Long-term effects of a community-based program on contraceptive use among sexually active unmarried youth in Shanghai, China.

PURPOSE: To evaluate the long-term (48-month) sustainable effect of a set of community-based interventions to promote contraceptive use among sexually active unmarried youth in suburban Shanghai, China. METHODS: A nonrandomized community trial with one intervention and one control group was conducted in two comparable towns of a suburban area of Shanghai. The intervention program was developed and implemented to increase knowledge and access to sexual and reproductive health services among unmarried youth aged 15-24 years. Baseline surveys were conducted in both sites before implementation of the intervention, and similar surveys were conducted in both sites 20 months after the launch of the intervention and 28 months after the end of the intervention. RESULTS: Statistically significant differences between the respondents surveyed at baseline in 2000 and at the long-term follow up in 2004 were observed in some age categories and in some educational groups. In the postproject period, there was a major improvement in all indicators in the control group. Among the sub-set of respondents interviewed both in 2000 and 2004 who were exposed to the intervention program, the interventions were associated with a significant increase in the frequency of contraceptive use among participants initiating sexual relations over the period of the intervention (odds ratio [OR] = 6.91), as well as with significant reduction in use ever of the withdrawal method of contraception among all sexually active respondents (OR = .37) compared with the control group during long-term follow-up period. No long-term effects on contraceptive practice were observed among new respondents who were not exposed to the intervention program. CONCLUSIONS: Comprehensive community-based interventions appear to have limited long-term effects on contraceptive use among unmarried youth in suburban Shanghai. It is necessary to provide sex and reproductive health education and services to all unmarried young people on a regular basis.     

服务行业未婚流动青少年避孕知识及行为的干预效果评价

目的:评价在服务行业未婚流动青少年中开展性和生殖健康教育/服务对人群的避孕知识及行为的影响,探讨向未婚流动青少年提供生殖健康教育/服务的适宜模式。方法:将研究对象分为干预组和对照组。干预活动为期半年,仅对干预组对象提供。在干预前后分别开展基线和终末问卷调查。通过两次问卷调查结果来评价干预效果。数据分析用SAS 9.1软件进行。结果:干预组和对照组基线的避孕知识平均得分均<50分(总分100)。干预后,干预组避孕知识得分(85.51)高于对照组得分(50.38)(P<0.01)。多因素分析结果也显示,干预显著增加了对象的避孕知识得分(B=33.24,P<0.01)。基线调查时,33.33%的干预组对象和59.09%的对照组对象报告在最近3次性行为中每次都使用避孕措施,两者差异具有统计学意义(P<0.01)。终末调查时,干预组对象的这一比例较基线上升(P<0.05),而对照组则没有改变(P>0.05)。多因素分析显示干预具有促进对象使用避孕措施的趋势(OR=3.06,P<0.01)。结论:干预可提高对象的避孕知识水平,并有促进其避孕措施使用的趋势。提示今后需考虑开展长期、连续的干预,以进一步改善未婚流动青少年的避孕行为。     

中国三城市未婚人工流产女性避孕状况及影响因素调查

目的:研究城市未婚人工流产女性的避孕行为及其影响因素,为促进避孕措施的使用提供科学依据。方法:在上海、成都、太原3城市提供常规人工流产服务的不同等级医院,对自愿要求做人工流产、年龄<25岁的1271例未婚女性进行问卷调查。结果:被调查者首次性行为的平均年龄为19.6～20.3岁。过去半年内,仅有5.0%～7.3%的女性坚持每次性行为时都使用避孕方法,17.6%～21.0%从未使用过避孕措施。最常用的避孕方法为避孕套(77.0%);不避孕或未坚持避孕的主要原因为"抱侥幸心理(49.7%)"。logistic回归分析显示,调查对象的学历、年龄、避孕和人工流产危害知识,以及男友的避孕知识和对避孕的关心程度与避孕措施使用频率及避孕套的使用有关。结论:未婚人工流产女性避孕措施使用率低,应提高这一人群避孕和人工流产相关知识水平,引导男性参与避孕。     

