Withdrawal method inquiries and user experiences: An analysis of content posted on 4 gendered forums on Reddit.

OBJECTIVES: Limited research and guidance on the use of "withdrawal" or coitus interruptus for contraception lead to inconsistent or even inaccurate physician recommendations regarding its use. Consequently, patients rely on online communities to learn about this commonly used contraceptive method. To identify knowledge gaps and concerns between men and women, as well as explore how they use withdrawal, we examined withdrawal-related posts on the popular internet discussion forum, Reddit. STUDY DESIGN: To explore gendered variations in withdrawal-related Reddit posts, we extracted posts from the gendered forums: "TwoXChromosomes," "Askwomen," "Askmen," and "OneY" between 2010 and 2019 that contained the search terms: "coitus interruptus," "withdrawal," "pull out," "preejaculate," or "precum." We developed an initial codebook with expected codes and augmented it with emerging findings from a random sampling of 10% of posts. We revised iteratively for interrater agreement, after which researchers coded the remaining posts independently. RESULTS: Of 269 withdrawal-related queries, 19% were submitted by men; 81% referenced the contributor's own withdrawal use. Salient domains included: concerns about pregnancy risk (59%), how to effectively use withdrawal (13%), benefits/pleasure from using withdrawal (12%), impact on personal life/relationship (9%), and problems encountered, inclusive of consent (7%). Posts to female-focused forums more frequently inquired about pregnancy risk, while those on male forums more frequently inquired about withdrawal-related logistics (p < 0.001); domains were not associated with contributor gender. CONCLUSION: Withdrawal-related queries within this Reddit sample are frequently posted by women, the majority of whom want to understand their risk of pregnancy with withdrawal. Research operationalizing withdrawal and more accurately estimating withdrawal-related pregnancy risk is warranted. IMPLICATIONS: Reddit users discuss their personal experiences with withdrawal as contraception, as well as seek advice regarding its use from the online community. Pregnancy risk, logistics of use, and ongoing stigma are salient topics. Further research on pregnancy risk, operationalizing success, and approaches for discussing this behavioral method is warranted.

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.

Correlates of use of withdrawal for contraception among women in Vietnam.

BACKGROUND: Despite its relatively low effectiveness, withdrawal is a common contraceptive practice. In Vietnam, health concerns about hormonal contraception are strong and account for substantial method discontinuation. Given the paucity of evidence on withdrawal, our objective was to identify correlates of using withdrawal among women not desiring pregnancy. METHODS: We conducted a secondary analysis of data from a cross-sectional study of sexually-active adult women attending a public hospital in Hanoi, who did not desire pregnancy. We enrolled a stratified sample of women using the intrauterine device, combination oral contraception, or neither method. Participants completed a questionnaire on demographics and reproductive history and behaviors. We used multinomial logistic regression to evaluate correlates of using a tier 3 contraception method (without withdrawal) and using withdrawal (alone or with a tier 3 method) compared to the referent category of using a tier 1 or 2 method (without withdrawal). RESULTS: Of the 489 participants in the analysis, 52.3% reported using tier 1 or 2 method (without withdrawal); 19.8% reported tier 3 contraception (without withdrawal) and 27.9% reported using withdrawal (alone or with a tier 3 method). Compared to those using a tier 1 or 2 method, women using withdrawal had lower odds of reporting that avoiding pregnancy was very important or important to them (aOR, 0.4; 95% CI, 0.3-0.7). Women using withdrawal had higher odds of reporting that their husband/partner refuses to give them money for household expenses, even when he has the money (aOR, 2.8; 95% CI, 1.4-5.6). CONCLUSIONS: Women using withdrawal might have less relationship power than nonusers. They also might rely on the practice because they are more ambivalent about pregnancy.

History of unintended pregnancy and patterns of contraceptive use among racial and ethnic minority women veterans.

