RESUMO
OBJECTIVE: This paper examines the factors related to emergency contraception (EC) use in the context of contraceptive discontinuation among undergraduate women in Brazil. STUDY DESIGN: This a retrospective cohort study conducted among a probability sample of 1679 undergraduate women in Sao Paulo, Brazil. Data were collected online using a contraceptive calendar. We examined factors related to EC use following contraceptive discontinuation for method-related reasons and contraceptive abandonment. We also analyzed factors related to EC use following inconsistent use of contraception. Analyses were conducted using Pearson's Chi-square tests and logistic regression. RESULTS: More than half (54.6%) of young women reported lifetime EC use and 16.5% had used EC in the 12-months prior to the survey. Last use of EC was mostly related to inconsistent or incorrect use of regular contraception (90.6%). Three quarters of women (76.2%) who discontinued contraception and were at risk of becoming pregnant did not use EC following discontinuation, and only 10.5% used EC after stopping contraception altogether. Women who were younger, who self-identified as Evangelicals, who reported more than four lifetime sexual partners, and who had no pregnancy history had higher odds of using EC following discontinuation for method-related reasons. CONCLUSION: We conclude that most undergraduate students in São Paulo Brazil do not use EC when needed, such as contraceptive discontinuation, potentially reflecting a lack of pregnancy risk recognition.
Assuntos
Comportamento Contraceptivo/estatística & dados numéricos , Anticoncepção Pós-Coito/estatística & dados numéricos , Estudantes/estatística & dados numéricos , Adolescente , Fatores Etários , Brasil , Cristianismo , Feminino , Número de Gestações , Humanos , Gravidez , Gravidez não Planejada , Estudos Retrospectivos , Parceiros Sexuais , Inquéritos e Questionários , Adulto JovemRESUMO
BACKGROUND: The rise in contraceptive use has largely been driven by short-acting methods of contraception, despite the high effectiveness of long-acting reversible contraceptives. Several countries in Latin America and the Caribbean have made important progress increasing the use of modern contraceptives, but important inequalities remain. We assessed the prevalence and demand for modern contraceptive use in Latin America and the Caribbean with data from national health surveys. METHODS: Our data sources included demographic and health surveys, multiple indicator cluster surveys, and reproductive health surveys carried out since 2004 in 23 countries of Latin America and the Caribbean. Analyses were based on sexually active women aged 15-49 years irrespective of marital status, except in Argentina and Brazil, where analyses were restricted to women who were married or in a union. We calculated contraceptive prevalence and demand for family planning satisfied. Contraceptive prevalence was defined as the percentage of sexually active women aged 15-49 years who (or whose partners) were using a contraceptive method at the time of the survey. Demand for family planning satisfied was defined as the proportion of women in need of contraception who were using a contraceptive method at the time of the survey. We separated survey data for modern contraceptive use by type of contraception used (long-acting, short-acting, or permanent). We also stratified survey data by wealth, area of residence, education, ethnicity, age, and a combination of wealth and area of residence. Wealth-related absolute and relative inequalities were estimated both for contraceptive prevalence and demand for family planning satisfied. FINDINGS: We report on surveys from 23 countries in Latin America and the Caribbean, analysing a sample of 212â573 women. The lowest modern contraceptive prevalence was observed in Haiti (31·3%) and Bolivia (34·6%); inequalities were wide in Bolivia, but almost non-existent in Haiti. Brazil, Colombia, Costa Rica, Cuba, and Paraguay had over 70% of modern contraceptive prevalence with low absolute inequalities. Use of long-acting reversible contraceptives was below 10% in 17 of the 23 countries. Only Cuba, Colombia, Mexico, Ecuador, Paraguay, and Trinidad and Tobago had more than 10% of women adopting long-acting contraceptive methods. Mexico was the only country in which long-acting contraceptive methods were more frequently used than short-acting methods. Young women aged 15-17 years, indigenous women, those in lower wealth quintiles, those living in rural areas, and those without education showed particularly low use of long-acting reversible contraceptives. INTERPRETATION: Long-acting reversible contraceptives are seldom used in Latin America and the Caribbean. Because of their high effectiveness, convenience, and ease of continuation, availability of long-acting reversible contraceptives should be expanded and their use promoted, including among young and nulliparous women. In addition to suitable family planning services, information and counselling should be provided to women on a personal basis. FUNDING: Wellcome Trust, Pan American Health Organization.
