Deborah B Nelson1, Huaqing Zhao2, Rachel Corrado3, Dimitrios M Mastrogiannnis4, Stephen J Lepore5. 1. 1 Department of Epidemiology, Biostatistics, and Ob/Gyn, Temple University , Philadelphia, Pennsylvania. 2. 2 Department of of Biostatistics and Epidemiology, Temple University School of Medicine , Philadelphia, Pennsylvania. 3. 3 Applied Public Health Informatics Fellow, Division of Informatics, Information Technology and Telecommunication Centers for Disease Control , New York, New York. 4. 4 Department of Obstetrics and Gynecology, University of Illinois at Chicago , Chicago, Illinois. 5. 5 Department of Social and Behavioral Sciences, Temple University , Philadelphia, Pennsylvania.
Abstract
OBJECTIVES: Ineffective contraceptive use among young sexually active women is extremely prevalent and poses a significant risk for unintended pregnancy (UP). Ineffective contraception involves the use of the withdrawal method or the inconsistent use of other types of contraception (i.e., condoms and birth control pills). This investigation examined violence exposure and psychological factors related to ineffective contraceptive use among young sexually active women. MATERIALS AND METHODS: Young, nonpregnant sexually active women (n = 315) were recruited from an urban family planning clinic in 2013 to participate in a longitudinal study. Tablet-based surveys measured childhood violence, community-level violence, intimate partner violence, depressive symptoms, and self-esteem. Follow-up surveys measured type and consistency of contraception used 9 months later. Multivariate logistic regression models assessed violence and psychological risk factors as main effects and moderators related to ineffective compared with effective use of contraception. RESULTS: The multivariate logistic regression model showed that childhood sexual violence and low self-esteem were significantly related to ineffective use of contraception (adjusted odds ratio [aOR] = 2.69, confidence interval [95% CI]: 1.18-6.17, and aOR = 0.51, 95% CI: 0.28-0.93; respectively), although self-esteem did not moderate the relationship between childhood sexual violence and ineffective use of contraception (aOR = 0.38, 95% CI: 0.08-1.84). Depressive symptoms were not related to ineffective use of contraception in the multivariate model. CONCLUSIONS: Interventions to reduce UP should recognize the long-term effects of childhood sexual violence and address the role of low self-esteem on the ability of young sexually active women to effectively and consistently use contraception to prevent UP.
OBJECTIVES: Ineffective contraceptive use among young sexually active women is extremely prevalent and poses a significant risk for unintended pregnancy (UP). Ineffective contraception involves the use of the withdrawal method or the inconsistent use of other types of contraception (i.e., condoms and birth control pills). This investigation examined violence exposure and psychological factors related to ineffective contraceptive use among young sexually active women. MATERIALS AND METHODS: Young, nonpregnant sexually active women (n = 315) were recruited from an urban family planning clinic in 2013 to participate in a longitudinal study. Tablet-based surveys measured childhood violence, community-level violence, intimate partner violence, depressive symptoms, and self-esteem. Follow-up surveys measured type and consistency of contraception used 9 months later. Multivariate logistic regression models assessed violence and psychological risk factors as main effects and moderators related to ineffective compared with effective use of contraception. RESULTS: The multivariate logistic regression model showed that childhood sexual violence and low self-esteem were significantly related to ineffective use of contraception (adjusted odds ratio [aOR] = 2.69, confidence interval [95% CI]: 1.18-6.17, and aOR = 0.51, 95% CI: 0.28-0.93; respectively), although self-esteem did not moderate the relationship between childhood sexual violence and ineffective use of contraception (aOR = 0.38, 95% CI: 0.08-1.84). Depressive symptoms were not related to ineffective use of contraception in the multivariate model. CONCLUSIONS: Interventions to reduce UP should recognize the long-term effects of childhood sexual violence and address the role of low self-esteem on the ability of young sexually active women to effectively and consistently use contraception to prevent UP.
Entities:
Keywords:
childhood sexual violence; contraception use; depressive symptoms; self-esteem
Authors: Esther C Atukunda; Godfrey R Mugyenyi; Celestino Obua; Elly B Atuhumuza; Edward J Lukyamuzi; Angela Kaida; Amon G Agaba; Lynn T Matthews Journal: PLoS Med Date: 2019-06-21 Impact factor: 11.069
Authors: Esther C Atukunda; Godfrey R Mugyenyi; Angella Musiimenta; Angela Kaida; Elly B Atuhumuza; Edward J Lukyamuzi; Amon G Agaba; Celestino Obua; Lynn T Matthews Journal: J Glob Health Date: 2021-06-05 Impact factor: 4.413