermore, early age at first intercourse (OR 1.29, 95% CI 1.08-1.55), having a new partner in the last 6 months (≥3 partners: OR 6.44, 95% CI 5.46-7.60) and lack of condom use with a recent new partner (OR 1.42, 95% CI 1.22-1.66) were found to be associated with ECP use. CONCLUSIONS: Our study shows that ECP use is common among Scandinavian women. Higher education and being single were associated with increased odds of ECP use. Risk behaviors such as smoking and early age at first sex were also associated with increased odds of ECP use. Since ECP use is not protective against sexually transmitted infections, our findings highlight the need to encourage awareness and regular use of condoms to prevent sexually transmitted diseases in women.

An Internet-Based, Peer-Delivered Messaging Intervention for HIV Testing and Condom Use Among Men Who Have Sex With Men in India (CHALO!): Pilot Randomized Comparative Trial.

BACKGROUND: Leveraging internet-based communication tools (eg, messaging apps, SMS text messaging, and email) may be an effective avenue for delivery of HIV prevention messages to men who have sex with men (MSM) in India, but there are limited models for such internet-based interventions. OBJECTIVE: The CHALO! pilot was an online educational and behavioral intervention aimed to determine the feasibility, acceptability, and preliminary impact of a peer-delivered, internet-based messaging intervention for HIV testing and consistent condom use for MSM in India. The messages addressed barriers to HIV testing and condom use and were theoretically based on the information-motivation-behavioral skills model. METHODS: Between February and March 2015, we recruited, enrolled, and randomized 244 participants via online advertisements on mobile dating apps and Facebook. Eligible men (18 years or older, sexually active with other men, and self-reported HIV-negative or unknown status) were randomized to receive educational and motivational messages framed as either approach (ie, a desirable outcome to be achieved) or avoidance (an undesirable outcome to be avoided) over 12 weeks via internet-based messaging platforms. Participants completed online surveys at baseline and immediately postintervention. RESULTS: Participants were similar across arms with respect to sociodemographic and behavioral characteristics. Over 82.0% (200/244) of participants were retained (ie, viewed final messages), and 52.3% (130/244) of them completed the follow-up survey. Of those completing the follow-up survey, 82.3% (107/130) liked or strongly liked participating in CHALO!. The results showed a significant increase in self-reported HIV testing in the past 6 months from baseline to follow-up (41/130, 31.5% to 57/130, 43.8%; P=.04). When including those who reported intentions to test, this percentage increased from 44.6% (58/130) at baseline to 65.4% (85/130) at follow-up (P<.01). When examining intentions to test among those without prior HIV testing, intentions increased from 32% (16/50) of the sample at baseline to 56% (28/50) of the sample at follow-up (P=.02). Condom use during anal sex did not significantly change from baseline to follow-up. HIV testing and condom use did not significantly differ between approach and avoidance conditions at follow-up. CONCLUSIONS: As one of the first studies of an online HIV prevention intervention for Indian MSM, CHALO! was feasible to implement by a community-based organization, was acceptable to participants, and demonstrated potential to improve HIV testing rates.

Post-abortion contraception before hospital discharge after installation of a surveillance network in Brazil.

OBJECTIVE: To evaluate the use of contraception soon after abortion, ectopic, or molar pregnancy following the establishment of a surveillance network (MUSA). METHODS: A cross-sectional study of women admitted for abortion, or ectopic or molar pregnancy at UNICAMP Women's Hospital (part of the MUSA Network), Campinas, Brazil, between July 2017 and August 2019. Clinical and sociodemographic data were compared between women who initiated contraception before discharge and those who did not by using a Cochran-Armitage test and multiple logistic regression. RESULTS: Overall, 382 women were enrolled (mean ± SD age, 29.6 ± 7.4 years). Most women (287, 75.2%) had abortions, and 146 (38.2%) initiated contraception before hospital discharge. The most common contraceptives were injectables (75, 51.4%) followed by pills (65, 44.5%). Use of contraception increased during the study period (Z=3.69, P<0.01), mostly due to injectables (Z=3.84, P<0.01). Factors independently associated with contraceptive initiation were admission in 2019 (odds ratio [OR], 2.65; 95% confidence interval [CI], 1.36-5.17) and not having an abortion for legal reasons (OR, 3.54; 95% CI, 1.30-9.62). CONCLUSION: Implementation of a surveillance network optimized the health service and quality of care. There was an increase in contraception use and a vulnerable population was identified.

Evidence on factors influencing contraceptive use and sexual behavior among women in South Africa: A scoping review.