Assuntos
Preservativos/estatística & dados numéricos , Comportamento Contraceptivo/estatística & dados numéricos , Anticoncepcionais/administração & dosagem , Dispositivos Intrauterinos/estatística & dados numéricos , Contracepção Reversível de Longo Prazo/estatística & dados numéricos , Esterilização Reprodutiva/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Região do Caribe , Anticoncepção Pós-Coito/estatística & dados numéricos , Anticoncepcionais Orais/uso terapêutico , Implantes de Medicamento/uso terapêutico , Escolaridade , Feminino , Inquéritos Epidemiológicos , Disparidades em Assistência à Saúde , Humanos , Renda , Povos Indígenas , América Latina , Modelos Logísticos , Pessoa de Meia-Idade , Métodos Naturais de Planejamento Familiar/estatística & dados numéricos , Avaliação das Necessidades , População Rural , Espermicidas/uso terapêutico , Adulto JovemRESUMO
OBJECTIVE: The aim of our study was to describe contraceptive patterns 30 days after use of emergency contraception (EC) among female undergraduate students in São Paulo, Brazil. METHODS: This study was part of a larger project conducted in 2015 among 1679 female students aged 18-24 enrolled at the University of São Paulo. Analysis was restricted to the 916 students who reported lifetime use of EC. Logistic regression models were used to examine factors related to the use of contraception within the 30 day period following the last use of EC, changes in contraceptive behaviour before and after EC use, and gaps in contraceptive use within 30 days after EC use. RESULTS: Most women (75.4%) used contraception after accessing EC; 92.9% who used contraception prior to EC exposure resumed use of contraception afterwards, compared with 40.7% who did not use contraception prior to EC exposure. Only 6.3% of women switched to a less effective contraceptive method after EC use. Few women (7.5%) reported post-EC gaps in contraception. CONCLUSIONS: The results of this study suggest that EC may serve as a potential precursor to regular contraception among undergraduates in Brazil, with few women reporting contraceptive gaps after EC use. These patterns may contribute to reducing the risk of unintended pregnancy in this population.
Assuntos
Comportamento Contraceptivo/estatística & dados numéricos , Anticoncepção Pós-Coito/estatística & dados numéricos , Anticoncepção/estatística & dados numéricos , Gravidez não Planejada/psicologia , Estudantes/psicologia , Adolescente , Brasil , Anticoncepção/psicologia , Comportamento Contraceptivo/psicologia , Anticoncepção Pós-Coito/psicologia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Gravidez , Inquéritos e Questionários , Universidades , Adulto JovemRESUMO
This is a study on sexual violence against women in the Brazilian State of Santa Catarina notified to the Notifiable Diseases Information System (SINAN) in the period 20082013. It aimed to estimate pregnancy and sexually transmitted infections (STIs) resulting from sexual violence and to test the association between pregnancy, STIs and care provided in health services. In total, 1,230 pregnancy notifications and 1.316 STI notifications were analyzed. Variables were age, schooling, time to receive care, STI prophylaxis, emergency contraception, number of perpetrators and recurrent violence, which were analyzed using proportions and 95% confidence intervals. Associations were tested by adjusted and non-adjusted logistic regression with values expressed in odds ratio. The occurrence of pregnancy was 7.6%. Receiving care within 72 hours and emergency contraception were protective factors. The occurrence of STIs was 3.5%. Care within 72 hours and prophylaxis did not result in lower proportions of STIs. Further studies are required regarding this issue.
Estudo da violência sexual contra a mulher em Santa Catarina, notificada no Sistema de Informações de Agravos de Notificação entre 2008 e 2013. O objetivo foi estimar a ocorrência de gravidez e infecção sexualmente transmissível (IST) decorrente da violência sexual e testar associação entre gravidez, IST e o atendimento nos serviços de saúde. Para a gravidez foram analisadas 1.230 notificações e para IST 1.316 notificações. As variáveis foram idade, escolaridade, tempo de atendimento, profilaxias para IST, contracepção de emergência, número de agressores e violência de repetição. As variáveis foram analisadas por meio de proporções e intervalos de confiança de 95%. As associações foram testadas por regressão logística não ajustada e ajustada com os valores expressos em razão de chance. A ocorrência de gravidez foi de 7,6%. Ser atendida em 72 horas e receber a contracepção de emergência foram fatores de proteção. A ocorrência de IST foi de 3,5%. Ser atendida em 72 horas e receber profilaxias não resultou em menor proporção de IST, são necessários estudos que aprofundem esta questão.