北京市未婚人工流产女青年避孕知识、态度、行为的调查研究

目的：研究未婚人工流产（人流）女青年的避孕知识,态度、行为以及影响避孕行为的因素。方法：以Lawrence的PROCEDE-pROCEED健康促进计划模式为基础的调查问卷,对306例自愿要求人工流产,年龄在18－24岁的未婚女青年进行断面的调查。结果：近12个月以来,仅有13％和女青地持每次性行为都使用避孕方法,偶尔使用和从未使用者的比例分别为26％和275,在224例曾经用过避孕方法的女青年中,最常用的方法分别是避孕套（495）、体外排精（285）、安全期（165）,在从未使用任何避孕方法的女青年中,735认为没想到会怀孕是最主要的不避孕的原因。logistic 逐步回归分析显示,女青年对避孕知识的了解,对意外妊娠风险的认识,男友对避孕方法使用的态度。与男友讨论避孕方法,对占孕服务可及性的感受是影响女 年既往避孕行为的主要因素,结论亟需对未婚青年开展有关避孕知识的性教育,提高对意外妊娠风险和人工并发症的认识促进男性积极参与避孕,加强性伴侣之间有关避孕方法的交流。     

人工流产女青年避孕知识、态度和行为的调查研究

目的:研究人工流产女青年的避孕知识、态度、行为及影响避孕行为的相关因素。方法:采用个人问卷调查方式,对618名年龄≤24周岁,自愿要求行人工流产的早孕女青年进行横断面调查。结果:在本次妊娠前3个月,仅有12.3%的女青年坚持每次性行为时使用避孕方法,偶尔使用和从未使用者的比例分别为58.9%和28.8%。在440名使用过避孕方法的女青年中,最常用的方法分别是避孕套(58.7%)、体外射精(28.5%)和安全期(27.5%),只有29.3%的人使用过紧急避孕药。本次妊娠原因58.7%是未采用任何避孕措施,其余是避孕失败。Logistic逐步回归分析显示,女青年的文化程度、对避孕知识的了解、对避孕方法的态度、男友对避孕的关心程度是影响避孕行为的主要因素。结论:亟需对女青年开展有关避孕知识的教育,促进安全、有效避孕措施的使用,促进男性积极参与避孕,以减少非意愿妊娠的发生,避免重复流产。     

上海药店避孕药具的可及性、可得性及服务质量调查

根据1996年对上海三个市区和两个郊县药店进行调查的资料,对该地区药店避孕药具的可及性、可得性及其服务质量进行分析。研究结果表明,各区、县销售避孕药具的药店都超过20个。药店销售的避孕药具种类包括口服药、避孕套、外用避孕药、避孕针、早孕诊断试剂等。三个市区药店避孕药具种类比两个郊县多。所有未婚青年在药店都能买到避孕药具。大部分营业员认为未婚青年到本店购买避孕药具较方便。经过培训的营业员,其药具知识得分高于未经培训的营业员。为更好地满足未婚青年的需求,药店的避孕服务有待进一步改善。     

未婚青年对避孕方法的选择

目的　了解未婚青年避孕状况 ,为婚前性教育提供依据。方法　利用上海市“未婚青年生殖健康保健需求调查”资料 ,对婚检青年关于避孕方法的选择进行分析。结果　未婚青年首次性行为时的避孕措施使用率为 2 4 0 % ;首次性生活后至首次怀孕间每次性生活时都使用避孕措施的使用率为 38 4 %。最常用的避孕方法为避孕套 ,其次依次为体外排精、口服药和安全期等。停用避孕套和体外排精法的主要原因是由于这两种方法影响性生活 ,停用口服药及安全期避孕的主要原因分别为不易获得、避孕失败。结论　未婚青年对常用避孕方法选择有性别差异和城乡差别 ,其它影响因素有文化程度性知识和避孕知识以及职业。     

向农村未婚青年提供生殖健康信息和服务的干预研究评估

目的:探索向农村未婚青年提供生殖健康信息和服务的有效方式。方法:采用社区干预试验方法于2001-2002年在成都市农村地区对1 895例16-20岁的未婚青年开展了调查研究。结果:干预活动使干预对象的性和生殖健康知识,如避孕原理、性传播疾病的传播途径及预防知识有显著提高;干预活动对调查对象的性观念改变不大,但促进了有性行为的未婚年轻人使用避孕措施。结论:向农村未婚青年提供生殖健康信息和服务的干预活动对于提高相关知识水平和促进安全性行为有显著效果。     

Fertility and contraceptive use among young adults in Harare, Zimbabwe

In 1986, a survey of young adults aged 14-24 in Harare, Zimbabwe obtained information about their knowledge, attitudes, and sexual behavior. Most adolescent childbearing took place within marriage, although sexual intercourse was generally initiated before marriage. Knowledge of family planning was high, but contraceptive use lagged behind knowledge. Fewer than half of the respondents had talked to an elder about family planning, sex, or pregnancy. Fourteen percent of young women who were unmarried at the time of first intercourse used contraceptives, compared to 18 percent of young unmarried men. Current contraceptive use among sexually active unmarried youths was 36 percent among women and 29 percent among men. One consequence of low contraceptive use was a high number of unwanted premarital pregnancies. Twenty-nine percent of the women had been pregnant; those not married at the time they got pregnant generally got married soon after. Of the girls who got pregnant while in school, 90 percent had to drop out of school. A second consequence of low contraceptive use is an increased risk of transmission of STDs and AIDS among the youth of Harare.     

