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1.
São Paulo; s.n; 2021. 134 p.
Tese em Português | LILACS | ID: biblio-1291347

RESUMO

Introdução: Apesar de serem altamente eficazes, os métodos contraceptivos de longa duração são usados por apenas 2% das mulheres brasileiras. A cidade de São Paulo tem realizado esforços para aumentar o uso desses métodos por meio da ampliação da oferta do dispositivo intrauterino (DIU) com cobre, especialmente no período pós-parto e pós-abortamento, e do implante contraceptivo para mulheres em situação de vulnerabilidade social. No entanto, pouco se sabe sobre a experiência das usuárias desses métodos, principalmente no que concerne à satisfação. Objetivo: Analisar a satisfação das mulheres com o uso do implante contraceptivo e do DIU com cobre. Método: Estudo quantitativo transversal, conduzido com 331 mulheres entre 15 e 49 anos que passaram por inserção de implante ou DIU com cobre em um hospital púbico da cidade de São Paulo/SP, entre 2016 e 2019. Os dados foram obtidos por meio de entrevista telefônica conduzida em 2020 por meio de um instrumento estruturado. A mensuração da satisfação com o método contraceptivo ocorreu de duas formas: por meio da resposta direta satisfação autorreferida e por meio da análise conjunta de quatro atributos (expectativa, experiência, efetividade e continuidade) nomeada como satisfação completa. A análise das duas formas de mensuração e dos aspectos associados a elas ocorreu por meio de teste de diferença entre duas proporções pelo Qui-quadrado. Resultados: A satisfação com o uso do implante foi superior a 90% e alcançou 85% entre as usuárias de DIU com cobre, pela forma de mensuração autorreferida. Pela análise por atributos (satisfação completa), a satisfação foi relacionada à expectativa de que o método fosse seguro para a prevenção da gravidez; à experiência ter sido melhor que o esperado, proporcionando a sensação de tranquilidade em razão da segurança; à efetividade do método em prevenir a gravidez; e à continuidade no uso indicando adesão ao método. O principal motivo para a alta satisfação foi a segurança de que o método seria eficaz para evitar a gravidez (94,6% das entrevistadas). As duas formas de mensuração não foram equivalentes. A melhora dos efeitos colaterais ao longo do tempo foi a única variável associada à satisfação autorreferida, para ambos os métodos (p=0,012 para usuárias de implante e p<0,001 para usuárias de DIU). Nenhuma variável foi associada à satisfação completa. Conclusão: A alta satisfação com o uso do implante e do DIU com cobre foi motivada pela segurança quanto à eficácia em prevenir a gravidez e mostrou estar associada à melhora dos efeitos colaterais ao longo do tempo de uso.


Introduction: Despite being highly effective, long-term contraceptives are used by only 2% of Brazilian women. The city of São Paulo has made efforts to increase the use of these methods by expanding the supply of the Copper intrauterine device (IUD), especially in the postpartum and post-abortion period, and contraceptive implant for women in social vulnerability situations. However, little is known about the experience of the users of these methods, especially with regard to satisfaction. Objective: To analyze women's satisfaction with the use of contraceptive implants and Copper IUDs. Method: Cross-sectional quantitative study, conducted with 331 women between 15 and 49 years who underwent implant or Copper IUD insertion in a public hospital in the city of São Paulo/SP, between 2016 and 2019. Data were obtained through a telephone interview conducted in 2020 through a structured instrument. The measurement of satisfaction with the contraceptive method occurred in two ways: through direct response - self-reported satisfaction - and through the joint analysis of four attributes (expectation, experience, effectiveness and continuity) - named as complete satisfaction. The analysis of the two forms of measurement and the aspects associated with them occurred through a test of difference between two proportions by Chi-square. Results: Satisfaction with the use of the implant was higher than 90% and reached 85% among the users of Copper IUD, by the self-reported measurement form. By the analysis by attributes (complete satisfaction), satisfaction was related to the expectation that the method was safe for pregnancy prevention; to experience to have been better than expected, providing the feeling of tranquility due to safety; to the effectiveness of the method in preventing pregnancy; and to the continuity in use indicating adhering to the method. The main reason for the high satisfaction was the safety that the method would be effective to avoid the pregnancy (94.6% of the interviewees). The two forms of measurement were not equivalent. The improvement of side effects over time was the only variable associated with self-reported satisfaction for both methods (p=0.012 for implant users and p<0.001 for IUD users). No variable was associated with complete satisfaction. Conclusion: The high satisfaction with the use of the implant and the Copper IUD was motivated by the safety regarding the efficacy in preventing pregnancy and was shown to be associated with the improvement of side effects over the time of use.


Assuntos
Satisfação do Paciente , Anticoncepção , Saúde Reprodutiva , Inquéritos sobre o Uso de Métodos Contraceptivos , Dispositivos Intrauterinos
2.
Contraception ; 101(5): 333-337, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32014521

RESUMO

OBJECTIVES: To evaluate perceptions of long-acting reversible contraceptives (LARC) among women receiving medication for opioid use disorder. STUDY DESIGN: Cross-sectional survey of 200 women receiving medication for opioid use disorder in Vermont. RESULTS: A considerable proportion of women receiving medication for opioid use disorder in Vermont reported previous use of an IUD (40%) and/or a subdermal contraceptive implant (16%); the majority of prior LARC users were satisfied with their IUD (68%) or their implant (74%). Of the 38% of participants who had never considered IUD use, 85% percent (64/75) said that they knew nothing or only a little about IUDs. Of the 61% of participants who had never considered an implant, 81% percent (98/121) said that they knew nothing or only a little about the contraceptive method. The most commonly reported reasons for a lack of interest in the IUD and/or implant were concerns about side effects and preference for a woman-controlled method. CONCLUSIONS: Gaps in LARC knowledge are common among those who have not used LARCs and concerns about side effects and preferences for a woman-controlled method limit some women's interest in these contraceptives. Additionally, reasons for dissatisfaction among past users are generally similar for IUD and implant and include irregular bleeding and having a bad experience with the method. IMPLICATIONS: Efforts to increase awareness of LARC methods among women receiving medication for opioid use disorder should address concerns about side effects and reproductive autonomy and encourage satisfied LARC users to share their experiences with their social networks.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Contracepção Reversível de Longo Prazo/efeitos adversos , Tratamento de Substituição de Opiáceos , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Adolescente , Adulto , Comportamento Contraceptivo , Anticoncepcionais Femininos/administração & dosagem , Anticoncepcionais Femininos/efeitos adversos , Eficácia de Contraceptivos , Inquéritos sobre o Uso de Métodos Contraceptivos , Estudos Transversais , Implantes de Medicamento/efeitos adversos , Feminino , Humanos , Dispositivos Intrauterinos/efeitos adversos , Percepção , Gravidez , Gravidez não Planejada , Vermont , Adulto Jovem
4.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 10(2): 368-373, abr.-jun. 2018. tab
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-908452