Assuntos
Estupro/estatística & dados numéricos , Delitos Sexuais/estatística & dados numéricos , Infecções Sexualmente Transmissíveis/epidemiologia , Adolescente , Adulto , Fatores Etários , Brasil/epidemiologia , Criança , Anticoncepção Pós-Coito/estatística & dados numéricos , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Pessoa de Meia-Idade , Gravidez , Fatores de Risco , Tempo para o Tratamento , Adulto JovemRESUMO
Resumo Estudo da violência sexual contra a mulher em Santa Catarina, notificada no Sistema de Informações de Agravos de Notificação entre 2008 e 2013. O objetivo foi estimar a ocorrência de gravidez e infecção sexualmente transmissível (IST) decorrente da violência sexual e testar associação entre gravidez, IST e o atendimento nos serviços de saúde. Para a gravidez foram analisadas 1.230 notificações e para IST 1.316 notificações. As variáveis foram idade, escolaridade, tempo de atendimento, profilaxias para IST, contracepção de emergência, número de agressores e violência de repetição. As variáveis foram analisadas por meio de proporções e intervalos de confiança de 95%. As associações foram testadas por regressão logística não ajustada e ajustada com os valores expressos em razão de chance. A ocorrência de gravidez foi de 7,6%. Ser atendida em 72 horas e receber a contracepção de emergência foram fatores de proteção. A ocorrência de IST foi de 3,5%. Ser atendida em 72 horas e receber profilaxias não resultou em menor proporção de IST, são necessários estudos que aprofundem esta questão.
Abstract This is a study on sexual violence against women in the Brazilian State of Santa Catarina notified to the Notifiable Diseases Information System (SINAN) in the period 20082013. It aimed to estimate pregnancy and sexually transmitted infections (STIs) resulting from sexual violence and to test the association between pregnancy, STIs and care provided in health services. In total, 1,230 pregnancy notifications and 1.316 STI notifications were analyzed. Variables were age, schooling, time to receive care, STI prophylaxis, emergency contraception, number of perpetrators and recurrent violence, which were analyzed using proportions and 95% confidence intervals. Associations were tested by adjusted and non-adjusted logistic regression with values expressed in odds ratio. The occurrence of pregnancy was 7.6%. Receiving care within 72 hours and emergency contraception were protective factors. The occurrence of STIs was 3.5%. Care within 72 hours and prophylaxis did not result in lower proportions of STIs. Further studies are required regarding this issue.
Assuntos
Humanos , Feminino , Gravidez , Criança , Adolescente , Adulto , Adulto Jovem , Estupro/estatística & dados numéricos , Delitos Sexuais/estatística & dados numéricos , Infecções Sexualmente Transmissíveis/epidemiologia , Brasil/epidemiologia , Modelos Logísticos , Estudos Transversais , Fatores de Risco , Fatores Etários , Anticoncepção Pós-Coito/estatística & dados numéricos , Tempo para o Tratamento , Pessoa de Meia-IdadeRESUMO
Background: Emergency contraception refers to contraceptive methods that can be used after a sexual intercourse Aim: To analyze the evolution of emergency contraception (EC) consultations on the Chilean public health system, at a communal level, in relation to the legal changes that recently took place, aimed to ease the delivery of the benefit. To analyze its association with socioeconomic, demographic and municipal healthcare system characteristics. Material and Methods: We analyzed data bases of the Ministry of Health to study EC consultation rates on Chilean communes, including consultations on emergency departments and by rape, from 2008 to 2013. We evaluated the association with communal characteristics, obtained from the National Municipal Information System. Results: Both the communal consultation rates and percentage of communes with consultations increased progressively during the period, with an explosive increase between 2009 and 2010. We observed a high dispersion in EC consultations both at a communal and regional level. There was an inverse significant association of the number of consultations with the communal poverty rate. Conclusions: Our results reveal the impact of legal modifications implemented in Chile since 2009 on the communal EC consultation rates. On other hand, our results reveal that although these modifications were oriented to favor the delivery of this benefit, a high dispersion subsists, associated with populations socioeconomic factors, mainly, the communal poverty level.