BACKGROUND: Nearly half of all pregnancies in the United States each year are unintended, with the highest rates observed among non-Hispanic black and Hispanic women. Little is known about whether variations in unintended pregnancy and contraceptive use across racial and ethnic groups persist among women veteran Veterans Affairs users who have more universal access than other populations to health care and contraceptive services. OBJECTIVES: The objectives of this study were to identify a history of unintended pregnancy and describe patterns of contraceptive use across racial and ethnic groups among women veterans accessing Veterans Affairs primary care. STUDY DESIGN: Cross-sectional data from a national random sample of women veterans (n = 2302) aged 18-44 years who had accessed Veterans Affairs primary care in the previous 12 month were used to assess a history of unintended pregnancy (pregnancies reported as either unwanted or having occurred too soon). Any contraceptive use at last sex (both prescription and nonprescription methods) and prescription contraceptive use at last sex were assessed in the subset of women (n = 1341) identified as being at risk for unintended pregnancy. Prescription contraceptive methods include long-acting reversible contraceptive methods (intrauterine devices and subdermal implants), hormonal methods (pill, patch, ring, and injection), and female or male sterilization; nonprescription methods include barrier methods (eg, condoms, diaphragm), fertility-awareness methods, and withdrawal. Multivariable logistic regression models were used to examine the relationship between race/ethnicity with unintended pregnancy and contraceptive use at last sex. RESULTS: Overall, 94.4% of women veterans at risk of unintended pregnancy used any method of contraception at last sex. Intrauterine devices (18.9%), female surgical sterilization (16.9%), and birth control pills (15.9%) were the 3 most frequently used methods across the sample. Intrauterine devices were the most frequently used method for Hispanic, non-Hispanic white, and other non-Hispanic women, while female surgical sterilization was the most frequently used method among non-Hispanic black women. In adjusted models, Hispanic women (adjusted odds ratio, 1.60, 95% confidence interval, 1.15-2.21) and non-Hispanic black women (adjusted odds ratio, 1.84, 95% confidence interval, 1.44-2.36) were significantly more likely than non-Hispanic white women to report any history of unintended pregnancy. In the subcohort of 1341 women at risk of unintended pregnancy, there were no significant racial/ethnic differences in use of any contraception at last sex. However, significant differences were observed in the use of prescription methods at last sex. Hispanic women (adjusted odds ratio, 0.51, 95% confidence interval, 0.35-0.75) and non-Hispanic black women (adjusted odds ratio, 0.69, 95% confidence interval, 0.51-0.95) were significantly less likely than non-Hispanic white women to have used prescription contraception at last sex. CONCLUSION: Significant racial and ethnic differences exist in unintended pregnancy and contraceptive use among women veterans using Veterans Affairs care, suggesting the need for interventions to address potential disparities. Improving access to and delivery of patient-centered reproductive goals assessment and contraceptive counseling that can address knowledge gaps while respectfully considering individual patient preferences is needed to support women veterans' decision making and ensure equitable reproductive health services across Veterans Affairs.

Development of Novel Male Contraceptives.

Unintended pregnancy is surprisingly common, accounting for 40-50% of pregnancies worldwide. Contraception is the most effective means of preventing unintended pregnancy. Seventy percent of all contraceptives are used by women; however, some women are unable to use contraceptives due to health conditions or side effects. Many men wish to take a more active role family planning, but currently have only two effective male contraceptive options, condoms and vasectomy. Therefore, work to develop novel male contraceptives analogous to popular female methods, such as daily pills or long-acting shots and implants, is underway. This paper will briefly discuss the pros and cons of condoms and vasectomies, and then review the research into novel methods of male contraception.

The views of Somali religious leaders on birth spacing - A qualitative study.

BACKGROUND: Birth spacing is an important health intervention for women to attain good physical and mental health. In Somalia, religious leaders play a decisive role in approving or rejecting the use of family planning. OBJECTIVE: The study aimed to investigate Somali Islamic religious leaders' views on birth spacing. METHOD: Qualitative individual interviews were conducted with 17 Somali Islamic religious leaders aged 28-59 years and analysed through content analysis. RESULTS: The main category that emerged from the analysis was that the concept "birth spacing should be used and nor family planning to be in accordance with the Islamic religion. Two perspectives of views of birth spacing were identified: accepted ways and unaccepted ways. The accepted ways include breastfeeding, use of contraceptives causing no harm to the women's health, and coitus interruptus. The preferred method should be determined by a joint agreement between the husband and wife, and that Muslim doctors should play a key role while the couples investigate their preferred method. Using contraceptives with the intention to limit the number of children was against Islamic values and practice. In addition, it was believed that using condoms promoted the temptation to engage in sex outside the marriage and was therefore prohibited. CONCLUSION: According to the religious Islamic leaders, selected practice recommendations for contraceptive use is permitted in relation to birth spacing to promote the health of the mother and child. When providing professional contraceptive counselling to Muslim women, the word "birth spacing" is recommended to be used instead of "family planning".

