To investigate the contraception and sexual health-related awareness, attitudes, and practices of a representative sample of Canadian women of childbearing age.
A self-report survey was mailed to a national sample of 3345 women, aged 15 to 44 years, who were members of a pre-recruited market research panel. Survey questions and methodology were similar to 3 previous Canadian Contraception Studies, allowing for description of current patterns of behaviours and beliefs and comparison of trends over time.
Of 3345 women contacted, 1582 returned completed surveys, for a response rate of 47.3%. Responses were weighted to represent Canadian women by region, age, and marital status on the basis of current census data. Eighty-six percent of women sampled had ever had sexual intercourse and 78% were currently sexually active. Women's familiarity with oral contraceptives and condoms as methods of contraception was high (96% and 93%, respectively), but familiarity with other methods was much lower (sterilization, 62%; withdrawal, 59%; the morning-after pill, 57%; intrauterine devices, 50%; depot [injectable] medroxyprogesterone acetate, 38%). A very favourable opinion was held by 63% of respondents concerning oral contraceptives, by 38% concerning condoms, and by 39% and 28% concerning male and female sterilization, respectively. Among respondents who have ever had sexual intercourse, the most frequently used current methods were oral contraceptives (32%), condoms (21%), male sterilization (15%), female sterilization (8%), and withdrawal (6%). Nine percent of these respondents reported using no method of contraception at all. The currently reported rate of female sterilization is the lowest ever recorded in Canada. Survey results show that adherence to contraceptive methods is a challenge for many women and their partners, and that risk of sexually transmitted disease is an ongoing concern.
This study provides a wide-ranging examination of contraception awareness, beliefs, and use among Canadian women that may provide guidance for clinical and public health practice. Part 1 of this report describes the methodology of the 2002 Canadian Contraception Study and the overall results of this study; Part 2 considers results pertaining specifically to adolescent women and women in their later reproductive years, reports on indicators of women's sexual function and reproductive health history, describes approaches to addressing challenges in contraception counselling, and presents data concerning trends in Canadian women's awareness and use of contraception over the past 2 decades.
The 2002 Canadian Contraception Study investigated the contraception and sexual health-related knowledge, attitudes, and practices of a representative sample of Canadian women of childbearing age. In Part 2 of the report of this research, the authors focus on the contraceptive attitudes and practices of adolescent women and women in their later reproductive years, provide data on sexual and reproductive health indicators of Canadian women, describe 2-decade trends in the awareness, opinion, and utilization of contraceptive methods among Canadian women, and describe contraception counselling strategies that may be used to improve patient choice and adherence to method. This report closes with an overall discussion of the findings of the 2002 Canadian Contraception Study.
Possible risk factors for abnormal Papanicolaou smear were investigated in a population-based cross-sectional study. From Nuuk (Greenland) and Nykøbing Falster (Denmark), random samples of 800 women aged 20-39 years were drawn. Totals of 586 and 661 women were included in Greenland and Denmark, respectively. All women went through a personal interview, and had a gynecologic examination including a PAP smear and cervical swab for HPV analysis. A blood sample was taken for analysis of HSV type specific antibodies. Multiple sexual partners was the most important risk factor for abnormal cervical cytology (OR = 4.2). An infectious etiology was also indirectly supported by a relatively protective effect of barrier contraceptive methods (OR = 0.6). The simultaneous finding of HPV 16/18 as a significant risk factor (OR = 2.4) cannot be taken uncritically as support for a causal effect of this HPV type, since such a relationship between cytological changes of the cervix and HPV infection could also emerge if the positive PAP smear was not just a measure of intra-epithelial neoplasia but also an expression of the infection itself on the cervix.