Assuntos
Humanos , Feminino , Criança , Adolescente , Adulto , Adulto Jovem , Encaminhamento e Consulta/estatística & dados numéricos , Atenção à Saúde/estatística & dados numéricos , Anticoncepção Pós-Coito/estatística & dados numéricos , Pobreza/estatística & dados numéricos , Estupro/estatística & dados numéricos , Encaminhamento e Consulta/tendências , Fatores Socioeconômicos , Chile , Estudos Retrospectivos , Estudos Longitudinais , Atenção à Saúde/legislação & jurisprudência , Anticoncepção Pós-Coito/tendênciasRESUMO
UNLABELLED: Abastract Objective: to discern the profile of the Spanish Emergency Contraceptive users (EC). DESIGN: systematic review of contraceptive use in the Spanish population. DATA SOURCE: Spanish and international databases, between January 2006 - March 2011. KEYWORDS: Contraceptives, Postcoital pills, emergency contraception, levonorgestrel, data collection. STUDY SELECTION: original papers, letters to the editor in which stated aims were the description, prediction or measurement of variables related to EC use. Twenty-two papers were retrieved and fourteen were finally selected, all of which were descriptive. DATA EXTRACTION: manuscripts were evaluated by two independent reviewers. RESULTS: Women requesting EC have ages between 21-24 years, mostly single and university students; declare that they have not previously used EC, and attend an Emergency department, at weekends and within 48 hours following unprotected sexual intercourse. The reason is condom rupture. None of the studies reviewed measured alcohol and other drug consumption, the number of sexual partners, nor any of the studies performed a comparison with a group not using EC. CONCLUSIONS: lack of homogeneity and comprehensiveness of studied variables resulted in a limited profile of Spanish EC users. Further studies are needed with a more comprehensive approach if sexual health interventions are to be carried out in possible users.
Assuntos
Anticoncepção Pós-Coito/estatística & dados numéricos , Adolescente , Adulto , Anticoncepcionais Pós-Coito , Feminino , Humanos , Pessoa de Meia-Idade , Adulto JovemRESUMO
This study aimed to test how knowledge on emergency contraception (according to age at sexual initiation, type of school, and knowing someone that has already used emergency contraception) influences the method's use. This was a cross-sectional study in a probabilistic sample of students 15-19 years of age enrolled in public and private middle schools in a medium-sized city in Southeast Brazil (n = 307). Data were collected in 2011 using a self-administered questionnaire. A structural equations model was used for the data analysis. Considering age at sexual initiation and type of school, knowledge of emergency contraception was not associated with its use, but knowing someone that had used the method showed a significant mean effect on use of emergency contraception. Peer group conversations on emergency contraception appear to have greater influence on use of the method than knowledge itself, economic status, or sexual experience.
Assuntos
Anticoncepção Pós-Coito/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Estudantes/estatística & dados numéricos , Adolescente , Comportamento do Adolescente , Brasil , Anticoncepção Pós-Coito/psicologia , Estudos Transversais , Feminino , Humanos , Comportamento Sexual , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto JovemRESUMO
BACKGROUND: Emergency contraception refers to contraceptive methods that can be used after a sexual intercourse Aim: To analyze the evolution of emergency contraception (EC) consultations on the Chilean public health system, at a communal level, in relation to the legal changes that recently took place, aimed to ease the delivery of the benefit. To analyze its association with socioeconomic, demographic and municipal healthcare system characteristics. MATERIAL AND METHODS: We analyzed data bases of the Ministry of Health to study EC consultation rates on Chilean communes, including consultations on emergency departments and by rape, from 2008 to 2013. We evaluated the association with communal characteristics, obtained from the National Municipal Information System. RESULTS: Both the communal consultation rates and percentage of communes with consultations increased progressively during the period, with an explosive increase between 2009 and 2010. We observed a high dispersion in EC consultations both at a communal and regional level. There was an inverse significant association of the number of consultations with the communal poverty rate. CONCLUSIONS: Our results reveal the impact of legal modifications implemented in Chile since 2009 on the communal EC consultation rates. On other hand, our results reveal that although these modifications were oriented to favor the delivery of this benefit, a high dispersion subsists, associated with populations socioeconomic factors, mainly, the communal poverty level.
