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Introduction: School-based health centers (SBHCs) are an evidence-based model for providing contraceptives to adolescents. SBHCs ability to provide reproductive health services is often limited by school district policies, state laws, and health center policies. Methods: We used data from the Teens Exploring and Managing Prevention (TEMPO) study to document demographic characteristics and birth control methods among patients at four SBHCs in New Mexico. A total of 264 teens were included in the baseline data collection at SBHCs in New Mexico. A baseline survey was administered via iPad, that specifically focused on questions related to sexual experiences and sexual health topics. Baseline questions included demographic questions, gender identity, sexual orientation, reasons for visits, reproductive practices, and birth control methods. Descriptive statistics were calculated, including means and standard deviations for continuous variables and categorical frequencies. Results: Our findings present reproductive health behaviors among New Mexican patients attending schools with SBHCs. More than 74% of respondents were Hispanic or Latino. The most common reason teens went to the SBHC was for birth control, and just 62% of teens reported using birth control methods in the past. Discussion: These behaviors are essential for policymakers to consider as they address policy gaps, the complex landscape of parental permission, reproductive rights, and health as a human right.

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OBJECTIVE: To report on long-acting reversible contraception (LARC) experience and continuation rates in the Adolescent Medicine LARC Collaborative. STUDY DESIGN: LARC insertion data (682 implants and 681 intrauterine devices [IUDs]) were prospectively collected from January 1, 2017, through December 31, 2019, across 3 Adolescent Medicine practices. Follow-up data through December 31, 2020, were included to ensure at least 1 year of follow-up of this cohort. Continuation rates were calculated at 1, 2, and 3 years, overall and by Adolescent Medicine site, as were descriptive statistics for LARC procedural complications and patient experience. RESULTS: Implant and IUD insertion complications were uncommon and largely self-limited, with no IUD-related uterine perforations. Uterine bleeding was the most frequently reported concern at follow-up (35% implant, 25% IUD), and a common reason for early device removal (45% of implant removals, 32% of IUD removals). IUD malposition or expulsion occurred following 6% of all insertions. The pooled implant continuation rate at 1 year was 87% (range, 86%-91% across sites; P = .63), 66% at 2 years (range, 62%-84%; P = .01), and 42% at 3 years (range, 36%-60%; P = .004). The pooled IUD continuation rate at 1 year was 88% (range, 87%-90% across sites; P = .82), 77% at 2 years (range, 76%-78%; P = .94), and 60% at 3 years (range, 57%-62%; P = .88). CONCLUSIONS: LARC is successfully provided in Adolescent Medicine clinical settings, with continuation rates analogous to those of well-resourced clinical trials. Uterine bleeding after LARC insertion is common, making counselling imperative. Future analyses will assess whether the medical management of LARC-related nuisance bleeding improves continuation rates in our Adolescent Medicine patient population.

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OBJECTIVE: Our objective was to observe the prevalence of postpartum contraceptive use in a population of rural women in Southwest Guatemala by type, and to determine characteristics associated with long-acting reversible contraceptive (LARC) use and sterilization. METHODS: We conducted a secondary analysis of prospectively collected quality improvement data from a cohort of postpartum women. We compared women intending to use or already using contraception to those not intending to utilize a method; bivariate comparisons were used to determine if there were differences in characteristics between these groups. If differences occurred (p < 0.2), those covariates were included in multivariable regression analyses to determine characteristics associated with use, and then specifically with LARC use and sterilization. RESULTS: In a cohort of 424 women who were surveyed between 2015-2017, the average age was 23 years old, and the prevalence of use or plan to use postpartum contraception was 87.5%. Women with a parity of 2 - 3 were 10% more likely to use any form of postpartum birth control (RR 1.1, CI [1.01, 1.2]) compared to primiparous women. Women who were married were also more likely to use a postpartum method (RR > 10, CI [>10,>10]). The prevalence of LARC use was low (4.0%), and women were more likely to choose this method if they were employed (RR 3.5 CI [1.1, 11.3]).Regarding sterilization, women with a parity of greater than one compared to primiparous women had an increased likelihood of sterilization (RR 3.6 CI [2.5,4.9]); each year a woman aged was associated with a 10% increased likelihood of postpartum sterilization (RR 1.1 CI [1.01,1.08]). Women were also more likely to choose sterilization if delivered by a skilled birth attendant (RR 1.8 CI [1.1,2.9]) or by cesarean birth (RR 2.1 CI [1.4,3.1]). CONCLUSION: In this cohort, married women of higher parity were more likely to use postpartum contraception, with employed women more likely to use a LARC method. Older women of higher parity who were delivered by a skilled attendant by cesarean birth were the most likely to pursue sterilization.

