RESUMO
OBJECTIVE: To evaluate the effect of menstrual changes induced by a nomegestrol acetate subdermal contraceptive implant (Uniplant; Thermex, Bahia, Brazil) on users' sexuality. DESIGN: Prospective observational survey. SETTING: San Borja-Arriarán Hospital, University of Chile, School of Medicine. PATIENT(S): Normally cycling healthy women and their partners. INTERVENTION(S): Structured interview before and during use of the contraceptive. MAIN OUTCOMES MEASURE(S): Sexual frequency, desire, and enjoyment; perception of health; and contraceptive satisfaction. RESULT(S): During the use of the implant more women reported irregular cycles (32% versus 11%) and vaginal spotting (38% versus 19%). Frequency of sexual relations was unchanged (2.3 versus 2.5/wk) but the percent of couples engaging in sexual relations during vaginal spotting increased (28% versus 11%). There was no significant difference in the percent of men or women who reported an increase, or decrease, in perceived sexual desire, sexual enjoyment, or perception of health during the use of Uniplant. CONCLUSION(S): Despite the alterations in menstrual cyclicity and the occurrence of spotting, the use of a contraceptive subdermal implant of nomegestrol acetate did not effect desire for, enjoyment of, or frequency of sexual relations in users.
PIP: Findings are presented from a study evaluating the effect of menstrual changes induced by a nomegestrol acetate subdermal contraceptive implant (Uniplant) on users' sexuality. The Uniplant implant evaluated is manufactured by Thermex of Bahia, Brazil. New subjects enrolled in a phase III clinical trial of the implant at San Borja-Arriaran Hospital, University of Chile, School of Medicine were observed prospectively. The participants were 118 normally cycling healthy women of median age 28 years and 60 male partners of median age 31 years. A structured interview was held before and during use of the contraceptive. Before insertion of the implant, 11% of the women reported irregular menstrual cycles, 19% reported vaginal spotting, and 11% of the couples reported engaging in sexual relations during vaginal spotting. During use of the implant, 32% of the women reported irregular cycles, 38% reported vaginal spotting, and 28% of the couples reported engaging in sexual relations during vaginal spotting. The frequency of sexual relations remained unchanged at 2.3-2.5 acts of coitus per weeks. There was no significant difference in the percentage of men or women who reported an increase or decrease in perceived sexual desire, sexual enjoyment, or perception of health during the use of Uniplant.
Assuntos
Megestrol , Menstruação/efeitos dos fármacos , Norpregnadienos/administração & dosagem , Comportamento Sexual/efeitos dos fármacos , Adolescente , Adulto , Criança , Coito , Implantes de Medicamento , Feminino , Nível de Saúde , Humanos , Masculino , Menstruação/fisiologia , Norpregnadienos/uso terapêutico , Satisfação do Paciente , Periodicidade , Estudos Prospectivos , AutoimagemRESUMO
BACKGROUND AND OBJECTIVES: Human papillomavirus is the major etiologic agent of cervical cancer. Although the incidence of cancer of the cervix is high in Jamaica, the prevalence of human papillomavirus among Jamaican women has not been defined. GOAL OF THE STUDY: To estimate the prevalence of human papillomavirus infection and associated risk factors in women attending an STD clinic in Kingston, Jamaica. STUDY DESIGN: A cross-sectional survey was done of 202 women attending an STD clinic in Kingston in 1990. Cervical and vaginal cells were collected by lavage, and human papillomavirus genomes were detected in extracted DNA using low-stringency Southern blot hybridization. RESULTS: Fifty-eight (28.7%) women were identified as HPV positive. Prevalence of HPV by age group was 39% in women 15-19 years old, 33% of women 20-24 years old, 31% in women 25-29 years old, and 17% in those 30 years or older. Increasing age was significantly associated with a lower prevalence of human papillomavirus infection (test for trend, P = 0.025). The effect of age was independent of years of sexual activity. Women reporting more than one sexual partner per month on average were found to have a significantly higher HPV prevalence (odds ratio 2.87, 95% confidence Interval 1.29-6.38), as were women who reported more frequent sex (test for trend, P = 0.006). CONCLUSIONS: Sexual behavior is associated with risk of human papillomavirus infection. The decrease of human papillomavirus prevalence in older women agrees with other studies that argue in favor of a biological effect, such as increased immunity to human papillomavirus with age. A better understanding of why immunity to human papillomavirus may develop in older women may provide the basis for developing an effective vaccine to prevent cancer of the cervix.
