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MARCH 2013 ISSUE OF
PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH
Under our Early View feature, articles in Perspectives on Sexual and Reproductive Health are published online as they complete the production process, which allows us to get material to you weeks before the printed journal arrives in your mailbox. Sign up at this link to receive an alert when new materials become available.
HERE'S WHAT YOU CAN FIND IN THE MARCH ISSUE OF PERSPECTIVES:
For young adults, some types of intimate partner violence are linked to anal sex
Young adult women in physically or sexually abusive relationships are more likely than those in nonviolent relationships to report anal intercourse, according to "Intimate Partner Violence and Anal Intercourse in Young Adult Heterosexual Relationships," by Kristen L. Hess, formerly of the University of California, Los Angeles, et al. The authors analyzed data from a sample of 6,280 women aged 18–28 who participated in the third wave of the National Longitudinal Study of Adolescent Health, to examine the relationship between intimate partner violence and anal sex.
The data showed that physical violence occurred in 29% of women's relationships in the last five years, sexual violence in 11% and anal intercourse in 14%. Women reported having used condoms during anal intercourse in only 23% of relationships that included such sex. Condom use during anal intercourse was less prevalent in relationships involving physical violence that was committed only by the male partner than in nonabusive relationships. Sexual violence was not linked to decreased condom use in this study. According to the authors, the finding linking physical violence to reduced condom use suggests that women in physically violent relationships may be at increased risk of STDs because of their elevated exposure to unprotected anal intercourse.
The authors acknowledge that their findings do not provide a complete understanding of the relationship between intimate partner violence and anal intercourse or information about the context of the abuse. However, they suggest that their study does offer insight into the risk of transmission and acquisition of STDs within violent relationships. Additional studies that address the role of violence in the decision to have anal intercourse and to use a condom could help inform sexual risk reduction interventions.
New evidence shows that most abortions in developed countries occur among women in their 20s
In developed countries, abortion is more common among women in their 20s than among women of other ages, according to "Legal Abortion Levels and Trends by Woman's Age at Termination," by Gilda Sedgh et al. of the Guttmacher Institute. In most industrialized nations, young adulthood is the period when women are most at risk of unintended pregnancy and its consequences. An increasing number of women want to postpone childbearing to pursue an education or work opportunities. To reduce the health toll of abortion complications—and decrease the incidence of abortion—it is vital to help women avoid unwanted pregnancies. Using data from more than 40 countries where legal abortion is generally available, the authors calculated age-specific abortion rates and percentage distributions of abortions by age, taking into account the estimated completeness of reporting. Drawing on information on contraceptive use and unmet need in the countries studied, the authors speculate that higher abortion rates in particular age-groups reflect higher-than-average levels of unmet need for contraception or difficulty in using methods effectively, as well as a stronger desire to avoid childbearing.
Women's perceptions of the benefits of childbearing may influence their risk of pregnancy
In a study of women seeking contraceptive services at San Francisco–area family planning clinics, participants' perceptions of the benefits of childbearing decreased with increasing age, and white women perceived fewer benefits than did black or Latina women, according to "Young Women's Perceptions of the Benefits of Childbearing: Associations with Contraceptive Use and Pregnancy," by Corinne H. Rocca, of the University of California, San Francisco, et al. The authors developed a scale to assess women's perceived benefits of childbearing and administered it to a sample of 1,377 women aged 15–24 who were initiating use of a hormonal contraceptive and did not want to become pregnant within the next year. As women's perceptions of the benefits of childbearing increased, so did their one-year pregnancy rates. However, the authors found no evidence that women discontinued their contraceptive method as their perceptions of the benefits of having children increased.
The authors suggest that their findings of racial and ethnic differences in attitudes toward childbearing indicate that further research should examine what role these attitudes might play in influencing disparities in unintended pregnancy. They recommend that providers examine women's perceptions about childbearing, in addition to their stated intentions, in order to better help them prevent unwanted pregnancies.
Brief intervention program may reduce risk among out-of-school young men
A new study by Arik V. Marcell, of Johns Hopkins Bloomberg School of Public Health, et al., examined findings from a risk reduction program conducted at a Baltimore youth employment and training program, which offers services to teens and young adults not currently in school or the workforce. Among the 197 predominantly black youth aged 16–24 who participated in the study, those who engaged in a three-part intervention focused on sexually transmitted diseases (STDs), condom use, clinical sexual and reproductive health care, and community sources of services showed greater improvements in outcomes between baseline and a three month follow-up than did men in the control group. According to "Effectiveness of a Brief Curriculum to Promote Condom and Health Care Use Among Out-of-School Young Adult Males," young men who received the intervention were more likely than controls to report increases in knowledge of STDs and health care use, use of condoms, use of lubricant with condoms, communication with a provider about STDs and STD testing.
The authors suggest that additional research could help assess whether a similar brief curriculum could be adapted to promote health care knowledge and behaviors among other populations of men who may not access needed sexual and reproductive health services.
Factors influencing women's motivation to avoid pregnancy differ across racial and ethnic groups
Young adults may have practical or emotional reasons for wanting to avoid pregnancy, and their motivations may vary by race and ethnicity, according to "Racial and Ethnic Variation in Unmarried Young Adults' Motivation to Avoid Pregnancy," by Sarah R. Hayford, of Arizona State University, and Karen Benjamin Guzzo, of Bowling Green State University. In analyses of data from 1,573 unmarried men and women aged 18–29 who participated in the National Survey of Reproductive and Contraceptive Knowledge, the authors found that 77% considered avoiding pregnancy very important, and 34% would be very upset if they were to experience an unplanned pregnancy. The findings revealed no significant racial or ethnic variation in the importance of avoiding pregnancy. However, foreign-born Hispanics were less likely than whites to say they would be upset if faced with an unintended pregnancy, and blacks were more likely than whites to report that they would be upset.
The authors suggest that motivation to avoid pregnancy be explored further as a possible explanation for disparities in rates of unintended pregnancy. Additionally, they recommend that future research explore whether motivation is related to behavior; if a relationship is found, it could help guide the design of policies and interventions aimed at reducing unintended childbearing and disparities among racial and ethnic groups.