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OBJECTIVE: Effective contraception prevents unintended pregnancy which disproportionately affects women in the criminal justice system. This study examined selected variables associated with contraceptive use by women on probation and parole living on the United States-Mexico border. DESIGN: This quantitative correlational study examined individual and interpersonal variables-age, parity, ethnicity, prior contraception, self-efficacy, pregnancy attitudes, and reproductive autonomy-that may influence contraception among 52 women under community supervision. MEASURES: Variable were examined with bivariate, multivariate analyses, and hierarchical logistic regression. Data were collected from a demographic and contraceptive use survey, and validated scales measuring reproductive autonomy and pregnancy attitudes. RESULTS: Contraceptive methods were used by 89% of the women; 65% used effective methods, but this decreased to 35% among those released within the past year. Reproductive autonomy was associated with effective contraceptive use. Prior contraception and contraceptive self-efficacy were significant, but wide confidence intervals suggested instability. The remaining variables were insignificant. CONCLUSION: No known studies have examined contraception use among women on probation and parole on the border. More women used some form of contraception than might be predicted. Collaborative efforts between correctional facilities and the community are needed to expand access to contraception.

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A reprodução descontrolada de animais semi-domiciliados está envolvida com abandono e riscos à saúde pública devido às possíveis zoonoses veiculadas. Projetos de extensão de controle da natalidade de cães e gatos proporcionam aprendizagem e treinamento dos alunos sob a supervisão, bem como a orientação de tutores sobre o manejo adequado de seus animais e a guarda responsável. O objetivo do projeto foi promover o treinamento clínico, cirúrgico e aproximação dos estudantes com os tutores de animais de companhia. Alunos do curso de medicina veterinária realizaram, sob supervisão dos docentes e pós graduandos, atendimento clínico e cirurgias eletivas de castração de cães e gatos de tutores desafiados financeiramente. Após seis meses de treinamento foi aplicado um questionário aos discentes, o objetivo foi avaliar a evolução dos conhecimentos adquiridos. Trinta alunos responderam aos questionários, sendo que 47% demonstraram ter adquirido maior conhecimento na prática cirúrgica; 23% nas habilidades anestésicas; 20% em outros procedimentos e 10% no trabalho em equipe. Estes resultados confirmam a necessidade de treinamento dos graduandos em ações extra sala de aula, para que seja possível a formação de um profissional capacitado e seguro para exercer a profissão, estimulando e fortalecendo o trabalho em equipe(AU)

The concern with semi-domiciled animals is involved with the uncontrolled reproduction, abandonment and risk to the public health due to the possible zoonoses transmitted. Cat and dog birth control extension projects provide learning and training for students, under the supervision of professors as well as tutors are advised on the proper management of their animals by encouraging responsible custody. The objective was to promote student training on clinical, surgical and access with the reality of pet owners. Veterinary medicine students underwent clinical and surgical care, under the supervision of the professors, in order to carry out elective castration of patients of financially challenged tutors. After six months of training, a questionnaire was developed in order to identify if there was evolution in relation to the acquired knowledge. Thirty students answered the questionnaires, 47% of whom demonstrated greater knowledge in the surgical practice; 23% in anesthetic skills; 20% in other procedures and 10% in teamwork. These results demonstrate the need for training of undergraduates, with participation in extra-classroom actions, so that it is possible to train a qualified and safe professional to practice the profession, stimulating and strengthening teamwork.(AU)

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A reprodução descontrolada de animais semi-domiciliados está envolvida com abandono e riscos à saúde pública devido às possíveis zoonoses veiculadas. Projetos de extensão de controle da natalidade de cães e gatos proporcionam aprendizagem e treinamento dos alunos sob a supervisão, bem como a orientação de tutores sobre o manejo adequado de seus animais e a guarda responsável. O objetivo do projeto foi promover o treinamento clínico, cirúrgico e aproximação dos estudantes com os tutores de animais de companhia. Alunos do curso de medicina veterinária realizaram, sob supervisão dos docentes e pós graduandos, atendimento clínico e cirurgias eletivas de castração de cães e gatos de tutores desafiados financeiramente. Após seis meses de treinamento foi aplicado um questionário aos discentes, o objetivo foi avaliar a evolução dos conhecimentos adquiridos. Trinta alunos responderam aos questionários, sendo que 47% demonstraram ter adquirido maior conhecimento na prática cirúrgica; 23% nas habilidades anestésicas; 20% em outros procedimentos e 10% no trabalho em equipe. Estes resultados confirmam a necessidade de treinamento dos graduandos em ações extra sala de aula, para que seja possível a formação de um profissional capacitado e seguro para exercer a profissão, estimulando e fortalecendo o trabalho em equipe