RESUMO

Objetivo: classificar usuárias de anticoncepcionais hormonais injetáveis (AHI) quanto ao uso seguro segundo critérios médicos de elegibilidade da Organização Mundial da Saúde (OMS) e verificar associação entre tipo de injetável e tempo de uso com o uso seguro. Métodos: Estudo transversal, descritivo e exploratório. A população foi composta pelas 52 usuárias de AHI. Os dados foram coletados por meio de entrevista, que seguiu formulário elaborado pelas autoras, sendo identificado fatores que contraindicassem ou indicassem o uso do método, classificando-as em categorias de 1 a 4. O Projeto foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal do Ceará, CAAE: 36668314.3.0000.5054. Resultados: Foram identificadas 44 (84,7%) mulheres em uso seguro e 8 (15,3%) inseguro. Usuárias há mais de um ano tiveram uma frequência maior de uso inseguro (p=0,001). Conclusão: Seguir as recomendações da OMS deve ser rotina nas consultas de enfermagem visando à proteção e segurança da mulher.


Objective: to classify users of injectable hormonal contraceptives (AHI) in accordance with the safe use according to medical eligibility criteria of the World Health Organization (WHO) and assess the association between type of injection and use of time with safe use. Methods: Cross-sectional, descriptive and exploratory study. The population was composed by 52 users of AHI. Data were collected through interviews, which followed form developed by the authors, and identified factors that contraindicate or indicate the use of the method, classifying them into categories from 1 to 4. The project was approved by the Ethics Committee of the University Federal do Ceará, CAAE: 36668314.3.0000.5054. Results: Were identified 44 (84.7%) women in safe use and 8 (15.3%) in unsafe use. Users with over a year of use had a higher frequency of unsafe use (p=0.001). Conclusion: Following WHO recommendations should be routine in nursing consultation to the protection and safety of women.


Objetivo: clasificar las usuarias de anticonceptivos hormonales inyectables (AHI) segundo criterio de elegibilidad médica de la Organización Mundial de la Salud (OMS) y evaluar la asociación entre el tipo de inyección y el uso del tiempo con uso seguro. Métodos: Estudio transversal, descriptivo y exploratorio. La población fue compuesta por 52 usuarias de AHI. Los datos fueron colectados a través de entrevistas desarrollada por las autoras, e identificó los factores que contraindican o indiquen el uso del método, clasificándolos en categorías 1 a 4. El proyecto fue aprobado por el Comité de Ética de Investigación de la Universidad Federal do Ceará, CAAE: 36668314.3.0000.5054. Resultados: Se identificaron 44 (84,7%) mujeres en el uso seguro y 8 (15,3%) no seguro. Las usuarias más de un año habían una mayor frecuencia de uso inseguro (p=0,001). Conclusión: El uso de las recomendaciones de la OMS debe ser rutinario en la consulta de enfermería.


Assuntos
Feminino , Humanos , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Anticoncepcionais Femininos , Anticoncepcionais Femininos/efeitos adversos , Anticoncepcionais Femininos/normas , Brasil , Inquéritos sobre o Uso de Métodos Contraceptivos
5.
Lancet ; 391(10123): 870-882, 2018 03 03.
Artigo em Inglês | MEDLINE | ID: mdl-29217374

RESUMO

BACKGROUND: The London Summit on Family Planning in 2012 inspired the Family Planning 2020 (FP2020) initiative and the 120×20 goal of having an additional 120 million women and adolescent girls become users of modern contraceptives in 69 of the world's poorest countries by the year 2020. Working towards achieving 120 × 20 is crucial for ultimately achieving the Sustainable Development Goals of universal access and satisfying demand for reproductive health. Thus, a performance assessment is required to determine countries' progress. METHODS: An updated version of the Family Planning Estimation Tool (FPET) was used to construct estimates and projections of the modern contraceptive prevalence rate (mCPR), unmet need for, and demand satisfied with modern methods of contraception among women of reproductive age who are married or in a union in the focus countries of the FP2020 initiative. We assessed current levels of family planning indicators and changes between 2012 and 2017. A counterfactual analysis was used to assess if recent levels of mCPR exceeded pre-FP2020 expectations. FINDINGS: In 2017, the mCPR among women of reproductive age who are married or in a union in the FP2020 focus countries was 45·7% (95% uncertainty interval [UI] 42·4-49·1), unmet need for modern methods was 21·6% (19·7-23·9), and the demand satisfied with modern methods was 67·9% (64·4-71·1). Between 2012 and 2017 the number of women of reproductive age who are married or in a union who use modern methods increased by 28·8 million (95% UI 5·8-52·5). At the regional level, Asia has seen the mCPR among women of reproductive age who are married or in a union grow from 51·0% (95% UI 48·5-53·4) to 51·8% (47·3-56·5) between 2012 and 2017, which is slow growth, particularly when compared with a change from 23·9% (22·9-25·0) to 28·5% (26·8-30·2) across Africa. At the country level, based on a counterfactual analysis, we found that 61% of the countries that have made a commitment to FP2020 exceeded pre-FP2020 expectations for modern contraceptive use. Country success stories include rapid increases in Kenya, Mozambique, Malawi, Lesotho, Sierra Leone, Liberia, and Chad relative to what was expected in 2012. INTERPRETATION: Whereas the estimate of additional users up to 2017 for women of reproductive age who are married or in a union would suggest that the 120 × 20 goal for all women is overly ambitious, the aggregate outcomes mask the diversity in progress at the country level. We identified countries with accelerated progress, that provide inspiration and guidance on how to increase the use of family planning and inform future efforts, especially in countries where progress has been poor. FUNDING: The Bill & Melinda Gates Foundation, through grant support to the University of Massachusetts Amherst and Avenir Health.