2006～2008年山东省部分女性性工作者安全套使用及其影响因素分析

[目的]了解女性性工作者安全套使用及其影响因素,为制定防治对策和干预措施提供依据。[方法]2006～2008年每年的7～9月,分层整群抽取青岛、烟台及德州3个市娱乐场所的女性性工作者,进行问卷调查。[结果]合计调查3 460人,75.17%的人<25岁,未婚者占75.87%,初中文化者占71.27%;最近1个月发生商业性行为时坚持使用安全套率为45.10%,与固定性伴这一比例为24.25%;11.20%的调查对象承认有吸毒史;31.42%最近1年做过HIV检测;不同场所、年龄、婚姻状况、文化程度、民族、艾滋病知识得分以及是否接受过干预服务之间安全套使用率有统计学意义(P<0.01或0.05)。[结论]山东省部分女性性工作者最近1个月与商业性伴及固定性伴安全套使用率呈上升趋势。     

Knowledge of contraceptives and sexually transmitted diseases and contraceptive practices amongst young people in Ho Chi Minh City, Vietnam

In this article, we examine knowledge of contraceptives and sexually transmitted diseases (STDs) and contraceptive practices amongst young Vietnamese people. We conducted a qualitative study on sexuality and abortion with young people in Ho Chi Minh City, Vietnam. Twelve female and 4 male young people were individually interviewed using an in-depth interview technique. We found that condoms and pills were contraceptives known by almost all young people, but their knowledge of condoms and pills was still inadequate. Fears of side effects of taking pills and rumors and beliefs regarding condoms were quite common among young people. The limitations in young people's knowledge of contraceptives and STDs were a reflection of limited sources of their knowledge. Sexual education provided by educational institutions and within families was very basic. It did not provide clear knowledge on the sensitive topics such as contraceptive methods, and other issues related to sexuality for unmarried people. From a gender perspective, there are two points to note here: While sex issues were discussed openly among unmarried men, most unmarried women felt uncomfortable or expressed difficulty when talking about these issues; and the passiveness of unmarried women in making the decision of using condoms as well as contraceptives was marked. Amongst young people, the use of contraceptives was based mainly on ineffective methods including withdrawal and periodic abstinence. Further, young people's understanding of these methods was neither clear nor adequate. For the young people who did not use any contraceptives, sexual relations occurred unexpectedly. We conclude that creating a climate in which sexual issues can be discussed openly is an important step for the improvement of sexual health for young people. This will inevitably improve knowledge and understanding of contraceptives and STDs and may lead to a safer sexual life among this group of young people.     

Impact of an intervention to improve contraceptive use through follow-up phone calls to female adolescent clinic patients

CONTEXT: Adolescent females often have questions or concerns about their contraceptive methods, and they may discontinue use if these questions are not answered. Little evidence exists on whether follow‐up phone calls to address young women’s concerns can help sustain contraceptive use. METHODS: Between 2005 and 2007, a total of 805 females aged 14–18 attending a reproductive health clinic in San Francisco were randomly assigned to receive either regular clinic services or regular clinic services plus nine follow‐up phone calls over 12 months. The young women were surveyed at baseline and roughly six, 12 and 18 months later to measure condom and contraceptive use, rates of pregnancy and STDs, and other outcomes and mediators. Multiple linear and logistic regression repeated measures analyses were used to assess the program’s effects. RESULTS: Clinic counselors completed only 2.7 calls per patient, and made 7.8 attempts for every completed call. Although contraceptive use increased from baseline to follow‐up at six months in both groups, levels of condom and contraceptive use, and rates of pregnancy and STDs, did not differ between the intervention and control groups at any of the follow‐up assessments. Moreover, the intervention did not improve clinic utilization or satisfaction or have consistent positive effects on participants' attitudes. CONCLUSIONS: Reaching young women by phone after a clinic visit for contraception is challenging and does not appear to provide significant benefits beyond those provided by basic clinic services. More intensive interventions may be needed to markedly change adolescent sexual and contraceptive behavior.     