The concern with semi-domiciled animals is involved with the uncontrolled reproduction, abandonment and risk to the public health due to the possible zoonoses transmitted. Cat and dog birth control extension projects provide learning and training for students, under the supervision of professors as well as tutors are advised on the proper management of their animals by encouraging responsible custody. The objective was to promote student training on clinical, surgical and access with the reality of pet owners. Veterinary medicine students underwent clinical and surgical care, under the supervision of the professors, in order to carry out elective castration of patients of financially challenged tutors. After six months of training, a questionnaire was developed in order to identify if there was evolution in relation to the acquired knowledge. Thirty students answered the questionnaires, 47% of whom demonstrated greater knowledge in the surgical practice; 23% in anesthetic skills; 20% in other procedures and 10% in teamwork. These results demonstrate the need for training of undergraduates, with participation in extra-classroom actions, so that it is possible to train a qualified and safe professional to practice the profession, stimulating and strengthening teamwork.

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In response to the Zika virus outbreak in Puerto Rico (2015-2016), the Zika Contraception Access Network (Z-CAN) was established to provide same-day access to the full range of reversible contraception at no cost to women. Formative research was conducted to inform the development of a communication campaign about Z-CAN. Ten focus groups with women and men, aged 18 to 49 years, in Puerto Rico were conducted to collect data on contraception awareness, use, and decision making during the Zika outbreak, as well as culturally appropriate messaging and outreach strategies. Thematic analysis was conducted using the constant comparative method. Data showed that there was community awareness regarding Zika in Puerto Rico. However, it was not a motivating factor in contraception decision making; instead, economic factors were the major drivers. Most participants preferred to receive information on contraception, potential side effects, and where to access contraceptive services via Internet-based channels and health care providers. Based on these findings, the Ante La Duda, Pregunta [When in Doubt, Ask] campaign was launched to promote awareness of Z-CAN services among those who chose to prevent pregnancy during the Zika outbreak. Our results underscore the importance of conducting formative research to develop communication initiatives, while also demonstrating that it is feasible to perform these activities as part of an emergency response.

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Adolescent pregnancy rates are high worldwide. However, insufficient information exists regarding the frequency of birth control methods used before the first pregnancy and postpartum. In the current study, we analyzed the association of sociodemographic factors with the knowledge of birth control methods and their use before and after pregnancy in a sample of adolescents in Mexico City. A cohort study was conducted on 600 pregnant adolescents in Mexico City, from 2013 to 2017, at a health care institution providing prenatal care. Participants were assessed during the second trimester and four months postpartum. The questionnaire explored the knowledge of birth control methods, their use, and other associated factors. Two logistic regression models were implemented to identify potential variables associated with the lack of birth control method use before and after pregnancy. The mean age of participants was 15.4 + 1 years, of which, 48% and 65.2% used a birth control method before pregnancy and postpartum, respectively. We found that the main factors associated with increased risk of not using any birth control method before pregnancy included being under the age of 15 years, school dropout, having an educational lag, initiation of sexual life before the age of 15, and having a mother who did not inform their child about contraceptives. By contrast, variables associated with a higher risk of not using any contraceptive methods after pregnancy included educational lag, lower level of education, and the fact that the adolescent had not used any birth control prior to the pregnancy.

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Resumo O artigo analisa matérias sobre pílulas anticoncepcionais publicadas em A Gazeta da Farmácia, entre 1960 e 1980, examinando aspectos pouco conhecidos da biografia desses medicamentos e da constituição do seu mercado. Para os profissionais de farmácia, os anticoncepcionais orais se apresentaram como "as pílulas da oportunidade", seja no sentido dos lucros, seja no sentido de resgatar seu prestígio no campo científico, clínico-terapêutico e político. As trajetórias das pílulas anticoncepcionais e do mundo da farmácia se interseccionaram, quando ambos buscavam tecer sua biografia, apadrinhados pela indústria. Farmacêuticos e pílulas se coconstituíram, um sendo importante ponto de passagem para outro.

Abstract The pharmacy world was a mandatory crossing point and active player in the establishment of hormonal contraception in Brazil. Through an analysis of articles published in A Gazeta da Farmácia from 1960 to 1981, the study explores little-known aspects of the birth control pill's biography and the construction of its Brazilian market. For pharmacy professionals, oral contraceptives were "opportunity pills" in two senses: they provided profits and they restored the prestige of these professionals within the scientific, clinical-therapeutic, and political realms. The pathways of the pill and the pharmacy world intersected as both wove their biographies under the patronage of industry. Pharmacists and the pill were co-constructed, and each was an important crossing point for the other.