AIM: The aim of this study was to analyse whether immigrant women request induced abortion more frequently than Swedish-born women and, if so, to study possible explanations, including contraceptive practices and attitudes. METHODS: All women who requested induced abortion during a period of one year were included in the study. The 1289 women, of whom 36% were born outside Sweden, were interviewed by a nurse-midwife who, using a structured protocol, gathered information on socioeconomic factors, reasons for abortion, experience of contraceptive methods, and family planning counselling. The proportion of women with non-Swedish origin in the study population was compared with the official demographic statistics of the corresponding area. RESULTS: The number of women born outside Sweden who requested induced abortion was larger than expected from their proportion in the population. The immigrant women originated from 77 countries and four continents, the largest subgroup, 11%, coming from Iran. Immigrant women had less experience of contraceptive use, more previous pregnancies and more induced abortions than women born in Sweden. In a multivariate analysis, immigrant status and educational level were found to be independent risk factors for repeat abortion. CONCLUSION: Immigrant status seems to be an independent risk factor for induced abortion. The immigrant women originated from a wide range of cultures. There is no reason to believe that the women in this heterogeneous group should have any cultural factor in common that could explain their higher proneness to seek induced abortion. The most probable cause is that immigrant status is associated more often with low education, weak social network, poverty, unemployment, and being outside common pathways to healthcare.
STUDY OBJECTIVE: To analyze if immigrant girls request early pregnancy termination more frequently than ethnic Swedish girls and, if so, study possible explanations, including contraceptive practices and attitudes. DESIGN AND PARTICIPANTS: All women under 19 years of age who attended a large abortion clinic during one year were interviewed. Out of 126 adolescents, 36% were born outside Sweden. The immigrant girls (37 born abroad and 23 with at least one parent born abroad) were compared to 66 ethnic Swedish girls regarding contraceptive habits, reasons for abortion and social factors. RESULTS: The proportion of adolescents born abroad was larger than expected: 38 (29%) were born outside Sweden, compared to 18% in corresponding areas of Stockholm. The ethnic Swedish girls had fewer previous pregnancies than first and second generation immigrants and had more experience of contraceptive counselling. The most common reason for abortion in both groups was the wish to finish education. Ethnical Swedish girls claimed young age as reason for abortion more often than immigrants; economic reasons and reasons related to partner relationship were also common. CONCLUSION: First generation immigrant girls are over-represented among adolescents who seek termination of pregnancy. This can be explained by the fact that the immigrant girls had less experience of contraceptive use and contraceptive counselling than ethnical Swedish girls.
The proportion of adolescents who report having sexual intercourse has increased steadily since the 1970s. The proportion of females aged 15- 19 years reporting such activity increased from 26.6% in 1970 to 51.5% in 1988, with the percentage of 15 year olds rising from 4.6% to 25.6% over the period. Data from the 1988 National Survey of Adolescent Males indicate that 64% of males aged 15-18 years had sexual intercourse at least once. Adolescents, however, tend to delay using contraception until 1 year after the initiation of sexual intercourse. Youths seen at family planning clinics have cited being afraid of their parents finding out about their visit, fear of pelvic exams, and fear of health consequences from the pill as reasons for their delay. This degree of sexual intercourse without contraception has led to annual pregnancies for more than 1 million women under age 20. Approximately 50% bear their children, while 40% abort their fetuses. Births to these young mothers increase their risk of delivery-related mortality and subsequent long-term economic and educational underachievement. The children born to these mothers also share similar risks in addition to the possibility of being born underweight and bearing infants themselves as teenagers. Teenage pregnancy and childbearing therefore comes at great social and public economic costs. Medical practitioners, counselors, policymakers, and the general public must realize, however, that teenage sexuality and its consequences are not the most alarming of social ills in the US. Of greater concern is the failed continuation of declines in the rate of adolescent childbearing began in the 1970s and the recent increase among younger adolescents. Central to these trends is the continually declining age of initial sexual intercourse among youths and the particular tendency among younger adolescents to delay using contraceptives. 18% of US adolescents have sexual intercourse before reaching age 15 and 66% do so by age 19, yet only 33% of those who are sexually active use contraceptives. Despite similar levels of sexual activity across countries, the US has higher rates of adolescent pregnancy, births, and elective abortions than Canada, France, the Netherlands, Great Britain, and Sweden. US efforts to prevent unwanted pregnancies among youths are therefore comparatively weak. Pediatricians are in a good position to speak out about the realities of adolescent sexuality, educate youths about their sexuality, and promote adolescents' access to contraceptives. Pediatricians are also well- situated to encourage discussion of these issues with their young male clients who generally avoid seeking contraceptives in traditional family planning settings.