Human papilloma virus vaccination and attitudes towards contraception: a cross-sectional study.

Objective: Human papilloma virus (HPV) vaccination may result in misconceptions that encourage young women to adopt risky contraceptive practices. The purpose of this article was to investigate whether HPV vaccination status was associated with choice of contraceptive method and adoption of risky sexual behaviour. Methods: Vaccinated and non-vaccinated visitors to a university department paediatric and adolescent gynaecology clinic were asked to anonymously fill in a survey comprising questions on sociodemographic characteristics, sexual history, opinions on contraception and attitudes towards contraception. Results: A total of 191 women were studied, 75 (39.3%) of whom had received the HPV vaccination and 116 (60.7%) of whom had not. The main contraceptive methods used in both groups were male condom (46%), emergency contraception (14%) and coitus interruptus (12%). The vaccinated group was less religious and had better educated mothers compared with the non-vaccinated group (relative risk [RR] 0.64; 95% confidence interval [CI] 0.45, 0.93; p = .016 vs RR 1.91; 95% CI 1.01, 3.63; p = .027, respectively). They also had an earlier sexual debut (RR 1.94; 95% CI 1.06, 3.55; p = .015), agreed that vaccination increased the safety of sex (RR 1.45; 95% CI 1.02, 2.05; p = .039) and considered the HPV vaccine a prerequisite to initiation of a sexual relationship (RR 1.87; 95% CI 1.34, 2.63; p < .001). Conclusion: HPV vaccination did not affect sexual behaviour, attitudes to condom use or choice of contraceptive method.

Contraception.

Contraception counseling and provision are vital components of comprehensive health care. Unplanned pregnancy can be devastating to any woman but is particularly dangerous for those with chronic illness. Internal medicine providers are in a unique position to provide contraception, as they often intersect with women at the moment of a new medical diagnosis or throughout care for a chronic problem. A shared decision-making approach can engage patients and ensure that they choose a contraceptive method that aligns with their reproductive plans and medical needs.

Global Contraceptive Failure Rates: Who Is Most at Risk?

Contraceptive failure is a major contributor to unintended pregnancy worldwide. DHS retrospective calendars, which are the most widely used data source for estimating contraceptive failure in low-income countries, vary in quality across countries and surveys. We identified surveys with the most reliable calendar data and analyzed 105,322 episodes of contraceptive use from 15 DHSs conducted between 1992 and 2014. We estimate contraceptive method-specific 12-month failure rates. We also examined how failure rates vary by age, education, socioeconomic status, contraceptive intention, residence, and marital status using multilevel piecewise exponential hazard models. Our failure rate estimates are significantly lower than results from the United States and slightly higher than previous studies that included more DHS surveys, including some with lower-quality data. We estimate age-specific global contraceptive failure rates and find strong, consistent age patterns with the youngest users experiencing failure rates up to ten times higher than older women for certain methods. Failure also varies by socioeconomic status, with the poorest, and youngest, women at highest risk of experiencing unintended pregnancy due to failure.

Predictors of contraceptive switching and discontinuation within the first 6 months of use among Highly Effective Reversible Contraceptive Initiative Salt Lake study participants.