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This study used infrared thermography to monitor the immediate inflammatory reaction to an intratesticular injection of 20% (calcium chloride) CaCl2 with 0.5% dimethyl sulfoxide (DMSO) for chemical castration and to provide evidence of the treatment's clinical viability. Six animals received a 0.25 mL intratesticular injection of 20% CaCl2 with 0.5% DMSO in each testis. Thermographic imaging, testicular measurement, penile spine evaluation, electroejaculation, and sperm analysis were performed before the injection. Eighty days post-injection, the cats were evaluated again, then received an orchiectomy followed by histological analysis. Infrared thermography of the testicular area was performed before (M0) and after anesthesia (M0A); after electroejaculation (M0E); 10 min (M1), 1 h, (M2) and 6 h (M3) after the injection for seven consecutive days (M4-10); after 15 (M11) and 30 days (M12); and after 80 days, before and after anesthesia and after electroejaculation (M13, M13A and M13E). No cats had a significant increase in testicular temperature or behavioral changes. All animals were azoospermic and had a 50% reduction in total testicular volume after 80 days. Histologically, the testes showed different degrees of degeneration, necrosis, calcification and replaced connective tissue, as well as Leydig cell hyperplasia in 7/12 of the testes. Infrared thermography efficiently diagnosed and monitored scrotal inflammation caused by intratesticular injection of 20% CaCl2 solution with 0.5% DMSO, and it is suggested that a single injection of this compound can cause azoospermia after 80 days. We concluded by infrared thermography with a clinical exam, that the adverse reactions were minimal and did not interfere with animal welfare.

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Objetivo: O Brasil sofreu um rápido e intenso declínio da fecundidade nos últimos 40 anos. Nos últimos 20 anos o jovem passou a ter mais acesso a informações sobre questões sexuais. No final dos anos 80 destacou-se o advento da AIDS e a precocidade da iniciação sexual entre adolescentes na última década. Assim, o presente trabalho propôs-se verificar o nível de conhecimento e utilização de métodos anticoncepcionais entre as mulheres residentes na região Sul da cidade de São Paulo. Métodos: Realizou-se um estudo do tipo inquérito CAP; Conhecimento, Atitude e Prática, em 40 mulheres com faixa etária entre 14 a 50 anos, na região Sul de São Paulo. Resultados: Dentre o total de mulheres entrevistadas, 66% apresentaram faixa etária entre 14 e 30 anos. O nível de escolaridade das entrevistadas foi de 37% com nível superior incompleto e 36% com nível superior completo totalizando 73% das entrevistadas. Quanto ao conhecimento frente aos diferentes métodos anticoncepcionas apresentados, observou-se que 34% fazem uso da pílula como contraceptivo hormonal oral e 33% utilizam a camisinha masculina como contraceptivo de barreira, perfazendo um total de 67 %. Discussão: Ficou evidente por esse estudo o baixo conhecimento da camisinha feminina, bem como da sua utilização como metodo contraceptivo feminino de barreira pelas entrevistadas (8%). Observou-se, ainda que 98% das mulheres entrevistadas já teve orientação sobre Doenças Sexualmente Transmissíveis (DSTs). Esses achados sugerem uma forte associação entre a prática da utilização de metodos contraceptiveis por mulheres com melhores níveis de escolaridade, uma vez que o acesso a informação em escolas, universidades e em leituras somaram 62,5% das mulheres entrevistadas.

Objective: The Brazil suffered a quick and intense decline of fertility in the last 40 years. In the last 20 years the young man had more access to information about sexual matters. In the late 80 occurred the advent of AIDS and the precocity of sexual initiation among teenagers in the last decade have been observed. Thus, the present work proposed to verify the level of knowledge and use of contraceptive methods among women residing in the region South of São Paulo city. Methods: Enquiry study type KAP; Knowledge, attitude and practice in 40 women between 14 to 50 years was performed in the South of São Paulo city. Results: Among the women interviewed, 66% showed 14 to 30 age years. The education level of the respondents was 37% with upper level incomplete and 36% with upper level complete totaling 73% of respondents. Concerning to the different contraceptives methods presented, it was noted that 34% make use of the pill as a hormonal oral contraceptive and 33% use the male condom as barrier contraceptive, making a total of 67%. Discussion: It became apparent by this study the low knowledge about the female condom, as well as its use as a contraceptive barrier method by female respondents (8%). It was also observed that 98% of women interviewed ever had guidance on sexually transmitted diseases (Std). These findings suggest a strong association between the practice of contraceptives methods used to the best levels of schooling, since the access to information in schools, universities and lectures totaled 62.5% of the interviewed woman.