A comparative study of adolescent reproductive behavior in the 1980s examined difference in pregnancy, birth, and abortion levels among teenagers in developed countries especially in the US, Canada, the UK, France, the Netherlands, and Sweden. Only 6 of 37 countries with total fertility rates 3.5 and per capita income US$2000/year, and at least 1 million people had adolescent birth rates higher than the US (Bulgaria, Cuba, Puerto Rico, Romania, Hungary, and Chile). The US had the highest abortion rate (42/1000) followed by Hungary (27/1000). Thus the US had the highest adolescent pregnancy rate (96/1000) as well as Hungary (96/1000). The 6 country analysis showed that reducing the level of sexual activity among teenagers is not necessarily needed to achieve lower pregnancy rates. For example, Sweden had the highest levels of sexual activity but its pregnancy rate were 33% as high as those of the US. The rates of sexual activity among teenagers in the Netherlands equaled those of the US, but its pregnancy rates were 14% as high as those of the US. All countries had earlier, more extensive, and better contraceptive use among sexually active teenagers than the US which accounted for their lower pregnancy rates. The more realistic acceptance of sexual activity among teenagers and provision of contraceptives in all the countries except the US differed from the societal ambivalence in the US. Thus ambivalence about sexuality and the appropriateness of contraceptive use results in lower contraceptive use and greater adolescent pregnancy rates. US adolescents constantly receive conflicting messages that sex is romantic, thrilling, and arousing but it is also immoral to have premarital sex. Thus adults need to be more candid about sexuality so they can clearly convey to adolescents their expectations for responsible behavior and to provide the information and services needed to make effective use of contraceptives when sexually active.
To study changes in adolescent sexual behavior in periods of increase (1994-2000) and decrease (2001-2007) in the abortion rate.
School surveys with self-administered questionnaires were carried out annually among eighth graders (mean age 14.8 years) and ninth graders (mean age 15.8 years) (N=286,665) in 1996/1997 and 2006/2007. Schools participated biennially. The proportions of respondents reporting noncoital (kissing, light petting, heavy petting) and coital (ever had sexual intercourse, intercourse at least 10 times, at least three partners) sexual experience and nonuse of contraception were studied.
Among adolescents, both coital and noncoital sexual experiences and the proportion of those not using contraception increased between 1996-1997 and 2000-2001 (P for trend
BACKGROUND: In order to understand and prevent unwanted health consequences related to sexual behaviour, we need to know the status and changes of sexual behaviour in adolescence. MATERIAL AND METHOD: In 1997 and 2001, surveys were conducted including a total of 1665 adolescents and young adults aged 15 to 24 (response rate > 90%) in secondary schools in a small town in a rural district in Norway. We analysed frequencies for boys and girls and estimated the change in median age of first intercourse. Logistic regression analyses of median age and other health-related parameters were performed. RESULTS: A greater proportion of the respondents reported sexual experience in 2001 than in 1997. Girls have their first intercourse at a younger age than boys, often with older partners. 21% of the girls had experienced unwanted sexual situations. Use of contraception has increased, though insignificantly. Still, 11% of sexually active girls had had unwanted pregnancies. First intercourse during adolescence is clearly associated with other forms of behaviour that compromise health. However, a great and stable majority report a stable partner during adolescence. CONCLUSIONS: In accordance with other studies we find changes in sexual behaviour over a short period of time among adolescents in rural Norway. Stable sexual relations may still be a protective factor.
Seven out of ten of the adolescents included in the study had experienced unsafe sex with a new partner. Afterwards, 48% worried about STD and 31% worried about pregnancy. Teenagers calculate the risk of contracting STD from the looks and the reputation of a new partner. Young women and men agree, that both share responsibility for the use of condoms, but more often the young women initiate the use of condoms. Many participants found it more embarrassing to buy condoms than to use them. The participants hoped for improved education in schools and less expensive condoms. The adolescents possessed good knowledge concerning how to protect themselves, but changes in attitudes are needed. School and youth clinics play important roles in this process.