BACKGROUND: Nearly half of women will switch or discontinue using their selected contraceptive method in the first year. Research on early switching or discontinuation provides important clinical and public health insights, although few studies have assessed associated factors, particularly among longitudinal cohorts. OBJECTIVE: The current study explores attributes associated with early contraceptive method switching or discontinuation (<6 months of initiation) among participants enrolled in the intervention cohorts of the Highly Effective Reversible Contraceptive Initiative Salt Lake Contraceptive Initiative (Utah, United States). MATERIALS AND METHODS: Highly Effective Reversible Contraceptive Initiative Salt Lake participants have access to no-cost contraception for 3 years. This includes both the initial selection and the ability to switch or to discontinue methods without cost. Methods available included the following: nonhormonal behavioral methods (male/female condoms, withdrawal, diaphragms, cervical caps, and fertility awareness); short-acting methods (pill, patch, ring, and injectable); and long-acting methods (intrauterine devices and contraceptive implants). Participants completed surveys at baseline and at 1, 3, and 6 months. We collected data on participant demographics, contraceptive continuation, switching, and discontinuation, as well as factors associated with these changes, including established measures of pregnancy intention and ambivalence and reasons for switching or discontinuing. We conducted descriptive statistics, univariable, and multivariable Poisson regression analyses to assess predictors of both discontinuation and switching. We also conducted χ2 analyses to compare reported reasons for stopping between switchers and discontinuers. RESULTS: At 6 months, 2,583 women (70.0%) reported continuation of their baseline method, 367 (10%) reported at least 1 period of discontinuation, 459 (12.4%) reported switching to a different method, and 279 (7.6%) did not provide 6-month follow-up. Factors associated with discontinuation included selection of a short-acting method (incidence rate ratio [IRR], 2.49; 95% confidence interval [CI], 1.97, 3.12), report of Hispanic ethnicity (IRR, 1.45; 95% CI, 1.12, 1.89) and nonwhite race (IRR, 1.48; 95% CI, 1.08, 2.02), and having any future pregnancy plans, even years out. Participants with some college education were less likely to report discontinuation (IRR, 0.73; 95% CI, 0.57, 0.94). Selecting a short-acting method at baseline was also associated with increased likelihood of method switching (IRR, 2.29, 95% CI, 1.87, 2.80), as was having 2 or more children (IRR, 1.37; 95% CI, 1.08, 1.74). Women were less likely to switch if they were on their parents' insurance (IRR, 0.74; 95% CI, 0.56, 0.99). Among participants who switched methods, 36.9% switched to a long-acting reversible method, 31.7% switched to a short-acting hormonal method, and 31.1% switched to a nonhormonal behavioral method, such as condom use. Of participants providing a reason for stopping, 454 women (73.2%) reported side effects as 1 reason for switching or discontinuing their initial method. CONCLUSION: Early contraceptive method switching and discontinuation are frequent outcomes of contraceptive use. These changes are common even with removal of contraceptive access barriers.

Preventing syndemic Zika virus, HIV/STIs and unintended pregnancy: dual method use and consistent condom use among Brazilian women in marital and civil unions.

Syndemic Zika virus, HIV and unintended pregnancy call for an urgent understanding of dual method (condoms with another modern non-barrier contraceptive) and consistent condom use. Multinomial and logistic regression analysis using data from the Pesquisa Nacional de Demografia e Saúde da Criança e da Mulher (PNDS), a nationally representative household survey of reproductive-aged women in Brazil, identified the socio-demographic, fertility and relationship context correlates of exclusive non-barrier contraception, dual method use and condom use consistency. Among women in marital and civil unions, half reported dual protection (30% condoms, 20% dual methods). In adjusted models, condom use was associated with older age and living in the northern region of Brazil or in urban areas, whereas dual method use (versus condom use) was associated with younger age, living in the southern region of Brazil, living in non-urban areas and relationship age homogamy. Among condom users, consistent condom use was associated with reporting Afro-religion or other religion, not wanting (more) children and using condoms only (versus dual methods). Findings highlight that integrated STI prevention and family planning services should target young married/in union women, couples not wanting (more) children and heterogamous relationships to increase dual method use and consistent condom use.

Satisfaction with the use of contraceptive methods among women from primary health care services in the city of São Paulo, Brazil / Satisfação com o uso de métodos contraceptivos entre usuárias de unidades básicas de saúde da cidade de São Paulo

Abstract Objectives: to assess satisfaction with the use of contraceptive methods among women attending primary health care services in São Paulo, Brazil. Methods: crosssectional study conducted with a sample of 668 women aged 1849 years, who were enrolled in 38 primary health care facilities in São Paulo city, Brazil, in 2015. Exclusion criteria were no sexual initiation, use of irreversible contraceptive methods for more than five years, pregnancy and no contraceptive method use. Data were analyzed using chisquare and multivariate logistic regression. Results: in general, women were satisfied with current contraceptive method (78.7%). The higher percentage of satisfaction was observed among IUD users (94.7%), and female and male sterilization users (93.5% and 91.7%, respectively). Withdrawal users were less satisfied (52.9%). Contraceptive method itself was the only factor associated with satisfaction. Barrier or traditional method users were less likely to be satisfied with their contraceptive methods than irreversible method users. Conclusions: long acting contraceptive method and irreversible method users were more satisfied with their contraceptive methods. Efforts should be undertaken in order to make these contraceptives available and accessible in primary health care facilities in Brazil.