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Objetivo: O Brasil sofreu um rápido e intenso declínio da fecundidade nos últimos 40 anos. Nos últimos 20 anos o jovem passou a ter mais acesso a informações sobre questões sexuais. No final dos anos 80 destacou-se o advento da AIDS e a precocidade da iniciação sexual entre adolescentes na última década. Assim, o presente trabalho propôs-se verificar o nível de conhecimento e utilização de métodos anticoncepcionais entre as mulheres residentes na região Sul da cidade de São Paulo. Métodos: Realizou-se um estudo do tipo inquérito CAP; Conhecimento, Atitude e Prática, em 40 mulheres com faixa etária entre 14 a 50 anos, na região Sul de São Paulo. Resultados: Dentre o total de mulheres entrevistadas, 66% apresentaram faixa etária entre 14 e 30 anos. O nível de escolaridade das entrevistadas foi de 37% com nível superior incompleto e 36% com nível superior completo totalizando 73% das entrevistadas. Quanto ao conhecimento frente aos diferentes métodos anticoncepcionas apresentados, observou-se que 34% fazem uso da pílula como contraceptivo hormonal oral e 33% utilizam a camisinha masculina como contraceptivo de barreira, perfazendo um total de 67 %. Discussão: Ficou evidente por esse estudo o baixo conhecimento da camisinha feminina, bem como da sua utilização como metodo contraceptivo feminino de barreira pelas entrevistadas (8%). Observou-se, ainda que 98% das mulheres entrevistadas já teve orientação sobre Doenças Sexualmente Transmissíveis (DSTs). Esses achados sugerem uma forte associação entre a prática da utilização de metodos contraceptiveis por mulheres com melhores níveis de escolaridade, uma vez que o acesso a informação em escolas, universidades e em leituras somaram 62,5% das mulheres entrevistadas.(AU)

Objective: The Brazil suffered a quick and intense decline of fertility in the last 40 years. In the last 20 years the young man had more access to information about sexual matters. In the late 80 occurred the advent of AIDS and the precocity of sexual initiation among teenagers in the last decade have been observed. Thus, the present work proposed to verify the level of knowledge and use of contraceptive methods among women residing in the region South of São Paulo city. Methods: Enquiry study type KAP; Knowledge, attitude and practice in 40 women between 14 to 50 years was performed in the South of São Paulo city. Results: Among the women interviewed, 66% showed 14 to 30 age years. The education level of the respondents was 37% with upper level incomplete and 36% with upper level complete totaling 73% of respondents. Concerning to the different contraceptives methods presented, it was noted that 34% make use of the pill as a hormonal oral contraceptive and 33% use the male condom as barrier contraceptive, making a total of 67%. Discussion: It became apparent by this study the low knowledge about the female condom, as well as its use as a contraceptive barrier method by female respondents (8%). It was also observed that 98% of women interviewed ever had guidance on sexually transmitted diseases (Std). These findings suggest a strong association between the practice of contraceptives methods used to the best levels of schooling, since the access to information in schools, universities and lectures totaled 62.5% of the interviewed woman.(AU)

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OBJECTIVE: The aim of this research was to develop a questionnaire to facilitate choice of the most appropriate contraceptive method for individual women. METHODS: A literature review was conducted to identify key aspects influencing contraceptive choice and inform development of a questionnaire for online completion. Questionnaire development was overseen by a steering committee consisting of eight gynaecologists from across Europe. The initial draft underwent conceptual validation through cognitive debriefing interviews with six native English-speaking women. A qualitative content analysis was conducted to accurately identify potential issues and areas for questionnaire improvement. A revised version of the questionnaire then underwent face-to-face and online evaluation by 115 international gynaecologists/obstetricians with expertise in contraception, prior to development of a final version. RESULTS: The final conceptually validated Contraception: HeLping for wOmen's choicE (CHLOE) questionnaire takes ≤10 min to complete and includes three sections to elicit general information about the individual, the health conditions that might influence contraceptive choice, and the woman's needs and preferences that might influence contraceptive choice. The questionnaire captures the core aspects of personalisation, efficacy and safety, identified as key attributes influencing contraceptive choice, and consists of 24 closed-ended questions for online completion prior to a health care provider (HCP) consultation. The HCP receives a summary of the responses. CONCLUSION: The CHLOE questionnaire has been developed to help women choose the contraception that best suits their needs and situation while optimising the HCP's time.