Assuntos
Comportamento Contraceptivo/estatística & dados numéricos , Anticoncepção/estatística & dados numéricos , Inquéritos sobre o Uso de Métodos Contraceptivos/métodos , Países em Desenvolvimento/estatística & dados numéricos , Serviços de Planejamento Familiar/métodos , Adolescente , Adulto , Anticoncepção/economia , Comportamento Contraceptivo/tendências , Feminino , Acesso aos Serviços de Saúde/estatística & dados numéricos , Necessidades e Demandas de Serviços de Saúde/tendências , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação Pessoal , Adulto Jovem
6.
Contraception ; 96(5): 370-377, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28801054

RESUMO

OBJECTIVE: Following the 2016US presidential election, social media posts and news stories amplified concerns about the potential for reduced access to contraception under the incoming administration and urged women to seek long-acting reversible contraception. We aimed to describe women's concerns about future access to contraception, in their own words. STUDY DESIGN: A social-media-based, anonymous online survey assessing thoughts and concerns about future access to contraception was distributed to reproductive-aged US women for 1 week in mid-January 2017. Participants who were concerned about future access to contraception could share their thoughts and feelings in an open-ended comments box. We qualitatively analyzed 449 written responses for content and themes, with the goal of characterizing key concerns. RESULTS: Women who provided written comments had a mean age of 28years; 85% were white, 88% had at least a college degree, and 93% identified as Democratic or Democratic-leaning. Women were highly concerned about future affordability of contraceptive methods due to potential loss of insurance, reduced insurance coverage for contraceptive methods and reduced access to low-cost care at Planned Parenthood. Many also worried about increased restrictions on abortion. Participants' concerns regarding access to contraception and abortion centered around themes of reproductive and bodily autonomy, which women described as fundamental rights. CONCLUSIONS: Women in this study expressed considerable fear and uncertainty regarding their future access to contraception and abortion following the 2016US presidential election. The potential for restricted access to affordable contraception and abortion was viewed as an unacceptable limitation on bodily autonomy. IMPLICATIONS: As the future of US health care policy is debated, many women are concerned about the impact of policy changes on their ability to access affordable contraception and abortion, which many view as essential to the preservation of bodily and reproductive autonomy.


Assuntos
Anticoncepção , Democracia , Acesso aos Serviços de Saúde , Autonomia Pessoal , Política , Mudança Social , Estresse Psicológico/etiologia , Aborto Legal/ética , Aborto Legal/psicologia , Adulto , Atitude Frente a Saúde , Anticoncepção/ética , Anticoncepção/psicologia , Inquéritos sobre o Uso de Métodos Contraceptivos , Feminino , Política de Saúde/tendências , Acesso aos Serviços de Saúde/ética , Inquéritos Epidemiológicos , Humanos , Cobertura do Seguro/ética , Seguro Saúde/ética , Internet , Direitos Sexuais e Reprodutivos/ética , Direitos Sexuais e Reprodutivos/psicologia , Estresse Psicológico/psicologia , Estados Unidos , Serviços de Saúde da Mulher/ética , Adulto Jovem
7.
Contraception ; 96(5): 365-369, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28778423

RESUMO

OBJECTIVES: To assess interest in, concerns about and knowledge of long-acting reversible contraceptives (LARC) among women in medication-assisted treatment (MAT) for opioid use disorder who were at risk for unintended pregnancy. STUDY DESIGN: Women in MAT completed a survey on contraceptive use, attitudes and knowledge, including LARC methods, as part of eligibility screening for an ongoing trial evaluating family planning interventions for this population. RESULTS: Eighty-three women at risk for unintended pregnancy completed the survey, and a subset of 51 completed supplemental questions about implants. All participants had heard of IUDs and 75/83 (90%) had heard of implants, but only 34/83 (41%) and 14/51 (27%) reported being likely to use IUDs and implants, respectively. Thirty-five women reported they were unlikely to use IUDs, with 29/35 (83%) citing unspecified "other reasons" for this position and 24/35 (69%) endorsing concerns about side effects. Seventeen women reported they were unlikely to use implants, with 8/17 (47%) citing "other reasons" and 9/17 (53%) and 10/17 (59%) reporting concerns about insertion and removal, respectively. Participants reported they knew "a little" about LARCs, but only their knowledge of implants was limited. Only 50/83 (60%) participants were aware of the superior effectiveness of IUDs and 26/51 (51%) were aware of the superior effectiveness of implants relative to other reversible methods. CONCLUSIONS: Participants reported relatively low interest in LARCs. Many women had unspecified reasons for not using LARCs. Participants also lacked information about LARC safety and effectiveness, especially with regard to implants. IMPLICATIONS: Women in medication-assisted treatment for opioid use disorder are at high risk of unintended pregnancy, yet contraceptive use is low and use of less effective methods is common. Women in MAT may benefit from efforts to increase knowledge about implants and assuage concerns about their insertion and removal as well as more general efforts to improve knowledge about the relative efficacy of LARCs. Many women in MAT endorsed unspecified "other reasons" for not using LARCs, which should be explored further.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Contracepção Reversível de Longo Prazo/efeitos adversos , Tratamento de Substituição de Opiáceos , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Adulto , Dissonância Cognitiva , Comportamento Contraceptivo , Anticoncepcionais Femininos/administração & dosagem , Anticoncepcionais Femininos/efeitos adversos , Eficácia de Contraceptivos , Inquéritos sobre o Uso de Métodos Contraceptivos , Implantes de Medicamento/efeitos adversos , Feminino , Humanos , Intenção , Dispositivos Intrauterinos/efeitos adversos , Gravidez , Gravidez não Planejada , Vermont , Adulto Jovem
8.
Contraception ; 96(5): 352-356, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28669507