PIP: During November 1990-January 1991, DNA was extracted from cervicovaginal cells from 202 women attending the Comprehensive Health Centre, a sexually transmitted disease (STD) clinic, in Kingston, Jamaica, to determine the prevalence of human papilloma virus (HPV). Health workers interviewed these women so researchers could identify risk factors for HPV. 58 women (28.7%) tested positive for HPV. 62% had uncharacterized HPV DNA types. 16% had more than one type of HPV. HPV prevalence fell with age (39% for 15-19 year olds, 33% for 20-24 year olds, 31% for 25-29 year olds and 17% for 30+ year olds; odds ratio [OR] for oldest group = 0.34; p = 0.025), suggesting that older women have developed an immunity to HPV infection. The higher the number of years of sexual activity, the lower the HPV prevalence (40% for 1-4 years, 32% for 5-9 years, and 23% for 10+ years; OR for 10+ years was 0.44; p = 0.03). Women with at least two sexual partners over the last 12 months had a higher HPV prevalence than those with fewer sexual partners (OR = 2.87; p = 0.01). The greater the average number of times women claimed to have had vaginal intercourse per month in the last year, the greater the HPV prevalence (OR for 3-4 times = 2.07, OR for 5+ times = 3.22; p = 0.006). A multiple logistic regression analysis revealed that age confounded the inverse association between HPV prevalence and years of sexual activity. 3% of Pap smears exhibited cervical dysplasia. Further studies are needed to obtain a better understanding of why immunity to HPV may occur in older women. This information could form the basis for developing an effective vaccine against cervical cancer.
Assuntos
Infecções por Papillomavirus/epidemiologia , Doenças Virais Sexualmente Transmissíveis/epidemiologia , Infecções Tumorais por Vírus/epidemiologia , Adolescente , Adulto , Fatores Etários , Colo do Útero/virologia , Estudos Transversais , DNA Viral/análise , Feminino , Humanos , Jamaica/epidemiologia , Papillomaviridae/genética , Papillomaviridae/isolamento & purificação , Prevalência , Fatores de Risco , Comportamento Sexual , Doenças Virais Sexualmente Transmissíveis/virologia , Vagina/virologiaRESUMO
PIP: Infertility is a problem for many couples who wish to conceive and bear children. This paper investigates the relationships of educational status, age, onset of menarche, first sexual intercourse, menstrual cycle, gestational interval, and coital frequency to infertility in 509 Mexican women who were not exposed to any contraceptive method. This study was conducted to gain insight into when infertility studies should commence during the course of a woman's sexual life. Two thirds of the women were married. On average, menarche took place at age 13 years, first intercourse at age 20, and they had sexual intercourse 9 times/month. 68% of women became pregnant within the first 12 months of sexual activity; earliest pregnancy was at age 14 and the latest was at age 44. A significant linear correlation was observed between chronological age and gestational interval with the achievement of first pregnancy significantly related to age and coital frequency. Overall, first pregnancy was achieved in almost 90% of monthly menstruating women. Significant estimated risk of sterility exists for older women and when periods of expectancy for pregnancy are longer than 1 year.^ieng
Assuntos
Fatores Etários , Coito , Infertilidade , Entrevistas como Assunto , Gravidez , Fatores de Risco , América , Comportamento , Biologia , Coleta de Dados , Demografia , Países em Desenvolvimento , América Latina , México , América do Norte , População , Características da População , Reprodução , Pesquisa , Comportamento SexualRESUMO
PIP: Results on adolescent's knowledge, attitude, and practice in sexuality and reproductive health are presented from 2 surveys of 1199 middle-class youths aged 13-18 years in main cities of Colombia. Survey populations were selected from high schools and users of Family Compensation Fund. While traditional values and customs prevail among these youths, they nonetheless tend to begin sex between ages 15-18, and have little concern over the consequences of their sexual behavior. They are, moreover, quite ignorant about reproductive health. Sexuality is not thought of as part of marriage, women are expected to be virgins at marriage, and a resounding 87% of the study population rejected abortion legislation. 90% of the young men had their 1st sexual encounter with either a prostitute or domestic servant, while 90% of the young women had their 1st encounters with friends from within their social groups. Sexual relations from adolescence on were supported by 35% of the girls and 60% of the boys, 72% of the girls and 38% of the boys supported virginity, yet less than 10% were in favor of the notion of open relationships. 20% of the girls and 25% of the boys had active sex lives, with homosexuality representing 1.6% and 3.1% of the two sex groupings, respectively. Sex education is practically non-existent. Most young women know little of contraception, and fail to use it out of misconceptions regarding method safety, and fear of one's parents finding out. The young men, on the other hand, cite forgetfulness and inability to obtain contraception as reasons for use failure. Accordingly, 5% of the girls fell pregnant between ages 15-17, with 66% ending in abortion, and 18.6% of the girls and 12.3% of the boys admitted to having had a sexually transmitted disease. 55% indicated that they would not use contraceptives.^ieng
Assuntos
Aborto Induzido , Síndrome da Imunodeficiência Adquirida , Adolescente , Atitude , Criança não Desejada , Coito , Comunicação , Comportamento Contraceptivo , Anticoncepção , Cultura , Infecções por HIV , Conhecimentos, Atitudes e Prática em Saúde , Homossexualidade , Conhecimento , Legislação como Assunto , Casamento , Gravidez na Adolescência , Instituições Acadêmicas , Educação Sexual , Comportamento Sexual , População Urbana , Fatores Etários , América , Comportamento , Coeficiente de Natalidade , Colômbia , Coleta de Dados , Demografia , Países em Desenvolvimento , Doença , Educação , Serviços de Planejamento Familiar , Fertilidade , América Latina , População , Características da População , Dinâmica Populacional , Psicologia , Pesquisa , Estudos de Amostragem , Comportamento Social , América do Sul , VirosesRESUMO
We studied the frequency of venereal disease in 329 prostitutes working at massage parlours in Santiago. The mean age was 24 years and half of them had high school or university studies. In spite of frequent sexual contacts averaging 2.8 per day, the prevalence of significant venereal disease was not high in this group. Notably, AIDS infection was not detected. Vaginitis due to Trichomonas or Candida infection was the commonest problem and this was half as frequent among gum preservative users. Marital condition, age, obstetrical history and other variables were not related to genital infection.