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Resumen Introducción. El aborto se ha convertido en un problema de salud pública. Una las causas que podría estar influyendo para su aumento es la falta de información sobre el control prenatal, por lo anterior, este es un tema que no escapa de la realidad y de la práctica médica. Objetivo. Caracterizar clínica y epidemiológicamente el aborto. Materiales y Métodos. Estudio observacional, descriptivo, retrospectivo, realizado en el Hospital "Gervasio Vera Custodio" Upata-Estado Bolívar, Venezuela, durante el periodo comprendido de enero a diciembre de 2013. Se recolecto datos de 207 historias clínicas de mujeres con diagnóstico de aborto. En el análisis estadístico se aplicó la prueba chi2 de Pearson. Resultados. Se encontró que la edad prevalente de aborto fue de 21 a 30 años con 42%. La edad gestacional más frecuente de las pacientes fue de 1 a 8 semanas con 50%. De estas 93,5% no cumplieron control prenatal. El tipo de aborto más frecuente fue espontáneo con 98,5%. Se realizó legrado uterino a 97%, de las cuales, 8,5% presentaron complicaciones. Se encontraron diferencias estadísticamente significativas al relacionar la edad materna con la edad gestacional. Conclusiones. Existió alta prevalencia de aborto espontáneo en el grupo de 21 a 30 años de edad, presentados entre las semanas 1 a 8 de gestación. La técnica más segura fue el legrado uterino. Finalmente, se encontró bajo cumplimiento del control prenatal.

Abstract Introduction. The abortion has become a public health problem may be due to the lack of information about prenatal care, so that this is an issue which does not escape reality and everyday medical practice. Objective. Characterize the abortion clinic and epidemiologically. Materials and Methods. An observational, descriptive, retrospective study at the Hospital "Gervasio Vera Custodio" Upata-Ciudad Bolivar, Venezuela was performed from January to December 2013. Data from 207 women with diagnosed a diagnosis of abortion were collected from medical records. Pearson chi-square test was applied for the statistical analysis. Results. It was found that abortion was prevalent among 21-30 years old with a 42%. The most common gestational age of abortion was 1 to 8 weeks in the 50% and 93.5% of them did not meet prenatal care. The most frequent abortion was spontaneous in 98.5% ot the patients. Curettage was performed in 97%, of which 8.5% had complications. Statistically significant differences were found to maternal age related to gestational age. Conclusion. There was high prevalence of abortion in the group of 21-30 years of age with 1 to 8 weeks of gestation. The safest practice was the uterine curettage. Finally, the mayority of the cases had no prenatal care.

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Introducción: Los implantes subdérmicos proveen alta efectividad anticonceptiva reversible; no obstante, con su empleo ocurren algunos efectos colaterales. Se ha demostrado que algunas mujeres son menos tolerantes a ellos y solicitan tempranamente el retiro. Objetivo: Evaluar factores relacionados con el retiro del implante subdérmico Implanon®, en mujeres usuarias del programa ambulatorio de Planificación Familiar de una institución de Salud ubicada en Tunja. Materiales y métodos: Estudio observacional, de corte transversal analítico. Se revisaron las historias clínicas de 184 usuarias que solicitaron el retiro del implante en el período comprendido entre 2009 y 2012; se registraron las razones aducidas por las pacientes para solicitar el retiro del implante subdérmico, excluyendo el deseo de una nueva gestación y el tiempo de empleo. Resultados: La media de edad fue de 27,8 años; el tiempo mínimo de uso fue 2 meses, con media de 2,7 años (SD=1,7), la principal razón fue cambios en el patrón de sangrado genital (74,5%), seguida de cefalea (71,7%), cambios en el estado de ánimo (57,6%), dolor pélvico 57,1% y dolor de origen venoso 42,9%; la mayoría de efectos se presentan al inicio de la inserción y tienden a desaparecer en el curso de los primeros meses, con excepción de la cefalea y los cambios de peso. Conclusiones: El implante subdérmico es un método anticonceptivo altamente eficaz; es recomendable realizar intervenciones de educación en salud previo a la inserción.

Introduction: Subdermal implants provide high reversible contraceptive effectiveness; however, some side effects occur with their use. It has been shown that some women are less tolerant to them so they ask for an early retirement. Objective: To assess factors related to the removal of the subdermal implant Implanon ® in women who are users of the ambulatory family planning program of a health institution located in Tunja. Materials and methods: An observational, analytical cross-sectional study was made where the medical histories of 184 users who requested the removal of the implant between 2009 and 2012 were reviewed. The reasons given by patients to request the removal of the subdermal implant were registered, excluding the desire for a new pregnancy and the time use. Results: It was found that the average age was of 27,8 years; the minimum time of use was 2 months with average of 2.7 years (SD = 1, 7). The main reason to request the procedure was due to the changes in their period (74.5%), followed by headache (71.7%), changes in mood (57.6%), pelvic pain (57.1%) and pain of venous origin (42.9%). Most effects occur at the beginning of the inclusion and tend to disappear in the course of the first months, except for the headache and weight changes. Conclusions: The subdermal implant is a highly effective method of birth control. It is recommended to make effective health education interventions prior to insertion.

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El artículo busca presentar el contexto y aproximación preliminares necesarios para comprender y abordar el debate sobre el control natal en Colombia en las décadas de 1960 y 1970. Recoge las principales posturas en conflicto en dicho período, y los discursos y lógicas que permearon la llegada de los programas de planificación norteamericanos a América Latina como forma de control político de los movimientos revolucionarios.