Resumo Objetivos: avaliar a satisfação com o método contraceptivo em uso entre usuárias de unidades básicas de saúde da cidade de São Paulo/SP. Métodos: estudo transversal conduzido com 668 mulheres com idade entre 18 e 49 anos, usuárias de 38 unidades básicas de saúde da cidade de São Paulo, Brasil, em 2015. Foram excluídas mulheres que não haviam iniciado a vida sexual, tinham feito laqueadura/parceiro foi vasectomizado há mais de cinco anos, estavam grávidas e não usavam métodos contraceptivos. Dados foram analisados usando teste de diferença entre proporções pelo quiquadrado e regressão logística múltipla. Resultados: a maior parte das mulheres estava satisfeita com o método contraceptivo utilizado (78,7%). A maior satisfação foi observada entre usuárias do DIU (94,7%), da laqueadura (93,5%) e vasectomia (91,7%). A menor satisfação foi entre usuárias de coito interrompido (52,9%). O tipo de método foi o único aspecto associado à satisfação com o método contraceptivo. Mulheres que usavam métodos de barreira ou tradicionais tiveram menos chance de estar satisfeitas com o método usado, quando comparadas às mulheres queusavam métodos irreversíveis. Conclusões: usuárias de métodos contraceptivos de longa duração ou irreversíveis relataram estar mais satisfeitas. Esforços devem ser empreendidos para que esses métodos estejam disponíveis nas unidades básicas de saúde e o acesso a eles seja facilitado.

Unmarried Men's Contraceptive Use at Recent Sexual Intercourse: United States, 2011-2015.

Contraception is used to help prevent unintended pregnancies and sexually transmitted infections (STI). Higher percentages of pregnancies to unmarried persons are unintended than for those who are married (1). Patterns of contraceptive use as reported by women, including differences by marital status, are well documented using National Survey of Family Growth (NSFG) data (2­4); however, less research focuses on contraceptive use as reported by men. Using 2011­2015 NSFG data from men, with selected time trends, this data brief describes contraceptive use at last recent vaginal sexual intercourse (within 3 months) among unmarried men, focusing primarily on male methods of contraception (condom, withdrawal, and vasectomy).

Trends of contraception use among married reproductive age women: Tehran lipid and glucose cohort study 2002-2011.

OBJECTIVES: This study aimed to examine the trends of contraception use among married reproductive age women in Tehran Lipid and Glucose study between 2002 and 2011. METHODS: This analysis investigated a proportion of women users and non-users of family planning, using data from 10year population-based Tehran Lipid Glucose Study from surveys conducted in 2002, 2005, 2008, and 2011. Of the 6813, 6993, 7077, and 6789 women in the four phases mentioned, 34.1%, 33.9%, 33.5% and 35% of participants in each phase preferred to use contraception. Number of participants studied were 2506 women in 2002, 2529 women in 2005, 2594 women in 2008 and 2525 women in 2011. RESULTS: Types of methods and patterns of change in contraception differed across time. The percentage of women using traditional methods increased significantly from 25.7% in 2002 to 34.6% in 2011 (p value for trend=0.001). Accordingly, modern contraception use showed a reverse trend. From 2002 to 2011, 61.4%, 61%, 57.7%, and 51% of married women reported currently using various modern contraceptives, respectively (p value for trend=0.001). The proportion of users relying on condoms showed a significant increase during this decade, being 10.9% in 2002, 15.2% in 2005, 20% in 2008 and 21.9% in 2011. The prevalence of non-users for contraception was generally low; 12.7%, 8.2%, 8% and 14.3%, respectively from 2002 to 2011, but increased significantly across time (p=0.005) CONCLUSION: Relying on less effective contraceptive methods has increased rapidly among women in the Tehran Lipid and Glucose cohort study, a trend that could be a warning to policy makers about the possibility of higher unsafe abortion and maternal mortality/morbidity rates in the near future.