RESUMO

OBJECTIVE: This qualitative study explores how adolescents and young women perceive the need for and describe the use of dual method contraception. STUDY DESIGN: We interviewed 20 sexually active women aged 16-24 who attended an adolescent-focused Title X family-planning clinic and were using a non-barrier contraceptive method. We used a semi-structured interview guide that included domains related to sexual activity, knowledge of and use of contraceptives and condoms, and relationship factors. We coded transcripts using grounded theory techniques and used an iterative process to develop overarching themes. RESULTS: Dual method contraceptive users primarily discussed pregnancy prevention as their motivating factor. Many expressed anxieties over an unplanned pregnancy and reported condom use as "back-up" contraception. Risk perception for pregnancy or STI acquisition did not necessarily change as relationship trust increased, but rather, their anxiety regarding the negativity of such outcomes decreased. Dual-method contraception use decreased when participants reported that condoms were not readily available, or when they self-described immaturity. Less frequently, participants reported dual method use for sexually transmitted infection (STI) prevention, and many substituted STI testing for condom use. Contraceptive type (short-acting vs. long-acting) did not influence reported attitudes towards dual method use. CONCLUSION: Health educators and clinicians encourage condom use in young women due to the significant morbidity associated with STI acquisition. Most participants in our study view condoms as a way to improve pregnancy prevention. Acknowledging and addressing this divergence in motivation will allow caregivers to improve strategies for communicating the importance of dual method use. IMPLICATIONS: Young women primarily describe pregnancy prevention as the reason for dual method use, STI protection is less salient. Consideration of this viewpoint by health educators and clinicians will allow us to communicate more effectively to prevent STI morbidity.


Assuntos
Preservativos , Comportamento Contraceptivo , Anticoncepcionais Femininos/administração & dosagem , Modelos Psicológicos , Motivação , Gravidez não Desejada , Doenças Sexualmente Transmissíveis/prevenção & controle , Adolescente , Comportamento do Adolescente , Adulto , Colorado/epidemiologia , Preservativos/efeitos adversos , Comportamento Contraceptivo/psicologia , Anticoncepcionais Femininos/efeitos adversos , Inquéritos sobre o Uso de Métodos Contraceptivos , Serviços de Planejamento Familiar , Feminino , Teoria Fundamentada , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Aceitação pelo Paciente de Cuidados de Saúde , Gravidez , Gravidez não Desejada/psicologia , Pesquisa Qualitativa , Risco , Doenças Sexualmente Transmissíveis/epidemiologia , Doenças Sexualmente Transmissíveis/transmissão , Adulto Jovem
9.
Health Care Women Int ; 38(10): 1075-1094, 2017 10.
Artigo em Inglês | MEDLINE | ID: mdl-28644720

RESUMO

We investigated the relation of internal migration to contraceptive use and adjusted for individual and contextual (community) characteristics. Multilevel logistic regression models were fitted to nationally representative data of 28,876 women from 884 communities in Nigeria. Only about one out of every 10 women (10.4%) currently used a contraceptive method. Contraceptive prevalence according to the migration status were rural-urban (12.5%), urban-rural (13.8%), rural nonmigrants (6.2%) and urban nonmigrants (17.1%). The relationship between internal migration and contraceptive use was fully explained by individual and community characteristics. Programs aimed at increasing contraceptive prevalence should address contextual challenges alongside socioeconomic factors.


Assuntos
Comportamento Contraceptivo/etnologia , Anticoncepção/estatística & dados numéricos , Dinâmica Populacional , Migrantes/estatística & dados numéricos , Adolescente , Adulto , Comportamento Contraceptivo/estatística & dados numéricos , Inquéritos sobre o Uso de Métodos Contraceptivos , Feminino , Inquéritos Epidemiológicos , Humanos , Entrevistas como Assunto , Modelos Logísticos , Pessoa de Meia-Idade , Prevalência , População Rural , Fatores Socioeconômicos , População Urbana , Adulto Jovem
10.
Rev. Bras. Saúde Mater. Infant. (Online) ; 17(2): 347-354, Apr.-June 2017. tab
Artigo em Inglês | LILACS | ID: biblio-1013031

RESUMO

Abstract Objectives: to determine the prevalence and factors associated with the rapid repeat pregnancy (RRP) in pregnant adolescents. Methods: a cross-sectional study was carried out with pregnant adolescents assisted at the Family Health Strategies in Caruaru-PE from March to August 2013. A questionnaire with sociodemographic, economic, schooling, gynecological, obstetric and contraceptive characteristics was used. The data were analyzed in the Statistical Package for Social Sciences (SPSS), version 20. Binary logistic regression models were used. Results: among the 204 pregnant adolescents interviewed, the data of 26.5% (n = 54) multiparous were analyzed. The occurrence of RRP was 42.6% (n = 23) [95% CI 29.23-56.79]. The variables associated with RRP were non-use of contraceptive methods [OR 7.40 (CI95% 1.56-3.49)] and no previous pregnancy planning [OR 0.19 (95% CI 0.05-0.78)]. Conclusions: the percentage of RRP in adolescents was high. The non-use of contracep-tive methods increased the chances of RRP, while the no previous pregnancy planning decreased the chances of adolescents getting pregnant again without previous program-ming.


Resumo Objetivos: determinar a prevalência e fatores associados a gravidez de repetição rápida (GRR) em gestantes adolescentes. Métodos: estudo transversal desenvolvido com gestantes adolescentes assistidas nas Estratégias de Saúde da Família de Caruaru-PE no período de março a agosto de 2013. Foi utilizado um questionário com características sociodemográficas, econômicas, escolares, ginecológicas, obstétricas e contraceptivas. Os dados foram analisados no Statistical Package for the Social Sciences (SPSS), versão 20. Empregou-se modelos de regressão logís-tica binária. Resultados: dentre as 204 gestantes adolescentes entrevistadas, foram analisados os dados de 26,5% (n=54) que eram multigestas. A ocorrência de GRR foi de 42,6% (n=23) [IC95% 29,23-56,79]. As variáveis associadas à GRR foram não uso de métodos contracep-tivos [OR 7,40 (IC95% 1,56-3,49)] e não planejamento da gravidez anterior [OR 0,19 (IC95% 0,05-0,78)]. Conclusões: foi elevado o percentual de GRR nas adolescentes. O não uso de métodos contraceptivos aumentou as chances de GRR, enquanto a não realização de planejamento da gestação anterior diminuiu as chances das adolescentes engravidarem novamente sem programação prévia.


