sábado, 12 de septiembre de 2009

Guttmacher Institute: The September 2009 issue of Perspectives on Sexual and Reproductive Health

A quarterly, peer-reviewed professional journal published by the Guttmacher Institute, features the following:

Anal sex can be very risky, yet many women participate in it, some without using protection. To better understand what motivates this behavior, Emily Maynard, author of “Women’s Experiences with Anal Sex: Motivations and Implications for STD Prevention,” and her coauthors conducted in-depth interviews with a sample of women in Boston. The researchers found that women were motivated to engage in anal sex by a desire to heighten intimacy with or to please their partner, and that they decided against condom use to avoid decreasing their own or their partner’s pleasure or because of their familiarity with their partner. Maynard and colleagues conclude that women who perceive condom use during anal sex as limiting their pleasure or intimacy may be at increased risk for acquiring HIV. Therefore, they suggest that interventions to promote safer anal sex must find a way to increase the use of barrier methods and safeguard women’s health without decreasing perceived pleasure and intimacy between partners.

A new analysis examines the links between arousal and sexual health outcomes such as unintended pregnancy. According to “Arousal Loss Related to Safer Sex and Risk of Pregnancy: Implications for Women’s and Men’s Sexual Health,” by Jenny A. Higgins et al., 34% of participants in an Internet survey reported that the use of safer-sex products, such as condoms, lessened arousal, while 46% reported that the risk of unintended pregnancy undermined their arousal. Participants who strongly agreed that safer-sex practices undermined their arousal were much more likely to have had unprotected sex in the last year than were those who strongly disagreed. Respondents who strongly disagreed that the risk of pregnancy undermined their arousa l were significantly more likely to have been involved in an unintended pregnancy than were those who strongly agreed. Given the importance of arousal in safer-sex practices and reducing pregnancy risk, the authors suggest that the issue be integrated into sexual health research and programming.

Each year, 73% of women of reproductive age nationally use a family planning or related medical service. In a qualitative study conducted in the San Francisco area, Davida Becker and colleagues examined women’s perceptions of the quality of health services they have received. According to their findings, presented in “Women’s Perspectives on Family Planning Service Quality: An Exploration of Differences by Race, Ethnicity and Language,” having family planning providers who exhibit warmth and friendliness, remember their patients from previous visits, are nonjudgmental, are respectful of patients’ autonomy and are caring and empathetic are all key to high-quality reproductive health care. There were virtually no difference s in responses among racial, ethnic or language groups.

Latinas’ high levels of out-of-wedlock childbearing may limit their social and economic prospects, yet the factors behind nonmarital childbearing among this group have not been closely studied. According to “Decomposing Trends in Nonmarital Fertility Among Latinas,” by Felicia Yang DeLeone et al., the proportion of births to Latinas that were nonmarital increased between 1994 and 2005, and that change can be explained mainly by a decline in the proportion of Latina women who were married. Changes in fertility rates and the age distribution of the population played little role. The authors suggest that efforts to reduce nonmarital childbearing among Latinas should promote healthy marriages.

Societal norms and widespread disapproval of teen childbearing in Sweden may leave teens with little choice but to terminate an unintended pregnancy, according to “An Illusion of Power: Qualitative Perspectives on Abortion Decision-Making Among Teenage Women in Sweden,” by Maria Ekstrand et al. The authors conducted in-depth interviews with a sample of Swedish women who had recently had abortions and found that contraception and pregnancy prevention are generally treated as the woman’s responsibility, but pregnancy is greeted with overwhelmingly negative reactions from partners, parents and peers. As a result, women who had been ambivalent about their pregnancy had felt pressured into having an abortion. The authors suggest that men and women need to share in the responsibility for contraceptive use and pregnancy prevention, and both should be involved in decision making if faced with an unplanned pregnancy.

The dynamics between teens and their dating partners are strongly related to the consistency of their condom use, according to “Relationship Dynamics and Consistency of Condom Use Among Adolescents,” by Wendy D. Manning et al. The authors examined data from a representative survey of seventh, ninth and 11th graders in the Toledo, Ohio, area and found that inconsistent condom use was associated with both negative relationship features, such as jealousy and mistrust, and positive relationship features, such as love and enmeshment. The authors suggest that sex education programs should intensify their focus on the relationship context of decision making, since adolescents in all types of relationships are at risk of pregnancy and sexually tra nsmitted infection.

The Guttmacher Institute works to advance sexual and reproductive health in the United States and worldwide through an interrelated program of social science research, policy analysis and public education designed to generate new ideas, encourage enlightened public debate, promote sound policy and program development, and, ultimately, inform individual decision making. Learn more at Guttmacher.org.

© copyright 2009, Guttmacher Institute

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