Contraceptive Failure in the United States: Estimates from the 2006-2010 National Survey of Family Growth.

CONTEXT: Contraceptive failure rates measure a woman's probability of becoming pregnant while using a contraceptive. Information about these rates enables couples to make informed contraceptive choices. Failure rates were last estimated for 2002, and social and economic changes that have occurred since then necessitate a reestimation. METHODS: To estimate failure rates for the most commonly used reversible methods in the United States, data from the 2006-2010 National Survey of Family Growth were used; some 15,728 contraceptive use intervals, contributed by 6,683 women, were analyzed. Data from the Guttmacher Institute's 2008 Abortion Patient Survey were used to adjust for abortion underreporting. Kaplan-Meier methods were used to estimate the associated single-decrement probability of failure by duration of use. Failure rates were compared with those from 1995 and 2002. RESULTS: Long-acting reversible contraceptives (the IUD and the implant) had the lowest failure rates of all methods (1%), while condoms and withdrawal carried the highest probabilities of failure (13% and 20%, respectively). However, the failure rate for the condom had declined significantly since 1995 (from 18%), as had the failure rate for all hormonal methods combined (from 8% to 6%). The failure rate for all reversible methods combined declined from 12% in 2002 to 10% in 2006-2010. CONCLUSIONS: These broad-based declines in failure rates reverse a long-term pattern of minimal change. Future research should explore what lies behind these trends, as well as possibilities for further improvements.

Construção do roteiro do vídeo educativo para pessoas surdas sobre o uso do coito interrompido / Construction of educational video roadmap for deaf persons on the use of coitus interruptus

O coito interrompido é praticado no mundo inteiro, com prevalência de uso estimada em cerca de 38 milhões de casais por ano. Pessoas surdas enfrentam barreira comunicativa, o que dificulta o acesso a conhecimentos acerca da saúde sexual e reprodutiva. Disseminação de informações acessíveis sobre o assunto é um dos elementos que contribuem para que tabus sejam revistos e, consequentemente, seu exercício seja possível, saudável e seguro. A Enfermagem tem utilizado tecnologias assistivas com esse público, para promover ações de saúde nos diversos ambientes de educação. Objetivou-se construir roteiro do vídeo educativo acessível para surdos sobre o uso do coito interrompido, bem como validar instrumento de validação de conteúdo educativo. Estudo de desenvolvimento de Tecnologia Assistiva, elaborado no período de fevereiro a dezembro de 2016, no Laboratório de Comunicação em Saúde do Departamento de Enfermagem da Universidade Federal do Ceará. Participaram cinco especialistas de conteúdo, três técnicos em roteiro de vídeo educativo, 11 da área de saúde e educação para validação do instrumento de medida. Dados obtidos foram organizados no Excel e analisados pelo software SPSS. Utilizou-se estatística descritiva e inferencial através de frequências absolutas, relativas e coeficiente de correlação intraclasse. Estudo aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal do Ceará sob parecer 1.520.285. Acerca da avaliação geral do roteiro do vídeo, foi considerado válido por todos os especialistas. Verificou-se que tanto os especialistas de conteúdo quanto os técnicos aprovaram com modificações. Dentre as modificações sugeridas, houve a ampliação de informações atualizadas e completas sobre o tema proposto; substituição de termos técnicos por linguagem coloquial; modificação do título do roteiro; diminuição de cenas explicativas, expositivas e consequentemente aumento do dinamismo dos diálogos; e retirada de cenas de reportagem. No que diz respeito ao Instrumento de Validação de Conteúdo Educativo, composto por três domínios, a saber, objetivos, estrutura e apresentação e relevância, considerou-se validado (ICC 0,877, p<0,001). Ademais, os itens do instrumento total apresentaram boa confiabilidade interna quanto aos seus domínios. Dessa forma, Instrumento de Validação de Conteúdo Educativo foi considerado uma ferramenta válida para ser utilizado em processos de elaboração e validação de conteúdos educativos de forma confiável. Conclui-se que a construção do roteiro do vídeo educativo como tecnologia assistiva para surdos contribua para o entendimento a respeito do coito interrompido, sendo viável e necessária a esta população. (AU)