Assuntos
Humanos , Feminino , Gravidez , Adolescente , Adulto , Gravidez na Adolescência/estatística & dados numéricos , Estratégias de Saúde Nacionais , Gravidez não Planejada , Inquéritos sobre o Uso de Métodos Contraceptivos , Comportamento Sexual , Brasil , Modelos Logísticos , Saúde Reprodutiva
11.
Hum Reprod ; 32(6): 1325-1333, 2017 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-28398523

RESUMO

STUDY QUESTION: Do the rates at which women transition among different intensities of pregnancy planning vary with age, marital status and race/ethnicity? SUMMARY ANSWER: Rates of transition from low or moderate pregnancy probability groups (PPGs) to higher PPGs vary by age, marital status and race/ethnicity. WHAT IS KNOWN ALREADY: The design of prospective studies of the effects of pre- and peri-conception exposures on fecundity, pregnancy and children's health is challenging because at any specific time only a small percentage of reproductive age women is attempting to conceive. To our knowledge, there has been no population-based, prospective study that repeatedly assessed pregnancy planning, which included women who were not already planning pregnancy at enrollment and whose ages spanned the female reproductive age range. STUDY DESIGN, SIZE, DURATION: A longitudinal study was carried out that repeatedly assessed pregnancy probability in 12 916 women for up to 21 months from January 2009 to September 2010. PARTICIPANTS/MATERIALS, SETTING, METHOD: We analyzed data from the National Children's Study Vanguard Study, a pilot study for a large-scale epidemiological birth cohort study of children and their parents. During the Vanguard Study, investigators followed population-based samples of reproductive age women in each of seven geographically dispersed and diverse study locations over time to identify when they sought to become pregnant, providing a unique opportunity to prospectively assess changes in pregnancy planning in a large sample of US women. At study entry and each follow-up contact, which occurred at 1, 3 or 6 month intervals depending on PPG, a questionnaire was used to assess behavior dimensions of pregnancy planning to assign women to low, moderate, high non-tryer and high tryer PPGs. MAIN RESULTS AND THE ROLE OF CHANCE: Crude rates of pregnancy increased with higher assigned PPG, validating the utility of the instrument. The initial PPG and probabilities of transitioning from low or moderate PPG to higher PPG or pregnancy varied with age, marital status and race/ethnicity. Women aged 25 to <35 years had shorter times to transition to higher PPGs or to pregnant compared with women <25 years. Women who were not currently married had longer times to transition from any initial PPG to pregnant, high tryer or high non-tryer status than currently married women. Non-Hispanic Black (NHB) and Hispanic women had shorter time to transition from low or moderate to high non-tryer than non-Hispanic White (NHW) women. NHB women also had shorter time to transition from low to high tryer than NHW women. High tryers are more likely to be aged 25 to <30 years, to be married, and to be Hispanic, NHB or other race/ethnicity than women in the low PPG. LIMITATIONS, REASONS FOR CAUTION: Loss to follow-up varied by age, marital status and race/ethnicity. Although weights were not developed for the Vanguard study, the self-weighting design minimizes the bias of unweighted analysis. Nonetheless, the SEs for some estimates may be under-estimated. WIDER IMPLICATIONS OF THE FINDINGS: Our results show that demographic characteristics are strong predictors of women's behaviors toward pregnancy. The results further show that frequent follow-up assessments of pregnancy planning behavior in large numbers of women are required to recruit an unbiased sample of preconception women. These findings will be useful to investigators designing prospective studies of fecundability, pregnancy outcomes and children's health. STUDY FUNDING/COMPETING INTERESTS: National Institutes of Health (contracts N01-HD53414, N01-HD63416, N01-HD53410, N01-HD53415, N01-HD53396, N01-HD53413 and N01-HD-53411; grant R21 ES016846) and by the University of California Irvine Center for Occupational and Environmental Health. No competing interests. TRIAL REGISTRATION NUMBER: None.


Assuntos
Inquéritos sobre o Uso de Métodos Contraceptivos , Serviços de Planejamento Familiar , Comportamento Reprodutivo , Adulto , Afro-Americanos , Americanos Asiáticos , Estudos de Coortes , Serviços de Planejamento Familiar/economia , Feminino , Humanos , Modelos Logísticos , Estudos Longitudinais , Estado Civil/etnologia , Projetos Piloto , Gravidez , Taxa de Gravidez/etnologia , Estudos Prospectivos , Comportamento Reprodutivo/etnologia , Fatores Socioeconômicos , Estados Unidos/epidemiologia
12.
Sultan Qaboos Univ Med J ; 17(1): e50-e58, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28417029

RESUMO

OBJECTIVES: This study aimed to determine contraceptive utilisation among mothers aged 18-49 years old in Ajman, United Arab Emirates (UAE). METHODS: This cross-sectional study was carried out from May to November 2013. A total of 400 participants were recruited from two primary healthcare centres and one private hospital in Ajman. An interviewer-administered validated questionnaire was used for data collection. RESULTS: The frequency of previous and current contraceptive use was 68.0% and 61.8%, respectively. Expatriates more frequently used contraceptives in comparison to Emiratis (77.3% versus 54.3%, respectively). Contraceptive use increased significantly with age (75.5% among >35-year-olds versus 57.3% among ≤25-year-olds; P <0.050) and education level (83.3% among postgraduates versus 60.0% among those with primary education; P <0.050). In addition, contraceptive use was significantly higher among those living in a nuclear family system (P <0.050). A univariate analysis indicated significant associations between contraceptive use and age, nationality, education level, type of family system, employment sector, parity, knowledge of birth control measures and source of birth control information (P <0.050 each). However, no significant associations were found via multivariate analysis. CONCLUSION: Healthcare practitioners can play a pivotal role in providing contraceptive advice which could lead to an improvement in contraceptive utilisation. Efforts are recommended to raise awareness regarding newer forms of contraceptives among mothers of reproductive age in the UAE.


