Browsing by Subject "Contraception"

Now showing 1 - 4 of 4
  • Thumbnail Image
    Item
    Birth Control Options for Dysmenorrhea and Menstrual Cramps
    (2012-04-10) Becker, Mackenzie
  • Thumbnail Image
    Item
    Empowerment and Sexual Wellbeing: Exploring Gender and Religious Ideologies in the Perception, Intention and Use of Contraception among Young Filipino Women
    (2020-02) Beltran, Raiza Jemie
    The Philippines passed its first comprehensive reproductive health law in 2012. The political tension between religious and women’s rights factions during this contentious debate exposed the influential role religion and gender ideology may play in young Filipino women’s decision to contracept. Guided by the reproductive justice and positive adolescent sexual wellbeing framework, and working in partnership a Philippine-based reproductive health organization, this three-paper dissertation examines the root causes behind the low contraceptive use among young Filipino women. Manuscript 1 (conceptual paper) examined the applicability of the reproductive justice framework using young Filipino women’s low contraceptive use as a case study. In Manuscript 2 (quantitative paper), descriptive and multiple logistic regression analyses were conducted among a sample of 459 young Filipino women to determine the influence of religion and traditional beliefs about dating and marriage, on young Filipino women’s condom intention and condom use. Results indicate strong religiosity in this population. However, only the traditional belief of remaining a virgin until marriage proved to be predictive of condom intention and condom knowledge about HIV/AIDS prevention was found to be associated with condom use. Manuscript 3 (qualitative paper), examined the extent of sexual agency, religiosity, and gender beliefs in influencing the contraceptive decisions of 19 college-attending young Filipino women using focus groups. The salient societal issues affecting low contraceptive use in this population were also determined based on individual interviews among five reproductive health professionals. Study results demonstrate that young Filipino women contend with contradictory expectations of sexual agency and empowerment. Remaining a virgin until marriage continue to be highly valued as it is equated with self-respect. Reproductive health professionals noted the negative effect of religious and gender ideology as well as poverty and government corruption on young Filipino women’s contraceptive access and use. The three papers combined suggest that while young Filipino women appear to have a sense of agency and empowerment, they continue to value virginity and deem it as the only route to respectability, disregarding other forms of sexual expression outside of remaining a virgin. In this way, religious and gender ideologies interact limiting young Filipino women’s sexual choice and freedom.
  • Thumbnail Image
    Item
    International travel, contraceptive use, and sexual behavior: A mixed methods study of female university students
    (2017-10) Martins, Summer
    BACKGROUND Adolescence and young adulthood are critical life stages for maintaining sexual and reproductive health (SRH), especially for women. There is a vast research literature dedicated to the determinants of young women’s SRH and related risk behaviors—e.g., contraception and condom use. While the factors influencing women’s SRH are broadly understood, it is less clear how risk mechanisms operate within specific contexts. Illuminating the unique settings that exacerbate or mitigate young women’s SRH risks could guide the development of more potent interventions. This dissertation examines young women’s SRH in the context of international travel. Traveling to a foreign country precipitates an abrupt shift in women’s psychosocial, physical, and cultural environments that may, in turn, influence SRH risk behaviors. Existing studies focus on travelers’ sexual behaviors in predominantly European and clinic-based samples. Data for women are mostly limited to prevalence estimates. Notably, no published studies report on women’s use of contraception, other than condoms, during international travel. With few studies comparing travelers with non-travelers, it is also unclear whether SRH outcomes are attributable to travel itself or if high-risk individuals disproportionately engage in international travel. DATA SOURCE We conducted a mixed-methods study of female university students who had traveled outside the United States in the past three months (“Traveler”) or planned to do so in the next three months (“Pre-Traveler”). Participants had a history of sex with men and considered the United States their home country. For the quantitative study, Travelers, (n=340) and Pre-Travelers (n=170) completed a cross-sectional online survey about their SRH and recent