2006-2008年山东省部分女性性工作者安全套使用及其影响因素分析

[目的]了解女性性工作者安全套使用及其影响因素,为制定防治对策和干预措施提供依据。[方法]2006～2008年每年的7～9月,分层整群抽取青岛、烟台及德州3个市娱乐场所的女性性工作者,进行问卷调查。[结果]合计调查3460人,75．17％的人〈25岁,未婚者占75．87％,初中文化者占71．27％;最近1个月发生商业性行为时坚持使用安全套率为45．10％,与固定性伴这一比例为24．25％;11．20％的调查对象承认有吸毒史;31．42％最近1年做过HIV检测;不同场所、年龄、婚姻状况、文化程度、民族、艾滋病知识得分以及是否接受过干预服务之间安全套使用率有统计学意义（P〈0．01或0．05）。[结论]山东省部分女性性工作者最近1个月与商业性伴及固定性伴安全套使用率呈上升趋势。     

女青年人工流产情况及避孕知识调查

目的:了解郑州市女青年人工流产和避孕知识知晓情况,探讨人工流产影响因素。方法:采用自填式调查问卷,对郑州市年龄≤25岁1100名人工流产女青年进行横断面调查。结果:调查对象年龄为(22.50±1.68)岁,平均月收入为800元,职业以公司职员为主(29.4%),大部分未婚,流动人口占75.1%,初中以下文化程度和常住人口相比有统计学意义;34.9%的女青年经历过流产,首次流产未婚者占72.6%,且随着年龄增加,重复流产率逐渐增高;本次妊娠原因67.9%的女青年未采用避孕措施,32.1%为避孕失败,避孕失败的主要原因是避孕套(44.5%)、安全期(25.2%)和体外排精(15.9%);过去3个月中,最常用的避孕方法是避孕套(82.3%),其次为紧急避孕(28.5%)、安全期(27.7%)、体外排精(22.7%);谈及避孕知识,深入到避孕措施具体使用方法回答正确率较低。结论:非意愿妊娠的主要原因是未采用避孕措施,而使用避孕措施的女青年中,坚持使用和正确使用有效避孕措施率低,且流产女青年掌握的避孕知识有限,应加强未婚人群和流动人口的避孕知识宣教和咨询,内容侧重坚持、正确使用高效避孕措施的宣传,提供优质的计划生育服务,从而避免非意愿妊娠和人工流产。     

广东省城市流动人口年轻女性避孕现况调查

目的 :调查广东省城市流动人口年轻女性避孕现况及需求 ,探讨加强该人群避孕意识、降低人工流产率的有效措施。方法 :采用个人问卷调查和小组访谈方式调查了 2 0 0 6名 15～ 35岁流动人口女性。结果 :有婚前性行为者占 2 3 4 % ,其中有人工流产史者占 6 6 8% ,75 7%是由于未采用避孕措施造成的。未婚人工流产者性行为中无避孕措施的高达 93.9%。 2 0 0 6人中避孕知识答卷得分≥6 0分占 35 9% ,<6 0分占 6 4 1% ,其中 0分占 7 6 % ;有人工流产史者避孕知识得分≥ 6 0分占18 7% ,<6 0分占 81 3%。能说出 3种以上避孕药具及正确使用方法的仅占 8 0 %。能正确描述紧急避孕方法者占 12 % ;听说过紧急避孕但不能正确描述者占 34 0 % ;不知道紧急避孕者占 5 3 9%。结论 :流动人口年轻女性避孕生殖健康知识贫乏 ,婚前性行为普遍 ,无防护性行为率高。     

计划生育优质服务综合干预对3个城市流动人口安全套使用的影响

目的：评估开展计划生育优质服务干预活动对上海、北京、成都三城市流动人口安全套使用的影响。方法采用多阶段整群抽样的方法，在北京、上海、成都三个中心选择流动人口集中的工厂、建筑工地和服务娱乐场所各4个，实际调查流动人口6304例。随机分为干预组（2974例）和对照组（3330例）。在选定的干预组实施计划生育优质服务综合干预方案，对照组开展常规工作。通过结构式问卷调查评估干预对安全套使用的效果。结果基线调查中有1130名流动人口使用安全套。干预后最近3次性生活均坚持使用安全套的比例上升。上海现场干预组从93.5％提高到95.9％；北京现场干预组从87.8％提高到95.5％；成都现场干预组从96.7％提高到97.8％。加权最小二乘估计模型结果提示，北京现场的干预能提高流动人口安全套坚持使用率。结论干预活动促进了流动人口安全套的使用，今后应将干预活动融入常规工作，提高安全套使用率。     