PIP: A sample of 329 prostitutes from the eastern area of Santiago, Chile, who attended the Dermatology Service of the Salvador Hospital in January-February 1988 were studied to determine the current incidence of sexually transmitted disease among prostitutes. Approximately 600 prostitutes attend the service for required monthly health examinations. The 329 women worked in established locales such as saunas, massage parlors, and nightclubs. None were uncontrolled street prostitutes. The average age was 24.3 years. 68% were single, 17% were separated, and 15% were married. Only 14% had no more than primary education, and half had high school or college educations. The average parity was 1.52. 83% used contraception. 31% used oral contraceptives (OCs), 21% used injectables, 24% used IUDs, and 7% used other methods. The average number of sexual contacts per day was 2.87. 54% always used condoms, 36% occasionally did so, and 10% never did so. The estimated number of monthly sexual contracts/woman was 65. 22% of the women had some sort of genital pathology. No cases of HIV infection were seen. 9.7% were diagnosed with trichomonas, 4.6% with unspecified vulvovaginitis, 3.3% with candidiasis, 1.8% with syphilis, 1.5% with gonorrhea, .9% with condyloma acuminata, and .3% with active herpes. The frequency of vaginitis did no appear to be associated with the number of sexual contacts, but other pathologies were more common in women with more partners. Women who always used condoms were only half as likely to have genital pathologies or vaginitis as women who never used condoms.
Assuntos
Trabalho Sexual , Infecções Sexualmente Transmissíveis/epidemiologia , Adulto , Chile/epidemiologia , Dispositivos Anticoncepcionais Masculinos , Estudos Transversais , Escolaridade , Feminino , Humanos , Infecções Sexualmente Transmissíveis/prevenção & controle , Vaginite/epidemiologiaRESUMO
Drawing on a theoretical model of adolescent contraceptive behavior, we examined the relationships between various social and behavioral variables and contraceptive use by sexually active female adolescents. Hypotheses were tested with the use of a national random sample of sexually active female adolescents (n = 1426), aged 15 to 20 years, from Cycle III of the National Survey of Family Growth. The data were analyzed with Pearson correlation coefficients and multiple regression analysis. Noncompliance with the initial birth control method was the strongest predictor of the adolescents' contraceptive behavior at the time of the interview. Not acquiring birth control at the initial family planning visit and the frequency of family planning visits during the previous 12 months were the second and third best predictors of subjects' contraceptive use. Coital frequency and the length of time between first coitus and the initiation of birth control each explained a small amount of additional variation in the regression model. When combined, these five variables explained 40% of the variation in the contraceptive behavior of this representative sample of sexually active female adolescents. The findings could be useful for clinicians in providing more effective birth control counseling to adolescent patients.
Assuntos
Comportamento do Adolescente , Comportamento Contraceptivo , Adolescente , Coito , Serviços de Planejamento Familiar , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Modelos Psicológicos , Cooperação do Paciente , Assunção de Riscos , Estados UnidosRESUMO
PIP: Data are analysed from the 1973 surveys of the Nigerian segment of the Changing African Family (CAFN) Project, which covered Yoruba women and men in Ibadan and the Western State of Nigeria. Of the 5874 women who were in union during the CAFN 1 survey, 54% reported that their husband had only 1 wife and 46% that their husband had more than 1 wife. Of the 1234 women in unions in the CAFN 2 survey, 49% reported monogamous husbands and 51% polygynous husbands. Differentials in fertility levels between women in monogamous unions and those in polygynous ones are investigated using mean number of children ever born as the measure of fertility. Factors examined include proportion of childless and infertile women, frequency of intercourse, age, educational level, religion, marital mobility (divorce) rank of wife and sexual abstinence. The CAFN 1 survey shows that wives of polygynists tend to be older than those of monogamists. Because of this the reported mean number of children ever born was higher for the wives of polygynists than for the wives of monogamists. When the data are standardized for the difference in age, the fertility levels of the women in the 2 types of unions were much closer to each other. When religion, education, abstinence, and occupation are also taken into account, it is observed that the 2 groups of women have similar levels of fertility. A multiple classification analysis was performed using number of wives of husband, educational level, religion and father's occupation as variables and occupation of spouse, place of birth, length of abstinence, contraceptive practice and age as covariates. The result also shows that the number of wives of the husband does not significantly affect the fertility level of women when other factors are taken into account. A high proportion of the Yoruba women are in polygynous unions and most of those in monogamous unions are potential wives of polygynists. Because of this, and particularly because most women try to have as many children as they can, the women in the 2 types of unions experience similar levels of fertility.^ieng