Construção do roteiro do vídeo educativo para pessoas surdas sobre o uso do coito interrompido / Construction of educational video roadmap for deaf persons on the use of coitus interruptus

O coito interrompido é praticado no mundo inteiro, com prevalência de uso estimada em cerca de 38 milhões de casais por ano. Pessoas surdas enfrentam barreira comunicativa, o que dificulta o acesso a conhecimentos acerca da saúde sexual e reprodutiva. Disseminação de informações acessíveis sobre o assunto é um dos elementos que contribuem para que tabus sejam revistos e, consequentemente, seu exercício seja possível, saudável e seguro. A Enfermagem tem utilizado tecnologias assistivas com esse público, para promover ações de saúde nos diversos ambientes de educação. Objetivou-se construir roteiro do vídeo educativo acessível para surdos sobre o uso do coito interrompido, bem como validar instrumento de validação de conteúdo educativo. Estudo de desenvolvimento de Tecnologia Assistiva, elaborado no período de fevereiro a dezembro de 2016, no Laboratório de Comunicação em Saúde do Departamento de Enfermagem da Universidade Federal do Ceará. Participaram cinco especialistas de conteúdo, três técnicos em roteiro de vídeo educativo, 11 da área de saúde e educação para validação do instrumento de medida. Dados obtidos foram organizados no Excel e analisados pelo software SPSS. Utilizou-se estatística descritiva e inferencial através de frequências absolutas, relativas e coeficiente de correlação intraclasse. Estudo aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal do Ceará sob parecer 1.520.285. Acerca da avaliação geral do roteiro do vídeo, foi considerado válido por todos os especialistas. Verificou-se que tanto os especialistas de conteúdo quanto os técnicos aprovaram com modificações. Dentre as modificações sugeridas, houve a ampliação de informações atualizadas e completas sobre o tema proposto; substituição de termos técnicos por linguagem coloquial; modificação do título do roteiro; diminuição de cenas explicativas, expositivas e consequentemente aumento do dinamismo dos diálogos; e retirada de cenas de reportagem. No que diz respeito ao Instrumento de Validação de Conteúdo Educativo, composto por três domínios, a saber, objetivos, estrutura e apresentação e relevância, considerou-se validado (ICC 0,877, p<0,001). Ademais, os itens do instrumento total apresentaram boa confiabilidade interna quanto aos seus domínios. Dessa forma, Instrumento de Validação de Conteúdo Educativo foi considerado uma ferramenta válida para ser utilizado em processos de elaboração e validação de conteúdos educativos de forma confiável. Conclui-se que a construção do roteiro do vídeo educativo como tecnologia assistiva para surdos contribua para o entendimento a respeito do coito interrompido, sendo viável e necessária a esta população. (AU)

Presencia o ausencia de espermatozoides en el líquido preeyaculatorio / Presence or absence of sperm in the pre ejaculatory fluid

Objetivo. Determinar la presencia o ausencia de espermatozoides en el líquido preeyaculatorio. Material y métodos. Estudio descriptivo, transversal, realizado en 25 varones universitarios, voluntarios, entre 18-25 años en Barranquilla, Colombia. A cada sujeto se le entregaron 2 portaobjetos para la toma del líquido preeyaculatorio y un recipiente para la toma de muestra del líquido seminal; se tomó primero y por autoestímulo la muestra preeyaculatoria y posteriormente la muestra para el espermiograma; la búsqueda de espermatozoides en el líquido preeyaculatorio se realizó en al menos 10 campos a un aumento de ×20 y en los 2 portaobjetos. El líquido seminal se procesó según normas de la OMS. Resultados. Los líquidos preeyaculatorios examinados no tenían espermatozoides. Todos los sujetos del estudio tenían espermiogramas con recuento total de espermatozoides superiores a 100 millones de espermatozoides, una movilidad superior al 50%; el pH promedio fue de 8,2±0,5. Conclusiones. El líquido preeyaculatorio secretado por las glándulas de Cowper y Littre durante la estimulación sexual no contiene espermatozoides, siempre que haya al menos 2 días de abstinencia eyaculatoria previa y, por lo tanto, no puede ser responsable de los embarazos ocurridos en la práctica del contacto sexual del pene sobre los genitales externos femeninos ni en la práctica del coito interrumpido como método anticonceptivo (AU)