Assuntos
Anticoncepção Pós-Coito/estatística & dados numéricos , Atenção à Saúde/estatística & dados numéricos , Encaminhamento e Consulta/estatística & dados numéricos , Adolescente , Adulto , Criança , Chile , Anticoncepção Pós-Coito/tendências , Atenção à Saúde/legislação & jurisprudência , Feminino , Humanos , Estudos Longitudinais , Pobreza/estatística & dados numéricos , Estupro/estatística & dados numéricos , Encaminhamento e Consulta/tendências , Estudos Retrospectivos , Fatores Socioeconômicos , Adulto JovemRESUMO
Abastract Objective: to discern the profile of the Spanish Emergency Contraceptive users (EC). Design: systematic review of contraceptive use in the Spanish population. Data Source: Spanish and international databases, between January 2006 - March 2011. Keywords: Contraceptives, Postcoital pills, emergency contraception, levonorgestrel, data collection. Study selection: original papers, letters to the editor in which stated aims were the description, prediction or measurement of variables related to EC use. Twenty-two papers were retrieved and fourteen were finally selected, all of which were descriptive. Data extraction: manuscripts were evaluated by two independent reviewers. Results: Women requesting EC have ages between 21-24 years, mostly single and university students; declare that they have not previously used EC, and attend an Emergency department, at weekends and within 48 hours following unprotected sexual intercourse. The reason is condom rupture. None of the studies reviewed measured alcohol and other drug consumption, the number of sexual partners, nor any of the studies performed a comparison with a group not using EC. Conclusions: lack of homogeneity and comprehensiveness of studied variables resulted in a limited profile of Spanish EC users. Further studies are needed with a more comprehensive approach if sexual health interventions are to be carried out in possible users.
Resumo Objetivo: caracterizar o perfil das usuárias espanholas de contraceptivos de emergência (CE). Desenho: revisão sistemática do uso de contraceptivos na população espanhola. Fontes de dados: Bases de dados espanholas e internacionais entre janeiro de 2006 e março de 2011. Palavras-chave: Contraceptivos, Pílulas pós-coitais, contracepção de emergência, levonorgestrel, coleta de dados. Seleção do estudo: trabalhos originais, cartas ao editor nas quais o objetivo expresso fosse a descrição, predição o medida de variáveis relacionadas ao uso de CE. Vinte e dois artigos foram recuperados e quatorze foram finalmente selecionados, todos eles de tipo descritivo. Extração dos dados: os manuscritos foram avaliados por dois revisores independentes. Resultados: mulheres que demandaram CE tinham idades entre 21 a 24 anos, principalmente solteiras e estudantes universitárias; declaram não ter utilizado CE previamente, e se apresentam num Serviço de Emergência no final de semana, dentro das 48 horas seguintes a uma relação sexual não protegida. A razão explicitada é ruptura de preservativo. Nenhum dos estudos incluídos na revisão mediu uso de álcool ou outras drogas, ou numero de parceiros sexuais. Também não foram identificados estudos fazendo comparações com grupos que não utilizam CE. Conclusões: falta de homogeneidade e abrangência das variáveis estudadas resulta num perfil limitado das usuárias espanholas de CE. Mais estudos, com enfoques mais abrangentes, são necessários para levar a cabo intervenções de saúde em possíveis usuárias.
Resumen Objetivo: caracterizar el perfil de las usuarias españolas de Anticonceptivos de Emergencia (AE). Diseño: Revisión sistemática del uso de anticonceptivos en la población española. Fuentes de datos: Bases de datos españolas e internacionales entre enero de 2006 y marzo de 2011. Palabras clave: anticonceptivos, píldoras postcoitales, anticoncepción de emergencia, levonorgestrel, recolección de datos. Selección del estudio: artículos originales, cartas al editor en las que se establecía como objetivo la descripción, la predicción o la medida de variables relacionadas con el uso de AE. Veintidós artículos fueron recuperados de los cuales catorce fueron finalmente seleccionados, todos ellos descriptivos. Extracción de los datos : Los manuscritos fueron evaluados por dos revisores independientes. Resultados: Las mujeres que requieren AE tienen edades entre 21 a 24 años, principalmente solteras y estudiantes universitarias,; declaran que no han usado AE previamente y concurren a un departamento de Emergencia en los fines de semana durante las 48 horas después de tener relaciones sexuales sin protección. La razón esgrimida es la ruptura de preservativo. Ninguno de los estudios revisados midió el consumo de alcohol o drogas, o el número de parejas sexuales. Tampoco fueron identificados que comparasen con un grupo que no usa AE. Conclusión: La falta de homogeneidad y de amplitud de las variables estudiadas resultó en un perfil limitado de las usuarias españolas de AE. Se precisan estudios ulteriores con enfoques mas amplios si se desea realizar intervenciones de salud sexual en potenciales usuarias.
