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Perspectives on Sexual and Reproductive Health

Leah E Masselink, Julie Lewis, Clare Coleman, Susan F Wood
CONTEXT: Under the Affordable Care Act (ACA), the number of patients who have health insurance among those receiving family planning and reproductive health services at Title X-funded health centers has grown. However, billing some patients' insurance for services may be difficult because of Title X's extensive confidentiality protections. Little is known about health centers' experiences in addressing these difficulties. METHODS: Eight focus group discussions were conducted with a convenience sample of 54 Title X-funded health center staff members and state program administrators in January and April 2015...
March 5, 2018: Perspectives on Sexual and Reproductive Health
Amy Bleakley, Atika Khurana, Michael Hennessy, Morgan Ellithorpe
CONTEXT: Parents, peers and media are informal sources of sexual information for adolescents. Although the content of sexual information communicated by these sources is known to vary, little is known about what adolescents report actually learning from each source. METHODS: Data from 1,990 U.S.14-17-year-olds who participated in an online survey in 2015 were used to assess learning about four topics (sex, condoms, hormonal birth control and romantic relationships) from three informal sources (parents, peers, and television and movies)...
February 20, 2018: Perspectives on Sexual and Reproductive Health
Molly Frances Battistelli, Sara Magnusson, M Antonia Biggs, Lori Freedman
CONTEXT: Access to abortion care in the United States varies according to multiple factors, including location, state regulation and provider availability. In 2013, California enacted a law that authorized nurse practitioners (NPs), certified nurse-midwives (CNMs) and physician assistants (PAs) to provide first-trimester aspiration abortions; little is known about organizations' experiences in implementing this policy change. METHODS: Beginning 10 and 24 months after implementation of the new law, semistructured interviews were conducted with 20 administrators whose five organizations trained and employed NPs, CNMs and PAs as providers of aspiration abortions...
February 14, 2018: Perspectives on Sexual and Reproductive Health
Tiara C Willie, Tamora A Callands, Trace S Kershaw
CONTEXT: The transition to parenthood is a stressful time for young couples and can put them at risk for acquiring STDs. Mechanisms underlying this risk-particularly, intimate partner violence (IPV) and sexual autonomy-have not been well studied. METHODS: Between 2007 and 2011, a prospective cohort study of the relationships and health of pregnant adolescents and their male partners recruited 296 couples at four hospital-based obstetrics and gynecology clinics in the U...
February 12, 2018: Perspectives on Sexual and Reproductive Health
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February 5, 2018: Perspectives on Sexual and Reproductive Health
Heidi Moseson, Diana Greene Foster, Ushma D Upadhyay, Eric Vittinghoff, Corinne H Rocca
CONTEXT: Nonuse and inconsistent use of contraceptives contribute to a high incidence of unintended pregnancy and abortion among U.S. women. Little is known, however, about how these outcomes shape women's subsequent contraceptive use and unintended pregnancy risk. METHODS: Contraceptive use was examined among 880 participants in the Turnaway Study, a five-year longitudinal study of women who sought abortions at 30 U.S. facilities in 2008-2010. Multivariable mixed-effects logistic and multinomial regression models assessed differences in use by whether women received the abortion; results were used to calculate predicted percentages of women using each method...
January 12, 2018: Perspectives on Sexual and Reproductive Health
Angela Kaida, Sophie Patterson, Allison Carter, Mona Loutfy, Erin Ding, Paul Sereda, Kath Webster, Neora Pick, Mary Kestler, Alexandra de Pokomandy
CONTEXT: Preventing unintended pregnancy and HIV transmission is important for women with HIV, but little is known about their contraceptive use, particularly under current antiretroviral therapy (ART) recommendations for treatment and prevention. METHODS: The prevalence of contraceptive use and of dual protection was examined among 453 sexually active women with HIV aged 16-49 and enrolled in the Canadian HIV Women's Sexual and Reproductive Health Cohort Study in 2013-2015; multivariable logistic regression was used to identify correlates of use...