The article seeks to present the necessary context and a preliminary approach to understanding and addressing the birth control debate in Colombia in the 1960s and 1970s. It covers the main conflicting positions during that period and the discourses and logics permeating the arrival of North American family planning programs to Latin America as a form of political control of revolutionary movements.

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Aim: To describe the sexual and birth control health practices of Brazilian female undergraduates and compare them according to family income. Method: This is a descriptive study of a sample of eighty female public university students, using the chi-square test, with a significance level of p<0.05, and modified contingency coefficient. Results: Female undergraduates with lower incomes initiated their sex lives between the ages of 14 and 16 years (53.3%), used protection in their first sexual experience (80%) and used public health services (66.7%). Those with higher incomes started their sex lives at the age of 17 years old or more (64.7%), their first sexual intercourse was unprotected (35.3%), and they used the private health network (88.2%). Discussion: The level of family income does not influence access to sexual and reproductive health in the investigated sample. Conclusion: There are differences in the type of service provider used between those with different family incomes.

Objetivos: Descrever as práticas de saúde sexual e contraceptivas das jovens universitárias e comparar as similaridades e diferenças destas práticas segundo a renda familiar. Método: Pesquisa descritiva. A amostra investigada foi de oitenta jovens de uma universidade pública. Foi aplicado o teste qui-quadrado, nível de significância p<0,05, e o coeficiente de contingência modificado. Resultados: As universitárias com menor renda iniciaram a prática sexual entre os 14 e 16 anos (53,3%), utilizaram o preservativo na primeira relação sexual (80%) e são usuárias de serviços públicos de saúde (66,7%). As jovens com maior rendimento começaram a vida sexual com 17 anos ou mais (64,7%), a primeira relação sexual foi mais desprotegida (35,3%) e são atendidas na rede suplementar (88,2%). Discussão: O nível de renda familiar não influencia no acesso à saúde sexual e reprodutiva da amostra investigada. Conclusão: Houve diferença para o tipo de prestador de serviço de saúde segundo a renda.

Objetivos: Describir las prácticas de salud sexual y contraceptivas de las jóvenes universitarias y comparar las similaridades y diferencias de estas prácticas según la renta familiar. Método: Pesquisa descriptiva. La muestra investigada fue de ochenta jóvenes de una universidad pública. Fue aplicado el test qui-cuadrado, nivel de significancia p<0,05, y el coheficiente de contingencia modificado. Resultados: Las universitarias con menor renta iniciaron la práctica sexual entre los 14 y16 años (53,3%), utilizaron el preservativo en la primera relación sexual (80%) y son usuarias de servicios públicos de salud (66,7%). Las jóvenes con mayor rendimiento comezaron la vida sexual con 17 años o más (64,7%), la primera relación sexual fue más desprotegida (35,3%) y son atendidas en la red suplementar (88,2%). Discusión: El nivel de renta familiar no influencia en el acceso a la salud sexual y reproductiva de la muestra investigada. Conclusión: Hubo diferencia para el tipo de proveedor del servicio de la salud según la renta.

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INTRODUCCIÓN: El embarazo en la adolescencia es un tema de gran importancia por su impacto en salud, economía y dentro de la sociedad. OBJETIVO: Analizar los aspectos familiares, socioeconómicos y ginecológicos como factores de riesgo implicados en el embarazo en adolescentes. MATERIALES Y MÉTODOS: Diseño metodológico: Casos y controles Estudio comparativo de adolescentes embarazadas de la comunidad Santa Ana la Nueva con adolescentes nuligestas del mismo núcleo, entre abril a junio del 2012. Se confeccionó una encuesta basada en la aglutinación de instrumentos previamente seleccionados. Cálculo de tamaño de muestra: 22 casos y 22 controles. RESULTADOS: La edad promedio fue 16.13 años (DS: ± 1.641) para controles y para los casos fue 17.7 años (DS: ± 1.445). De los casos, 10 (45.45%) eran solteras, 10 (45.45%) concubinas y 2 (9.09%) casadas; para los controles 20 (90.1%) fueron solteras. En los casos 16 (72.73%) se dedicaban a los labores de casa, 5 (22.73%) eran estudiantes y 1 (4.55%) dedicada al comercio. Para los casos, el 40.91% tuvieron un nivel de educación igual a primaria o menor comparado con el total de los controles que cursaban secundaria. 19 mujeres de los casos (86.36%) tuvo madre cuyo primer hijo nació antes de los 20 años, comparado con 12 (54.55%) de los controles (p=0.045) (OR: 5.27, IC 95% 1.02 - 34.58). La funcionalidad familiar y el tipo familiar no representaron diferencia cuando se compararon ambos grupos. En relación al nivel socioeconómico, 100% de los casos provenían de un nivel bajo comparado con el 95.45% de los controles. En este grupo poblacional el consumo de tabaco, alcohol y drogas no tuvo relación con el embarazo en la adolescencia. El inicio de vida sexual activa ≤ 15 años en el grupo de casos no representó un factor para el embarazo en adolescentes comparado con el grupo control, donde 16 (72.73%) no iniciaron vida sexual (p=0.08). Todas las mujeres del grupo control tenían conocimiento de métodos anticonceptivos, comparado con sólo 12 (45.45%) de los casos (p<0.001).18 de los casos (81.82%) no utiliza anticonceptivos actualmente (OR:15.3, IC 95% 2.93 - 87.71) y 9 (41.01%) tuvieron más de una pareja sexual (OR: 6.92, IC 95% 1.11 - 72.63). CONCLUSION: Haber tenido una madre cuyo hijo haya nacido en la adolescencia, el conocimiento de métodos anticonceptivos, la falta de uso de los mismos y tener más de una pareja sexual en esta etapa son factores relacionados con un incremento de la probabilidad de embarazo en la adolescencia.