or upcoming trip (“index trip”). In the retrospective portion of the survey, Travelers reported on their index trip and Pre-Travelers for a recent period of similar duration in the United States. The qualitative study consisted of in-depth, semi-structured interviews with 25 Travelers and 19 Pre-Travelers. This dissertation is presented in three manuscripts, whose aims, methods, and results are described below. MANUSCRIPT 1 Aim: To evaluate whether traveling internationally increases young women’s risk of adverse SRH outcomes, compared to not traveling. Methods: Using multivariable modified Poisson regression, we estimated relative risk of contraceptive lapse (errors or non-adherence) and new male sexual partnership associated with international travel (Travelers) versus staying in the United States (Pre-Travelers). Results: During international travel, women were no more likely to lapse on their contraception (RR 1.05, 95% CI 0.83—1.32) but were 70% more likely to report a new male sex partner (RR 1.71, 95% CI 1.07—2.74). MANUSCRIPT 2 Aim: To describe the prevalence and correlates of contraceptive lapse among young women during international travel. Methods: In this exploratory analysis of surveyed Travelers (n=340), we examined crude bivariate associations between contraceptive lapse and potential correlates in three domains: baseline/pre-travel variables, travel characteristics and experiences, and SRH-related travel variables. Correlates associated with lapse at p<.20 were evaluated using multivariable modified Poisson regression, including two sensitivity analyses restricted to pill users and women who had sex while traveling. Results: Prevalence of contraceptive lapse was 29% overall and especially high among pill users (50%) and travelers who had trouble communicating with male sex partners about contraception (57%). Multivariable correlates of lapse were: using the pill (RR 4.51, 95% CI 2.57—7.94) compared to other or no contraception; trip duration of >30 days versus 1-7 days (RR 2.02, 95% CI 1.14—3.57); having trouble communicating with a male sex partner about contraception (RR 1.79, 95% CI 1.16—2.75); a high perceived impact of language barriers (RR 1.77, 95% CI 1.02—3.08); and perceiving local access to abortion as difficult (RR 1.67, 95% CI 1.22—2.27). There was a trend toward increased lapse risk among participants who had difficulty maintaining their contraceptive schedule while traveling across time zones (RR 1.38, 95% CI 1.00—1.91). Findings were generally similar in sensitivity analyses except for attenuation in the effect for pill use among sexually active travelers (RR 2.47, 95% CI 1.14—5.35). MANUSCRIPT 3 Aim: To characterize the spectrum and antecedents of young women’s sexual and contraceptive behaviors during international travel. Methods: We analyzed qualitative interview transcripts to identify themes related to: (1) Participants’ pre-travel expectations of sex; (2) The circumstances surrounding their sexual encounters with men while traveling; (3) Negotiation of condoms and contraception with these sex partners; and (4) Facilitators and barriers affecting contraceptive adherence. Results: Participants frequently expected to be abstinent during travel, citing myriad rationales that included personal values, no perceived opportunities for sex, and the nature of the trip. Some Travelers had unexpected sexual encounters, which were typified by health-promoting behaviors but also by unprotected sex, substance use, and condom errors. New sexual partnerships were fueled by increased attention from men, situational disinhibition, and heightened intimacy among travel companions. We observed an array of contraceptive considerations brought on by international travel—e.g., procuring extra supplies, adjusting schedules, and maintaining use during air travel—and obstacles that triggered contraceptive lapses and discontinuation. The logistical requirements of travel magnified differences between contraceptive methods: challenges were most acute for pill users, while women with intrauterine devices appreciated their maintenance-free contraception. CONCLUSION Young women may be at higher risk of new sexual partnership during international travel, while contraceptive lapse is frequent in both travel and non-travel settings. During international travel, risk of contraceptive lapse varies by women’s chosen contraceptive method as well as trip-specific factors. Pre-departure counseling by clinicians and other travel specialists should address travel-related barriers to women’s contraceptive use, prepare women for the possibility of unexpected sexual encounters, and encourage behavioral strategies that prevent both unintended pregnancy and sexually transmitted infections.
  • Thumbnail Image
    Item
    Long-Acting Birth Control: What are my options??
    (2012-09-24) Berger, Allison