December 2017: Perspectives on Sexual and Reproductive Health
Kate Grindlay, Jane W Seymour, Laura Fix, Sarah Reiger, Brianna Keefe-Oates, Daniel Grossman
CONTEXT: U.S. servicewomen have a higher rate of unintended pregnancy than civilian women, yet the military does not provide or cover abortion, except in limited circumstances. Servicewomen's experiences with abortion care have received little research attention. METHODS: Twenty-one in-depth interviews with servicewomen who had had an abortion during active-duty service in the prior two years were conducted between January 2015 and July 2016. Women reported on their experiences accessing abortion, as well as their knowledge and opinions of the military's abortion policy...
December 2017: Perspectives on Sexual and Reproductive Health
Brittni N Frederiksen, Katherine A Ahrens, Susan Moskosky, Loretta Gavin
CONTEXT: The United Nations Sustainable Development Goals (SDGs) seek to achieve health equity, and they apply to all countries. SDG contraceptive use estimates for the United States are needed to contextualize U.S. performance in relation to that of other countries. METHODS: Data from the 2011-2013 and 2013-2015 waves of the National Survey of Family Growth were used to calculate three SDG indicators of contraceptive use for U.S. women aged 15-44: contraceptive prevalence, unmet need for family planning and demand for family planning satisfied by modern methods...
December 2017: Perspectives on Sexual and Reproductive Health
Caroline Sten Hartnett, Lisa Lindley, Katrina M Walsemann, Daniela V Negraia
CONTEXT: A woman's happiness about a pregnancy and birth has implications for her child's health and her own well-being. Sexual orientation and, particularly, the extent of concordance across its dimensions (sexual identity, behavior and attraction) may be related to happiness about these events, but research on this relationship has been lacking. METHODS: Data on 5,744 pregnancies ending in births among women aged 15-44 in three waves of the National Survey of Family Growth (2006-2015) were examined...
December 2017: Perspectives on Sexual and Reproductive Health
Kristen N Jozkowski, Tiffany L Marcantonio, Mary E Hunt
CONTEXT: Affirmative consent standards adopted by colleges and universities are meant to decrease miscommunication that may lead to sexual assault. However, they may not take into account sociocultural factors that influence consent. In particular, the role of gender norms needs to be better understood. METHODS: In-depth interviews about college students' sexual activity, including sexual consent communication, were conducted with 17 female and 13 male students at a large southern university during the spring 2013 semester...
December 2017: Perspectives on Sexual and Reproductive Health
Maryam Guiahi, Stephanie B Teal, Maryke Swartz, Sandy Huynh, Georgia Schiller, Jeanelle Sheeder
CONTEXT: Catholic Church directives restrict family planning service provision at Catholic health care institutions. It is unclear whether obstetrics and gynecology clinics that are owned by or have business affiliations with Catholic hospitals offer family planning appointments. METHODS: Mystery callers phoned 144 clinics nationwide that were found on Catholic hospital websites between December 2014 and February 2016, and requested appointments for birth control generally, copper IUD services specifically, tubal ligation and abortion...
December 2017: Perspectives on Sexual and Reproductive Health
Mieke C W Eeckhaut
CONTEXT: Most studies of contraceptive use have relied solely on the woman's perspective, but because men's attitudes and preferences are also important, analytic approaches based on couples should also be explored. METHODS: Data from the 2006-2010 and 2011-2013 rounds of the National Survey of Family Growth yielded a sample of 4,591 men and women who were married or cohabiting with an opposite-sex partner and who had completed their intended childbearing. Respondents' reports of both their own and their partners' characteristics and behaviors were employed in two sets of analyses examining educational and racial and ethnic differences in contraceptive use: an individualistic approach (using multinomial logistic regression) and a couple approach (using multinomial logistic diagonal reference models)...
September 2017: Perspectives on Sexual and Reproductive Health
Megan A Cahn, S Marie Harvey, Matthew A Town
CONTEXT: American Indian and Alaska Native men experience poorer sexual health than white men. Barriers related to their sex and racial identity may prevent them from seeking care; however, little is known about this population's use of sexual health services. METHODS: Sexual health service usage was examined among 923 American Indian and Alaska Native men and 5,322 white men aged 15-44 who participated in the 2006-2010 National Survey of Family Growth. Logistic regression models explored differences in service use by race and examined correlates of use among American Indians and Alaska Natives...