Assuntos
Humanos , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Anticoncepção Pós-Coito/estatística & dados numéricos , Anticoncepcionais Pós-CoitoRESUMO
Emergency oral contraception is part of the sexual and reproductive rights of women. In 2001, this health policy was incorporated into the Rules of the National Family Planning Program of the Ministry of Health, primarily to prevent unwanted pregnancy and its serious consequences, induced abortion and the high associated maternal mortality rate, which are major public health problems. Scientific research has confirmed that the main mechanism of action of levonorgestrel, component of emergency oral contraception (EOC) is to inhibit or delay ovulation, preventing fertilization of the egg; additionally, it increases the thickening of the cervical mucus, making the sperm migration more difficult. No study has found endometrial abnormalities that may interfere with the implantation of the fertilized egg or embryo development of an implanted egg. However, despite the support of medical science and legal backing, the EOC is available only to users with economic resources, but its use has not been fully implemented in public sector services, due to obstacles created by groups opposed to contraception under claim of an alleged abortive effect that has already been ruled out scientifically. This article describes the administrative experience and legal confrontations between groups of power that prevent the proper implementation of an emergency contraception policy in Peru.
Assuntos
Anticoncepção Pós-Coito , Política Pública , Anticoncepção Pós-Coito/estatística & dados numéricos , Feminino , Humanos , Peru , Política Pública/legislação & jurisprudênciaRESUMO
OBJECTIVE: To evaluate the knowledge and experience of, and desire for, emergency contraception (EC) in postpartum women in Haiti, and to determine the knowledge and practices of EC providers. METHODS: As part of a larger postpartum family planning study, 6 focus groups were conducted with postpartum women (n=33), 3 were conducted with providers (n=22), and a questionnaire was given to postpartum women (n=250). RESULTS: Of the 249 women who completed the survey, 145 (58.2%) were aware of the concept of EC as an emergency measure in the postcoital period. Of these, 130 (89.7%) had knowledge of traditional methods only. Twenty-eight (11.2%) women had used some form of EC in the past, but only 2 (0.8%) reported ever using a modern form of EC. Providers reported that EC was offered to women only in cases of sexual assault. Their impression was that there was no demand for EC. CONCLUSION: Awareness and use of EC is low in the context of high unmet need. The results demonstrate a need for improved education and provision of modern effective EC as part of the constellation of family planning choices.
Assuntos
Atitude do Pessoal de Saúde , Anticoncepção Pós-Coito/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Adolescente , Adulto , Serviços de Planejamento Familiar/métodos , Feminino , Grupos Focais , Haiti , Humanos , Medicina Tradicional/métodos , Educação de Pacientes como Assunto , Período Pós-Parto , Gravidez , Gravidez não Desejada/psicologia , Inquéritos e Questionários , Adulto JovemRESUMO
The scope of this study was to investigate knowledge about and access to emergency contraception among female university students in the south of the State of Santa Catarina. A cross-sectional observational study was conducted between September and October 2008, in which a questionnaire was given to 360 women aged 18 to 45 years. Most belonged to the B2 economic class or higher (74.2%) and 79.4% of them had already had intercourse. Of these, 48.6% had used emergency contraception, though this was more frequent among younger women. Emergency contraception was used 2.4 times, and 87.1% had used contraceptive methods within 24 hours after intercourse. Adverse reactions were reported by 20.9%, the most common being menstrual cycle changes (44.8%) and nausea (44.8%). The reasons for using emergency contraception included the lack of condom use (44.6%) and condom rupture (39.6%). Of the women interviewed, 15% either failed to answer the question on STD prevention or answered incorrectly, while 97.8% denied having changed the method used routinely. Only 2.9% of the participants had acquired the medication via prescription, and 35.3% received guidance on application of the medication at the time of purchase.