Assuntos
Anticoncepcionais/administração & dosagem , Inquéritos sobre o Uso de Métodos Contraceptivos , Mães/estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Análise de Variância , Anticoncepção , Estudos Transversais , Serviços de Planejamento Familiar , Feminino , Humanos , Pessoa de Meia-Idade , Projetos Piloto , Gravidez , Fatores Socioeconômicos , Emirados Árabes Unidos , Adulto Jovem
13.
N Z Med J ; 129(1444): 58-67, 2016 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-27806029

RESUMO

AIMS: To estimate the prevalence of contraceptive use among New Zealand women and to measure changes in contraceptive use since the last population-based prevalence estimates were published in 1988. METHODS: Nine hundred and four women, aged 35-69 years were randomly selected from the electoral roll. A postal questionnaire was used to gather information on contraceptive use, socio-demographic characteristics and risk factors for ovarian cancer. Data were collected in 2013-2015. Estimates of current and ever-use of contraceptives were made and compared with the findings of the 1988 study by Paul et al. In both studies, participants were members of the control arm of case-control studies. RESULTS: The study by Paul et al had a response proportion of 84%, whereas that of the current study was 47%. Oral contraceptives had the highest prevalence of ever-use among women aged 35-69 years (89% [347/389]), followed by condom use (54% [211/389]) and vasectomy (44% [170/389]). Compared to the previous study, there has been an increase in ever-use of condoms (24% [185/767] to 64% [148/231]), vasectomy (26% [202/767] to 40% [92/231]) and oral contraceptives (75% [575/767] to 89% [205/231]) among women aged 35-54 years. In contrast, a lower prevalence of tubal ligation (22% [168/767] to 8% [19/231]) was observed. CONCLUSION: The study demonstrates a change in patterns of contraceptive use among women aged 35-54 years. The prevalence of ever-use of oral contraceptives and vasectomy remains high in New Zealand compared with other countries.


Assuntos
Preservativos/estatística & dados numéricos , Comportamento Contraceptivo/estatística & dados numéricos , Anticoncepção/classificação , Esterilização Tubária/estatística & dados numéricos , Vasectomia/estatística & dados numéricos , Adulto , Idoso , Estudos de Casos e Controles , Inquéritos sobre o Uso de Métodos Contraceptivos , Anticoncepcionais Orais/uso terapêutico , Feminino , Humanos , Pessoa de Meia-Idade , Nova Zelândia/epidemiologia
14.
Reprod Health ; 13(1): 67, 2016 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-27246329

RESUMO

BACKGROUND: Manifest socio-economic differences are a trigger for internal migration in many sub-Saharan settings including Kenya. An interplay of the social, political and economic factors often lead to internal migration. Internal migration potentially has significant consequences on an individual's economic growth and on access to health services, however, there has been little research on these dynamics. In Kenya, where regional differentials in population growth and poverty reduction continue to be priorities in the post MDG development agenda, understanding the relationships between contraceptive use and internal migration is highly relevant. METHODS: Using data from the 2008-09 Kenya Demographic and Health Survey (DHS), we analyze data from 5,905 women aged 15-49 years who reported being sexually active in the last 12 months prior to the survey. Bivariate and multivariate logistic regressions are fitted to predict correlates of contraceptive use in the presence of migration streams among other explanatory variables. RESULTS: Modern contraceptive use was significantly higher among women in all migration streams (non-migrant urban (OR = 2.8, p < 0.001), urban-urban (OR = 2.0, p < 0.001), urban-rural (OR = 2.0, p < 0.001), rural-urban (OR = 2.6, p < 0.001), rural-rural (OR = 1.7, p < 0.001), than non-migrant rural women. CONCLUSION: Women who internally migrate within Kenya, whether from rural to urban or between urban centres, were more likely to use modern contraception than non-migrant rural women. This phenomenon appears to be due to selection, adaption and disruption effects which are likely to promote use of modern contraceptives. Programmatically, the differentials in modern contraceptive use by the different migration streams should be considered when designing family planning programmes among migrant and non-migrant women.


Assuntos
Comportamento Contraceptivo , Anticoncepcionais Femininos/administração & dosagem , Dispositivos Anticoncepcionais Femininos , Modelos Econômicos , Saúde da População Rural , Migrantes , Saúde da População Urbana , Adolescente , Adulto , Comportamento Contraceptivo/etnologia , Anticoncepcionais Femininos/economia , Dispositivos Anticoncepcionais Femininos/economia , Inquéritos sobre o Uso de Métodos Contraceptivos , Países em Desenvolvimento , Feminino , Custos de Cuidados de Saúde , Inquéritos Epidemiológicos , Humanos , Quênia , Pessoa de Meia-Idade , Pobreza/etnologia , Pobreza/prevenção & controle , Saúde da População Rural/etnologia , Fatores Socioeconômicos , Saúde da População Urbana/etnologia , Adulto Jovem
15.
J Womens Health (Larchmt) ; 25(12): 1262-1269, 2016 12.
Artigo em Inglês | MEDLINE | ID: mdl-27295335

RESUMO

BACKGROUND: Women with chronic diseases are at increased risk of having unintended pregnancies. Little is known whether chronic diseases are associated with increased likelihood of effective/highly effective contraceptive use. METHODS: We analyzed 2008-2010 Florida Behavioral Risk Factor Surveillance System data for women aged 18-44 years who were at risk of unintended pregnancy. Multivariable Poisson regression estimated adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) for contraceptive use in relation to diabetes, cardiovascular disease (CVD), and current asthma. We assessed the association of chronic disease status with use of three different contraception outcomes: (1) any method versus none, (2) less effective methods (methods associated with ≥10 unintended pregnancies/100 women/year) versus none, and (3) effective/highly effective methods (<10 unintended pregnancies/100 women/year) versus none. RESULTS: Among 4473 women at risk for unintended pregnancy, 87% were using any method of contraception (22.5% less effective methods and 64.5% effective/highly effective methods). Women with CVD were more likely than those without CVD to use any contraception (aPR = 1.09, 95% CI: 1.04, 1.15), less effective (aPR = 1.39, 95% CI: 1.13, 1.70), and effective/highly effective (aPR = 1.10, 95% CI: 1.03, 1.19) contraception. Women with diabetes were more likely to use less effective methods than women without diabetes (aPR = 1.34, 95% CI: 1.05, 1.72). No significant associations were observed for asthma, regardless of contraceptive effectiveness. CONCLUSIONS: Self-reported use of effective/highly effective contraception was higher than nonuse or use of less effective methods among all women at risk of unintended pregnancy, but could be improved, especially among women with chronic diseases.