INTRODUCTION: Contraceptive use and sexual health behavior remain a prominent public health concern in South Africa (SA). Despite many government interventions, unintended pregnancies and termination of pregnancies remain relatively high. This review aimed to map evidence on factors influencing contraceptive use and sexual behavior in SA. METHODS: We conducted a scoping review guided by Arksey and O'Malley's framework. We searched for articles from the following databases: PubMed/MEDLINE, American Doctoral Dissertations via EBSCO host, Union Catalogue of Theses and Dissertations (UCTD) and SA ePublications via SABINET Online and World Cat Dissertations, Theses via OCLC and Google Scholar. Studies published from January 1990 to March 2018 were included. We used the Population, Concept, and Context (PCC) framework and the PRISMA chart to report the screening of results. The Mixed Method Appraisal Tool (MMAT) version 11 and ACCODS tools were used to determine the quality of the included studies. RESULTS: A total of 2030 articles were identified by our search criteria for title screening. Only 21 studies met our inclusion criteria and were included in quality assessment stage. We found that knowledge of a contraceptive method, length of a relationship, sexual debut, age difference between partners availability of a contraceptive method, long waiting hours, and nurse's attitudes toward human immunodeficiency virus (HIV) positive or younger clients predict whether or not women use a contraceptive method or improve sexual behavior. CONCLUSION: There remains a necessity for improving educational programs aimed at transferring knowledge on contraceptives and sexual behavior to both women and their male counterparts, alongside the public health systems' improvements.

Contraceptive use among women with cystic fibrosis: A pilot study linking reproductive health questions to the Cystic Fibrosis Foundation National Patient Registry.

OBJECTIVES: To examine contraceptive use, pregnancy intention and the association of hormonal contraceptive type with adverse health outcomes among women with cystic fibrosis (CF). STUDY DESIGN: We recruited 150 women with CF, ages 18-49 from three adult CF programs to complete an online survey regarding their pregnancy and contraceptive use history. Survey findings were merged with retrospective clinical information from the CF Foundation Patient Registry (CFFPR). We used descriptive analyses to report contraceptive method and pregnancy frequencies, and logistic regression to examine the association between contraceptive method type and adverse health outcomes. RESULTS: Combined hormonal contraceptives were the most commonly used methods (42%), followed by condoms (34%), and long-acting reversible contraceptives methods (27%). Thirty-three percent (n = 50) reported ever being pregnant, half of whom reported having at least one unplanned pregnancy. We found no significant association for mucoid Pseudomonas aeruginosa infection among progestin-only (aOR 1.53, 95% CI 0.07-32.2) and estrogen-containing hormonal contraceptive users (aOR 3.9, 95 % CI 0.20-76.5). Risk of osteoporosis was elevated among women with CF who used depot-medroxyprogesterone acetate compared to non-users (OR 5.36, 95% CI 1.00-29.12). CONCLUSIONS: Both contraceptive use and unplanned pregnancy among women with CF are common. Associations between hormonal contraceptive use and adverse pulmonary or bone outcomes among women with CF are inconclusive due to the study s small sample size. Larger studies are warranted. IMPLICATIONS: Women with CF should be informed about the risks and benefits of contraceptives in the context of their disease. CFFPR data capturing contraceptive method use may be the most efficient way to elucidate the association of hormonal contraceptives on disease in women with CF.

Sex Without Contraceptives in a Multicenter Study of Adolescent Emergency Department Patients.

OBJECTIVES: In the United States, rates of teenage pregnancy and sexually transmitted infections (STIs) remain exceptionally high, and racial and ethnic disparities persist. Emergency departments (EDs) care for over 19 million adolescents each year, the majority being minority and low socioeconomic status. Single-center studies demonstrate infrequent use of contraceptives among adolescent ED patients and an association between risky sex and behaviors such as alcohol and drug use; however, no multicenter ED data exist. The objectives of this study were to 1) determine the prevalence of sex without contraceptives in a large multicenter adolescent ED study and 2) assess patient demographic and risky behaviors associated with sex without contraceptives. METHODS: Participants aged 14 to 17 years (n = 3,247) in 16 pediatric EDs across the United States completed an electronic survey. Questions focused on validated measures of risky sex; use of alcohol, tobacco, marijuana, and other drugs; and depression and violence. In this secondary analysis, we constructed univariable and multivariable models to identify demographic and behavioral factors associated with sex without contraceptives (our primary outcome), separately for adolescent males and females. RESULTS: In the prior year, 17.4% (236/1,356) of males and 15.8% (299/1,891) of females had sex without contraceptives. In the multivariable model, sex without contraceptives for both genders was more likely among teens who were black, with conduct problems and participated in casual sex, binge drinking, or cannabis use. Sex without contraceptives was also more likely among Hispanic and cigarette-smoking males, as well as depressed females. CONCLUSIONS: Adolescent ED patients across the United States are participating in risky sexual behaviors that increase their likelihood of pregnancy and STI acquisition. These adolescents report a number of problem behaviors, including substance use, which are strongly correlated with unprotected sex. The ED visit may be an opportunity to identify at-risk adolescent patients, address risky behaviors, and intervene to improve adolescent health.