Assuntos
Anticoncepção Pós-Coito/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Adolescente , Adulto , Brasil , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Estudantes , Universidades , Adulto JovemAssuntos
Humanos , Feminino , Adolescente , Adulto , Adulto Jovem , Educação de Pacientes como Assunto , Levanogestrel/administração & dosagem , Anticoncepção Pós-Coito/estatística & dados numéricos , Farmácias , Automedicação , Epidemiologia Descritiva , Anticoncepcionais Pós-Coito/administração & dosagemRESUMO
This paper focuses both the risk and the occurrence of non-planned pregnancy, abortions, as well as the awareness about and the use of emergency contraception among HIV/aids-infected women. A quantitative observational approach was used after a domiciliary survey in Santo Andre, São Paulo State, Brazil, where it was found that, after receiving the information about the infection, 62.8% adopted the use of male condom, 77.2% using it exclusively, 13% associated with hormone injections, and 9.8% alternated with either interrupted intercourse, fertility schedule or vaginal shower. Mechanical flaws by the use of the preservative occurred to 38%. Added to flaws associated to the alternation with behavioral methods, they caused together 40% of non-planned pregnancy, which occurred to 24% of the interviewed women, 22% resulting in self-provoked abortions. Emergency contraception was known by 51.4%, although only 2.7% had used it. The conclusion is that mechanical or behavioral flaws related to the use of preservative by HIV/aids-infected women increased their exposure to non-planned gestations and abortions. It is needed to amplify both the options and the supply of contraceptive methods, including emergency contraception, with constant re-orientation on the use of preservative among this public.
Assuntos
Síndrome da Imunodeficiência Adquirida , Preservativos/estatística & dados numéricos , Anticoncepção Pós-Coito/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Gravidez não Planejada , Adulto , Idoso , Feminino , Infecções por HIV , Humanos , Pessoa de Meia-Idade , Fatores de Risco , Adulto JovemRESUMO
This study investigated contraceptive practices and especially the use of emergency contraception by 487 young students at a public university in São Paulo State. A structured questionnaire was sent by e-mail and completed online in December 2007. Contraceptive methods and use of emergency contraception were investigated. Female and male students reported a high proportion of contraceptive use, mainly condoms and the pill. Half of the students had already used emergency contraception, often when already using some other highly effective method. Among female students, multiple regression analysis showed that current age, age at sexual initiation, not having used condoms in sexual relations, condom failure, and knowing someone that has used emergency contraception were associated with use of the latter. The option for emergency contraception proved to be more closely related to inconsistencies in the use of regular methods than to lack of their use, and can thus be considered a marker for discontinuity in regular contraception.
Assuntos
Preservativos/estatística & dados numéricos , Anticoncepção/métodos , Anticoncepcionais Orais/uso terapêutico , Comportamento Sexual/estatística & dados numéricos , Adolescente , Anticoncepção/estatística & dados numéricos , Anticoncepção Pós-Coito/estatística & dados numéricos , Estudos Transversais , Feminino , Humanos , Masculino , Inquéritos e Questionários , Adulto JovemRESUMO
OBJECTIVE: To evaluate emergency contraception (EC) knowledge and use as well as identify factors associated to correct EC knowledge among public schools students in Morelos, Mexico. MATERIAL AND METHODS: Cross-sectional study conducted in 2003-2004 in a sample of 1,550 students (ages 14-24). Logistic regression was used to identify factors associated to EC correct knowledge. RESULTS: Among all, 40% were men and 60% women with an average age of 19 years. Sixty percent have heard about EC, nevertheless, only 45% have correct knowledge about it; 3% of sexually active students (43%) reported its use. Factors associated to EC correct knowledge are: being a woman (OR=1.66; CI 1,33, 2,06), being sexually active (OR=1.77; CI 1,43, 2,18), middle income (OR=1.87; CI 1,04, 3,37), living in a semi-urban zone (OR=1.34; CI 1,02, 1,77), drinking alcohol (OR=1.78; CI 1,42, 2,22). CONCLUSIONS: In Morelos, adolescents' knowledge of EC is scarce. Specific messages regarding its correct use are necessary.
Assuntos
Anticoncepção Pós-Coito/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Adolescente , Estudos Transversais , Feminino , Humanos , Masculino , México , Estudantes , Inquéritos e Questionários , Adulto JovemRESUMO
In this article reporting on our qualitative study, we describe changes in parent-adolescent sexual health communication following an intervention for parents of 10th graders in Mexico. The intervention was aimed to sensitize and develop skills for appropriate parent-child communication about the prevention of sexually transmitted infections (STIs), unplanned pregnancy, and birth control, and focused on encouraging condom use with emergency contraception backup. We conducted 66 in-depth interviews with adolescents and parents after the intervention. Following the principals of grounded theory, we carried out inductive analysis to create codes and organize central themes. Our findings identify previously undefined critical steps or movements important for parent-child communication about sex. When parents are sensitized to the risks their adolescent children face, it is easier to initiate communication about prevention. These initial movements are essential to achieve substantive conversation, and must be considered in future strategies that aim to promote parent-adolescent communication about sexuality and the prevention of STIs and unplanned pregnancy.