Assuntos
Doença Crônica , Comportamento Contraceptivo , Anticoncepção/estatística & dados numéricos , Gravidez não Planejada , Adolescente , Adulto , Sistema de Vigilância de Fator de Risco Comportamental , Inquéritos sobre o Uso de Métodos Contraceptivos , Estudos Transversais , Feminino , Florida/epidemiologia , Humanos , Modelos Logísticos , Gravidez , Prevalência , Análise de Regressão , Adulto Jovem
16.
Reprod Health ; 13: 25, 2016 Mar 17.
Artigo em Inglês | MEDLINE | ID: mdl-26987368

RESUMO

BACKGROUND: Family planning (FP) interventions aimed at reducing population growth have negligible during the last two decades in Pakistan. Innovative FP interventions that help reduce the growing population burden are the need of the hour. Marie Stopes Society--Pakistan implemented an operational research project--'Evidence for Innovating to Save Lives', to explore effective and viable intervention models that can promote healthy timing and spacing of pregnancy in rural and under-served communities of Sindh, Punjab and Khyber Pakhtunkhwa provinces of Pakistan. METHODS: We conducted a quasi-experimental (pre- and post-intervention with control arm) study to assess the effectiveness of each of the two intervention models, (1) Suraj model (meaning 'Sun' in English), which uses social franchises (SF) along with a demand-side financing (DSF) approach using free vouchers, and (2) Community Midwife (CMW) model, in promoting the use of modern contraceptive methods compared to respective controls. Baseline and endline cross-sectional household surveys were conducted, 24 months apart, by recruiting 5566 and 6316 married women of reproductive age (MWRA) respectively. We used Stata version 8 to report the net effect of interventions on outcome indicators using difference-in-differences analysis. Multivariate Cox proportional hazard regression analysis was used to assess the net effect of the intervention on current contraceptive use, keeping time constant and adjusting for other variables in the model. RESULTS: The Suraj model was effective in significantly increasing awareness about FP methods among MWRA by 14% percentage points, current contraceptive use by 5% percentage points and long term modern method--intrauterine device (IUD) use by 6% percentage points. The CMW model significantly increased contraceptive awareness by 28% percentage points, ever use of contraceptives by 7% percentage points and, IUD use by 3% percentage points. Additionally the Suraj intervention led to a 35% greater prevalence (prevalence ratio: 1.35, 95% CI: 1.22-1.50) of contraceptive use among MWRA. CONCLUSION: Suraj intervention highlights the importance of embedding subsidized FP services within the communities of the beneficiaries. The outcomes of the CMW intervention also improved the use of long-term contraceptives. These findings indicate the necessity of designing and implementing FP initiatives involving local mid-level providers to expand contraceptive coverage in under-served areas.


Assuntos
Intervalo entre Nascimentos , Redes Comunitárias , Comportamento Contraceptivo , Anticoncepção , Assistência à Saúde Culturalmente Competente , Política de Planejamento Familiar , Serviços de Planejamento Familiar , Adulto , Intervalo entre Nascimentos/etnologia , Agentes Comunitários de Saúde , Anticoncepção/efeitos adversos , Anticoncepção/economia , Anticoncepção/tendências , Comportamento Contraceptivo/etnologia , Inquéritos sobre o Uso de Métodos Contraceptivos , Estudos Transversais , Assistência à Saúde Culturalmente Competente/etnologia , Política de Planejamento Familiar/tendências , Serviços de Planejamento Familiar/educação , Feminino , Gastos em Saúde , Humanos , Dispositivos Intrauterinos/efeitos adversos , Dispositivos Intrauterinos/economia , Tocologia , Paquistão , Educação de Pacientes como Assunto , Setor Privado , Setor Público , Saúde da População Rural/etnologia , Cônjuges/etnologia
17.
Perspect Sex Reprod Health ; 48(1): 9-16, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26841331

RESUMO

CONTEXT: Understanding the nature of rural-urban variation in U.S. family planning services would help address disparities in unmet contraceptive need. METHODS: In 2012, some 558 Title X-supported clinics in 16 Great Plains and Midwestern states were surveyed. Rural-urban commuting area (RUCA) codes were used to categorize clinic locations as urban, large rural city, small rural town or isolated small rural town. Bivariate analyses examined key domains of service provision by RUCA category and clinic type. RESULTS: The proportion of clinics offering walk-in appointments was lower in isolated small rural towns (47%) than in the other RUCA categories (67-73%). Results were similar for sites that do not specialize in family planning or reproductive health, but no variation was seen among specialty clinics. Overall, availability of evening or weekend appointments varied in a linear fashion, falling from 73% in urban areas to 29% in isolated small rural towns. On-site provision of most hormonal methods was most common in urban areas and least common in isolated small rural towns, while provision of nonhormonal methods was similar across RUCA categories. Sixty percent of clinics provided IUDs or implants. For clinics that did not, the only barriers that varied geographically were low IUD demand and lack of trained IUD providers; these barriers were most common in isolated rural towns (42% and 70%, respectively). CONCLUSIONS: While important characteristics, such as clinics' specialization (or lack thereof), are linked to the provision of family planning services, geographic disparities exist.


Assuntos
Serviços de Planejamento Familiar , Acesso aos Serviços de Saúde/estatística & dados numéricos , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Adulto , Inquéritos sobre o Uso de Métodos Contraceptivos/estatística & dados numéricos , Serviços de Planejamento Familiar/organização & administração , Serviços de Planejamento Familiar/estatística & dados numéricos , Feminino , Humanos , Masculino , Meio-Oeste dos Estados Unidos/epidemiologia , Serviços de Saúde Rural/estatística & dados numéricos , Serviços Urbanos de Saúde/estatística & dados numéricos
18.
Reprod Health ; 13: 8, 2016 Feb 03.
Artigo em Inglês | MEDLINE | ID: mdl-26842976