未婚女青年流产及接受流产后服务的现况调查

目的:了解未婚女青年流产原因以及避孕知识、行为和在医院接受的流产后服务现况。方法:采用分层整群随机抽样的方法,选取在郑州市8家医院自愿要求流产、年龄≤25岁的女青年进行横断面现场问卷调查,获得合格调查问卷992名,本文仅分析其中的705名未婚妇女数据。结果:调查对象年龄在16.4～25岁之间,62.1%未婚同居,33.3%有流产史。本次流产原因未避孕66.7%,避孕失败33.3%。58.2%曾使用过避孕措施,既往使用的避孕方法构成为:避孕套47.2%、紧急避孕药18.3%、安全期16.0%、体外射精13.8%、口服避孕药4.6%、宫内节育器0.1%。避孕和生殖健康知识得分无1人满分,13个问题中能正确回答7个问题的占44.7%。术后接受宣教内容最多的是流产后注意事项(95.6%),最少的是避孕药具的优缺点(26%)。没有接受过医生提供的咨询服务有83.0%;医生没有提供免费的避孕药具和转诊服务。93.9%的愿意接受流产后宣教服务。结论:未婚女青年流产原因多为未避孕,她们缺乏避孕知识,避孕措施使用率低,现医院提供的流产后服务不能满足育龄妇女的需求。     

Trends and determinants of contraceptive use in Rakai District, Uganda, 1995-98

A prospective study conducted between 1995 and 1998 assessed trends in contraceptive use in rural Rakai District, Uganda. Over a period of 30 months, women's use of modern contraceptives increased significantly from 11 percent to 20 percent. Male condom use increased from 10 percent to 17 percent. The prevalence of pregnancy among sexually active women 15-49 declined significantly from 15 percent to 13 percent. Women practicing family planning for pregnancy prevention were predominantly in the 20-39-year age group, married, better educated, and had higher parity than others, whereas women or men adopting condoms were predominantly young, unmarried, and better educated. Condom use was particularly high among individuals reporting multiple sexual partners or extramarital relationships. Contraceptive use was higher among women who desired fewer children, among those who wished to space or terminate childbearing, and among women with previous experience of unwanted births or abortions. Self-perception of HIV risk increased condom use, but HIV testing and counseling had only modest effects. Contraception for pregnancy prevention and for HIV/STD prophylaxis are complementary.     

Determinants of condom use among young people in urban Cameroon

To reduce the prevalence of reproductive health problems among adolescents, governmental and nongovernmental organizations in Cameroon are implementing youth-oriented reproductive health programs. To facilitate the design of effective programs to increase condom use, this study examines survey data on the determinants of having ever used condoms and on current condom use with regular and casual partners among unmarried young people in urban Cameroon. While most adolescents have tried condoms at least once, use remains inconsistent. Parental support, personal risk perception, and self-efficacy are found to be associated with higher levels of condom use. Youth-oriented programs seeking to increase the number of new condom users among the young should promote parental support for condom use and enhance young people's perceptions of personal risk. Programs that work to convince the young that their sexual history can put them at risk of HIV infection and that dispel the myth that HIV risk with regular partners is low may serve to increase personal risk perception. Finally, communications programs should aim to increase adolescents' self-efficacy, particularly in terms of their perceived ability to convince partners to use condoms and to use them correctly.     

非户籍育龄妇女避孕现状及影响因素分析

[目的]了解非户籍育龄妇女的避孕节育现状并分析其影响因素,为进一步完善非户籍人口避孕节育服务提供依据。[方法]对2007年7月至2008年12月在某社区卫生服务中心妇科就诊的所有非上海户籍育龄妇女共430例进行避孕情况的问卷调查,分析影响因素。[结果]有79.3%的妇女近1年内采取避孕措施,已婚妇女以采用宫内节育器(IUD)为主(占50.8%),未婚妇女以使用避孕套为主(占61.3%)。71.3%的妇女对所采取的避孕方法满意。获取避孕药具的途径,90.3%的未婚者为自行购买,免费获取的仅占9.7%。[结论]管理-宣教-服务相结合的服务模式有利于提高非户籍妇女的避孕率和避孕方法满意率。