Assuntos
Comunicação , Relações Pais-Filho , Pais/psicologia , Educação Sexual , Sexualidade/psicologia , Infecções Sexualmente Transmissíveis/prevenção & controle , Adolescente , Preservativos/estatística & dados numéricos , Anticoncepção , Anticoncepção Pós-Coito/estatística & dados numéricos , Educação , Feminino , Infecções por HIV/prevenção & controle , Humanos , Entrevista Psicológica , Masculino , México , Gravidez não Planejada , Pesquisa Qualitativa , Fatores de RiscoRESUMO
Este estudo investigou as práticas contraceptivas de 487 jovens estudantes de uma universidade pública paulista, tendo como enfoque o uso da anticoncepção de emergência. Um questionário estruturado foi enviado por endereço eletrônico em dezembro de 2007. Os jovens referiram altas proporções de uso de métodos, principalmente o preservativo masculino e a pílula. A anticoncepção de emergência já havia sido utilizada por metade dos estudantes, muitas vezes concomitantemente a métodos de alta eficácia. Entre as mulheres, análise de regressão logística múltipla mostrou associação do uso da anticoncepção de emergência com a idade, idade de início da vida sexual, ter deixado de usar preservativo masculino em alguma relação sexual, ter vivenciado ruptura acidental do preservativo masculino e conhecer alguém que já a tenha utilizado. A opção pela anticoncepção de emergência mostrou-se mais relacionada a inconsistências no uso de métodos regulares do que ao não uso propriamente dito, podendo ser considerada um marcador de descontinuidades nas práticas contraceptivas.
This study investigated contraceptive practices and especially the use of emergency contraception by 487 young students at a public university in São Paulo State. A structured questionnaire was sent by e-mail and completed online in December 2007. Contraceptive methods and use of emergency contraception were investigated. Female and male students reported a high proportion of contraceptive use, mainly condoms and the pill. Half of the students had already used emergency contraception, often when already using some other highly effective method. Among female students, multiple regression analysis showed that current age, age at sexual initiation, not having used condoms in sexual relations, condom failure, and knowing someone that has used emergency contraception were associated with use of the latter. The option for emergency contraception proved to be more closely related to inconsistencies in the use of regular methods than to lack of their use, and can thus be considered a marker for discontinuity in regular contraception.
Assuntos
Adolescente , Feminino , Humanos , Masculino , Adulto Jovem , Preservativos , Anticoncepção/métodos , Anticoncepcionais Orais/uso terapêutico , Comportamento Sexual/estatística & dados numéricos , Estudos Transversais , Anticoncepção Pós-Coito/estatística & dados numéricos , Anticoncepção , Inquéritos e Questionários , Adulto JovemRESUMO
OBJECTIVE: New Mexico enacted a law in 2003 requiring that emergency departments (EDs) offer emergency contraception (EC) to survivors of sexual assault and that both doses be administered in the ED. This investigation sought to examine practices and knowledge of ED providers about EC in the setting of sexual assault. METHODS: We visited hospitals in New Mexico from July 2005 to December 2005 and administered an 18-item questionnaire to three providers-a physician, a nurse, and a clerk-in the ED. The questionnaire included items related to characteristics of the hospital, knowledge of providers about EC and the law, and ED practices relevant to EC for sexual assault survivors as well as for women who had consensual unprotected intercourse. RESULTS: Surveys were completed at 33 of 38 hospitals (87%). Overall, 52% of respondents reported that EC was routinely offered to sexual assault survivors, and 33% reported that both doses were administered in the ED. Forty-one percent of RNs, MDs, and clerks reported that EC was offered to sexual assault survivors who were minors regardless of age. Overall, 64% of respondents knew that EC may prevent pregnancy up to 72 hours after unprotected intercourse, and only 12% of respondents reported awareness of any requirements to offer EC to sexual assault survivors. Respondents reported that physicians in the ED more often routinely offered EC to sexual assault survivors (52%) than to women who requested it after consensual sex (20%). Thirty-three percent of respondents indicated parental consent was necessary for minors in the setting of sexual assault, although there is no requirement for parental notification in New Mexico. CONCLUSIONS: EDs in New Mexico are not universally complying with the law. Better dissemination of the law and education about EC could improve care of sexual assault survivors in New Mexico.