Objective. To determine the presence or absence of sperm in pre ejaculate fluid. Material and methods. A descriptive, cross-sectional study in 25 college male volunteers, aged between 18 and 25 in Barranquilla (Colombia). Each subject was given two slides for making pre-ejaculatory fluid and a container for sampling of seminal fluid; pre-ejaculatory sample was taken first by self-stimulation, and subsequently the sample for semen analysis was collected. Search for sperm in pre-ejaculatory liquid was held in at least 10 fields at ×20 magnification and the two slides. The seminal fluid was processed according to WHO standards. Results. None of the pre-ejaculatory fluids examined had sperm. All study subjects had spermiograms with total count in excess of 100 million sperm mobility greater than 50%; the average pH was 8.2±0.5. Conclusions. Pre-ejaculatory fluid secreted by the glands of Cowper and Littre during sexual stimulation, does not contain sperm and therefore cannot be responsible for pregnancies occurring in the practice of sexual intercourse where the penis is in contact with the external female genitalia or in practice of withdrawal as a contraceptive method (AU)

Presence of Sperm in Pre-Ejaculatory Fluid of Healthy Males.

BACKGROUND: Coitus interruptus, a common contraceptive method, has a high failure rate. Two reasons have been proposed for this: delayed withdrawal after ejaculation and presence of sperm in the pre-ejaculatory fluid. OBJECTIVE: To determine whether sperm was present in the pre-ejaculatory fluid of healthy males. MATERIAL AND METHOD: A total of 42 healthy Thai men were enrolled in the study between August 1, 2009 and November 30, 2009 at the Department of Obstetrics and Gynecology, Rajavithi Hospital. They were asked to collect pre-ejaculatory fluid smears in two glass slides and then deposit a semen sample in a plastic bottle after masturbation. Microscopic examination of wet and air-dried preparations and routine semen analyses were done consecutively in the human genetics laboratory. RESULTS: Actively mobile sperm were found in 16.7% (7/42 cases) of the pre-ejaculatory penile secretions of subjects whose sperm counts were 2 in 2 cases, 3 in 3 cases and 4 per high power field in the other 2 cases of positive sperm. Semen analyses were normal in 41/42 volunteers (97.6%); there was one case of oligospermia (14 x 106/ml). CONCLUSION: Actively mobile sperm were discovered in the pre-ejaculatory fluid of 16.7% of healthy men.

Withdrawal as pregnancy prevention and associated risk factors among US high school students: findings from the 2011 National Youth Risk Behavior Survey.

PURPOSE: Withdrawal is less effective for preventing pregnancy than other contraceptive methods and offers no protection against sexually transmitted infections including HIV. Little is known from a national perspective about adolescents who primarily use withdrawal. This study describes the prevalence of withdrawal as their primary method of pregnancy prevention at last sexual intercourse among sexually active US high school students and associations with sexual risk and substance use. METHODS: Data from the 2011 National Youth Risk Behavior Survey were used to estimate sexually active students' most recent contraceptive method. Logistic regressions examined sexual behaviors and substance use, comparing students who used withdrawal to those who used no method, a condom and a highly effective method. RESULTS: Among 4793 currently sexually active students, 10.2% used withdrawal only, 12.4% used no method, 53.6% used a condom and 23.8% used a more effective method as their primary form of pregnancy prevention during last sexual intercourse. Students who used withdrawal were less likely than those who used no method to have had sexual intercourse before age 13 years (Adjusted Prevalence Ratio (APR) =.56) and currently use cocaine (APR=.36). Among females, students who used withdrawal were more likely to engage in risky behaviors than those who used a condom and those who used a highly effective method of pregnancy prevention in a number of ways (e.g., having multiple sex partners during the past 3 months, current alcohol use, binge drinking, current marijuana use, drank alcohol or used drugs before last sexual intercourse). CONCLUSIONS: Approximately 1 in 10 sexually active students used withdrawal only, about the same percentage as those who used no method. Health care providers and others who serve adolescents may want to discuss its pros and cons with their clients and help ensure that they have information about and access to other contraceptive methods that are more effective at preventing pregnancy and sexually transmitted infections. Health care professionals should not consider young people who use withdrawal similar in risk to those that use no method.