[Unexpected pregnancy, experience of sexual violence and contraception among women who use cannabis or other illegal substance in the Great Paris Region: Data from the 2016 Health Barometer]. / Grossesses non prévues, violences sexuelles et contraception chez les femmes consommant du cannabis ou d'autres substances psychoactives illégales en Île-de-France : données du Baromètre Santé 2016.

BACKGROUND: Women who use psychoactive substances could have higher levels of unplanned pregnancy and of difficulties accessing long-term contraceptive methods than those who do not use these substances. General population data on this topic are rare, particularly in France. METHODS: This study is based on data from the French Health Survey 2016, collected from women aged 15 to 49 years and living in the Great Paris region (N=1626). Use of illegal psychoactive substances (cannabis, substances used via intranasal or intravenous administration) were evaluated over the lifecourse and, for cannabis, over the 12 months preceding the study. Unplanned pregnancies were ascertained over the preceding 5 years, emergency contraception, abortion, and the experience of sexual violence during the lifecourse. We also studied the number of sexual partners in the preceding 12 months, as well as current contraception. Data were analyzed using weighted logistic regression models, adjusted for participants' sociodemographic characteristics and tobacco use. RESULTS: Women who use illegal substances have a higher probability than non-users to experience an unplanned pregnancy in the preceding 5 years (OR associated with lifecourse cannabis use: 1.61, 95% CI 1.00-2.58), to have used emergency contraception (ORs between 2.20 to 2.90), to have had an abortion (OR associated with lifecourse cannabis use: 1.77, 95% CI 1.26-2.49), and to have experienced sexual violence (ORs between 1.87 to 3.14). They also had more sexual partners than non-users, but did not differ in terms of contraception. CONCLUSION: In the general population, there is a relationship between women's use of illegal substances and their probability of experiencing sexual violence. These results should be brought to the attention of health professionals in contact with women, to help identify those who have addictive behaviors and identify their sexual and reproductive health needs.

Choices and services related to contraception in the Gaza strip, Palestine: perceptions of service users and providers.

BACKGROUND: Reliable contraception enables women and men to plan their family sizes and avoid unintended pregnancies, which can cause distress and anxiety, but also increase maternal mortality. This study explored potential barriers to contraceptive use for women in the Gaza Strip, Palestine from user and provider perspectives. METHODS: A convenient sample was used to recruit women, who were current contraception users, from three healthcare clinics that provide family planning care, two governmental and one non-governmental. A 16-item questionnaire was completed by 204 women, including socio-demographic data, contraceptive use and eight questions exploring user experience. Additionally, 51 women attended focus groups for a deeper insight into their contraceptive use experience and potential barriers. Furthermore, 14 healthcare providers were interviewed about their experience with service provision. Quantitative data are presented as means and frequencies and qualitative data were analysed item by item and are presented in themes jointly with the quantitative data. RESULTS: Women reported usage of only three main modern methods of contraception with 35.2% using intrauterine devices, 25.8% combined oral contraception and 16.4% condoms, while only 3.1% used the hormonal implant. Expectations from family planning services were low with most women attending the clinic having already decided their contraceptive method with decisions being made by husbands (41.2%) or women jointly with their partner (33.3%), only 13.7% took advice from service providers. Healthcare providers experienced high prevalence of beliefs that modern contraceptives cause infertility and cancer. Main barriers to effective family planning services were misconceptions of potential harm, poor availability and limited choice of contraceptive methods. CONCLUSION: Women's contraceptive choices in Gaza are limited by prevalent misconceptions and fears as well as recurring shortages, negatively impacting fertility control. Men are a major factor in choosing a contraceptive method, however, they have limited access to information and therefore, potentially more misconceptions. Therefore, male community members need to be included in the delivery of information on contraceptives to increase women's choice. Furthermore, greater access to long-acting reversible contraceptives, such as the hormonal implant, and improved availability might be key factors in improving contraceptive uptake in Gaza and, thus, reducing unintended pregnancies.