RESUMO

BACKGROUND: Describe dual contraceptive method use and the intention to become pregnant of people living with HIV (PLHIV) and their partners in Thailand. METHODS: From January 2008-March 2009, we systematically selected a cohort of PLHIV from PLHIV seeking care at five tertiary care hospitals and one community hospital to complete a questionnaire assessing sexual activity, intention to become pregnant, and contraceptive practices at baseline and 12 months after enrollment. Participants received short family planning messages every 2-3 months to promote the use of dual contraceptives and were offered family planning services. RESULTS: A total of 1,388 PLHIV enrolled, their median age was 37 years (IQR 33-43), 898 (64.7%) had a steady partner, and 737 (53.1%) were male. Among those with a steady partner, 862 (96.0%) did not intend to become pregnant; 709 (82.3%) had sex during the previous 3 months, 683 (96.3%) used at least one contraceptive method, and 202 (29.6%) used dual contraceptive methods. Of the 317 PLHIV who used a single contraceptive method at baseline, 66 (20.8%) reported using dual methods at 12 months. Participants at two tertiary care hospitals where coordinators facilitated PLHIV referral between HIV and OB/GYN clinics were more likely than participants at the other hospitals to change from single method to dual method (p ≤ 0.03). CONCLUSION: Few PLHIV in this study intended to become pregnant; however, only one-fourth used dual contraceptive methods. Integrating an assessment of the intention to become pregnant and strengthening the PLHIV referral systems in family planning services may contribute to higher rates of dual contraceptive use.


Assuntos
Atitude Frente a Saúde , Comportamento Contraceptivo , Infecções por HIV/tratamento farmacológico , Cooperação do Paciente , Comportamento Reprodutivo , Adulto , Atitude Frente a Saúde/etnologia , Estudos de Coortes , Comportamento Contraceptivo/etnologia , Inquéritos sobre o Uso de Métodos Contraceptivos , Serviços de Planejamento Familiar/educação , Feminino , Seguimentos , Infecções por HIV/etnologia , Soropositividade para HIV/etnologia , Humanos , Perda de Seguimento , Masculino , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Cooperação do Paciente/etnologia , Educação de Pacientes como Assunto , Guias de Prática Clínica como Assunto , Encaminhamento e Consulta , Comportamento Reprodutivo/etnologia , Parceiros Sexuais , Centros de Atenção Terciária , Tailândia
19.
Reprod Health ; 13: 12, 2016 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-26873678

RESUMO

BACKGROUND: Fertility desires and contraceptive behavior often change over time. This study examined the influence of change in fertility desires on change in modern contraceptive use over time in three peri-urban communities in sub-Saharan Africa. METHODS: This multi-site study includes baseline and follow up data from 3 sites in the Family Health and Wealth Study. Following a census in each site, a probability sample of at least 500 households was obtained. Generalized linear models were employed. RESULTS: Modern contraceptive use increased in Ipetumodu, Nigeria (29.4% to 36.7%), but declined slightly in Sebeta, Ethiopia (66.9% to 61.3%) and Asawase, Ghana (12.6% to 10.8%). Across sites, at baseline and follow up, women who wanted no more children reported more contraceptive use, compared with those who wanted more children, and were more likely to shift to being contraceptive users in Ipetumodu [aOR(95% CI):1.55 (1.07,2.26)]. CONCLUSIONS: Women's fertility desires influenced their contraceptive behavior, although there were cross-site differences. Changing contraceptive demand and program factors will be important to enable peri-urban women to frame and act on their fertility desires.


Assuntos
Comportamento Contraceptivo , Serviços de Planejamento Familiar , Conhecimentos, Atitudes e Prática em Saúde , Comportamento Reprodutivo , Saúde Suburbana , Adolescente , Adulto , África ao Sul do Saara , Estudos de Coortes , Comportamento Contraceptivo/etnologia , Comportamento Contraceptivo/tendências , Inquéritos sobre o Uso de Métodos Contraceptivos , Escolaridade , Características da Família , Serviços de Planejamento Familiar/tendências , Feminino , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Humanos , Modelos Lineares , Estudos Longitudinais , Paridade , Comportamento Reprodutivo/etnologia , Fatores Socioeconômicos , Análise Espaço-Temporal , Saúde Suburbana/etnologia , Saúde Suburbana/tendências , Adulto Jovem
20.
J Fam Plann Reprod Health Care ; 42(1): 12-6, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25900524

RESUMO

OBJECTIVES: Contraceptive use is important for reproductive-aged women living with HIV to plan and optimise safety of pregnancies. Clinicians play a vital role in counselling patients about contraception and safe sexual activity. This study aimed to determine the frequency and predictors of discussions regarding sexual activity and contraceptive use. METHODS: Retrospective clinical study of all reproductive-aged women (n=128) treated for HIV between 2010 and 2012 at two metropolitan hospitals. Evidence of discussion between treating doctors and patients regarding sexual activity and contraception and variables including patient age, gender of doctor, time since HIV diagnosis, previous pregnancy, country of birth and antiretroviral regimen were obtained from medical records. RESULTS: Sexual activity status was documented for 54% of the women and discussion regarding contraception was recorded for less than one-third of the study participants. Contraceptive use was not recorded in 63% of the medical records. In the study cohort 27% of the women used contraception, 10% did not use contraception, and when a discussion regarding sexual activity was documented, contraception was 3.7 times more likely to also be discussed (p=0.04). Excluding women who were pregnant, women who were documented as using contraception were 1.8 times as likely to have had a discussion about contraception documented (p=0.05). After adjustment for other factors, previous pregnancy, gender of doctor and age of patient were not associated with discussions regarding sexual activity or contraception. CONCLUSIONS: Discussions regarding sexual activity and contraception between HIV-infected women of reproductive age and their clinicians were inconsistent and suboptimal. Mechanisms to facilitate regular discussion about sexual activity and contraception between clinicians and women with HIV warrant further investigation.


Assuntos
Comportamento Contraceptivo/estatística & dados numéricos , Infecções por HIV/epidemiologia , Educação de Pacientes como Assunto/estatística & dados numéricos , Comportamento Sexual/estatística & dados numéricos , Adulto , Antirretrovirais/uso terapêutico , Austrália , Anticoncepcionais Femininos/administração & dosagem , Inquéritos sobre o Uso de Métodos Contraceptivos , Feminino , Infecções por HIV/tratamento farmacológico , Humanos , Relações Profissional-Paciente , Estudos Retrospectivos , Parceiros Sexuais , Adulto Jovem
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