September 2017: Perspectives on Sexual and Reproductive Health
Bethany G Everett, Katharine F McCabe, Tonda L Hughes
CONTEXT: Many sexual minority women, regardless of sexual identity, engage in heterosexual behavior across the life course, which provides them opportunities to experience an unintended pregnancy. In addition, sexual minority women are more likely than others to report characteristics that may make them vulnerable to unintended pregnancy. Little research, however, has examined whether the risk of unintended pregnancy is elevated among these women. METHODS: Using data from the 2006-2010 National Survey of Family Growth, logistic regression models were fitted to examine sexual orientation disparities in mistimed and unwanted pregnancies among 9,807 women aged 20-45; mixed-effects hazard models assessed disparities in the intention status of 5,238 pregnancies among these women by maternal sexual orientation...
September 2017: Perspectives on Sexual and Reproductive Health
Justine P Wu, Kimberly S McKee, Michael M McKee, Michelle A Meade, Melissa A Plegue, Ananda Sen
CONTEXT: Women with disabilities experience a higher rate of adverse pregnancy outcomes than women without disabilities. Preventing or delaying pregnancy when that is the best choice for a woman is a critical strategy to reducing pregnancy-related disparities, yet little is known about current contraceptive use among women with disabilities. METHODS: A cohort of 545 reproductive-age women with physical disabilities (i.e., difficulty walking, climbing, dressing or bathing) or sensory disabilities (i...
September 2017: Perspectives on Sexual and Reproductive Health
Cheryl L Robbins, Loretta Gavin, Marion W Carter, Susan B Moskosky
CONTEXT: Federal and clinical guidelines recommend integrating reproductive life plan assessments into routine family planning encounters to increase provision of preconception care. Yet, the prevalence of clinical protocols and of relevant practices at publicly funded health centers is unknown. METHODS: Administrators and providers at a nationally representative sample of publicly funded health centers that provide family planning services were surveyed in 2013-2014; data from 1,039 linked pairs were used to explore the reported prevalence of reproductive life plan protocols, frequent assessment of patients' reproductive life plan and frequent provision of preconception care...
September 2017: Perspectives on Sexual and Reproductive Health
Jenny A Higgins
CONTEXT: Many young adults are unclear about how much they want to have, or prevent having, a baby. However, pregnancy ambivalence is an underexamined factor in the uptake of long-acting reversible contraceptive (LARC) methods-IUDs and implants-the most effective methods available. METHODS: In 2014, investigators conducted six focus groups and 12 interviews with 50 women aged 18-29 in Dane County, Wisconsin; participants were either university students or community residents receiving public assistance...
September 2017: Perspectives on Sexual and Reproductive Health
Jenneke van Ditzhuijzen, Margreet Ten Have, Ron de Graaf, Carolus H C J van Nijnatten, Wilma A M Vollebergh
CONTEXT: Credible research has not found any evidence that abortion causes mental disorders. It is not known, however, whether abortion-specific risk indicators and other variables are associated with the incidence or recurrence of mental disorders after abortion. METHODS: As part of a prospective cohort study conducted in the Netherlands, 325 women were interviewed between April 2010 and January 2011, between 20 and 40 days after having an abortion; 264 were followed up an average of 2...
June 2017: Perspectives on Sexual and Reproductive Health
Jennifer Yarger, Sara Daniel, M Antonia Biggs, Jan Malvin, Claire D Brindis
CONTEXT: Publicly funded family planning providers are well positioned to help uninsured individuals learn about health insurance coverage options and effectively navigate the enrollment process. Understanding how these providers are engaged in enrollment assistance and the challenges they face in providing assistance is important for maximizing their role in health insurance outreach and enrollment. METHODS: In 2014, some 684 sites participating in California's family planning program were surveyed about their involvement in helping clients enroll in health insurance...
June 2017: Perspectives on Sexual and Reproductive Health
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