INTRODUCTION: Pregnancy in adolescence is topic of great importance for the impact in public health, economy and society. OBJETIVE: To analyze familiar, social, economic and gynecologic aspects as risks factors involved in teen pregnancy. MATERIAL AND MÉTHODS: Design: Case-control study. Comparative study of adolescents with previous or current pregnancy from the community Santa Ana la Nueva - Tarija, with nulliparous adolescents from the same area, between april and june, 2012. A questionnaire was made based on different chosen instruments. Sample size: 22 cases and 22 controls RESULTS: Mean age was 16.13 years (SD: ± 1.641) for controls and for the cases was 17.7 years old (SD: ± 1.445). Of cases, 10 (45.45%) were single, 10 (45.45%) lived with couple and 2 (9.09%) were married. 20 controls were single (90.1%). Among the cases 16 (72.73%) were households and 5 (22.73%) were students, 1 (4.55%) worked in business. From this cases, 40.91% had a primary education, uncompleted or complete, compared to the total of controls who were enrolled in secondary education (p<0.001), 19 (86.36%) of the cases had a mother who had her first born before 20 years, compared to 12 (54.55%) of the controls (p=0.045) (OR: 5.27 95% IC 1.02 - 34.58). Type of family and familiar dysfunctionality did not represent differences when comparing both groups. About the socioeconomical status, 100% of cases came from a low status, compared to 95.45% of controls. In this studied group nor tabacco, alcohol or drug consumption had relation with pregnancy. Starting sexual intercourse at the age of ≤ 15 years did not represent a risk factor for pregnancy, compared to the control group where 16 (72.73%) did not initiated intercourse (p=0.08) . All women from the control group had knowledge about contraception, compared to only 12 (45.45%) of cases (p<0.001). 18 (81.82%) cases do not use contraception actually (OR:15.3, 95% IC 2.93 - 87.71) and 9 (41.01%) had more than 1 sexual couple (OR: 6.92, 95% IC 1.11 - 72.63). CONCLUSION: Having a mother whose first child was born in her adolescence, lack of knowledge in contraception, and its use, and having more than one sexual couple in this period are risk factors related with a major probability for pregnancy in adolescence.

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Se realizó un estudio descriptivo y comparativo, de corte longitudinal, de 201 estudiantes entre 11-17 años (de un universo de 220), de un liceo público de la localidad de Quisiro, del municipio de Miranda, en la República Bolivariana de Venezuela, con vistas a evaluar el comportamiento sexual y el conocimiento de infecciones de transmisión sexual, previo consentimiento informado de los padres y de la muestra en cuestión. El análisis de los datos se efectuó con el paquete estadístico SAS R, versión 9.3.1. En los integrantes de la serie, la actividad sexual era bastante común, con predominio de los que la iniciaron activamente entre los 14 y 15 años, poco uso de métodos anticonceptivos, mayor número de parejas sexuales en los varones, así como un mejor conocimiento acerca de las infecciones de transmisión sexual en el caso de las chicas.

A descriptive and longitudinal controlled study in 201 students aged 11-17 years (from a total of 220) of a public high school in Quisiro town, Miranda municipality in the Bolivarian Republic of Venezuela was conducted to evaluate sexual behavior and knowledge of sexually transmitted infections, with previous informed consent of the parents and of the sample in question. Data were analyzed using the SAS R statistical package, version 9.3.1. In the members of the series the sexual activity was quite common, with predominance of those that actively started it between 14 and 15 years, little use of birth-control methods, higher number of sexual partners for boys and a better knowledge of sexually transmitted infections for girls.