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Objectives: Women with substance use disorders often experience unique challenges to obtaining contraception and adhering to user-dependent methods. As a result, this at-risk population of women tends to have higher than average rates of unintended pregnancy. The objective of this study was to describe contraceptive use, pregnancy intentions, and adequacy of access to reproductive healthcare among women receiving opioid agonist therapy in northeast Tennessee. Methods: A cross-sectional survey was piloted among female patients aged 18 to 55 years from two opioid agonist therapy clinics. Descriptive analyses were conducted using logistic regression to evaluate the statistical significance of bivariate associations. Results: Of 91 participants, 84% reported having health insurance, with 70% perceiving having adequate access to health care. More than half had a history of unwanted pregnancy (53%), among whom few (23.1%) reported the consistent use of contraception at time of conception. Although most desired to avoid pregnancy (90%), only 59% of women reported the current use of regular contraception. Most of those not using regular contraception believed that they were not at risk for pregnancy (54.3%). Conclusions: Although most participants reported adequate access to health care and a desire to avoid pregnancy, few reported the consistent use of regular contraception. Furthermore, misperceptions regarding pregnancy risk were common among participants. Research is needed to identify barriers to contraceptive acceptance and causes of pregnancy risk misperceptions in this population of women at increased risk of unintended pregnancy.

This study explored knowledge, perceptions and attitudes regarding contraception and contraceptive practices among secondary school learners in the Limpopo Province. Self-administered questionnaires were completed by 612 Grade 8 and 332 Grade 12 learners from 24 randomly selected secondary schools. The study found that permissive attitudes prevailed towards sex, characterised by casual sexual activities commencing at 12 years of age. The availability of contraceptive and termination of pregnancy (TOP) services did not enable learners to utilise them, because of social, cultural, financial and service barriers. Most learners were sexually active without being knowledgeable about contraceptives, emergency contraceptives and TOP services. Two workshops conducted with learners produced similar results to those obtained from the completed questionnaires. Semi-structured interviews conducted with nurses, providing contraceptive and TOP services in the Limpopo Province, also substantiated the findings from the questionnaires. Secondary school learners in the Limpopo Province require more knowledge about and ready access to contraceptives to enable them to delay child bearing until they are emotionally, financially and physically ready for these responsibilities. Nurses and teachers in this province can enhance the learners' contraceptive knowledge and utilisation to help learners make better informed decisions about their own and their future children's lives. / Health Studies / D. Litt. et Phil. (Health Studies)

This study explored knowledge, perceptions and attitudes regarding contraception and contraceptive practices among secondary school learners in the Limpopo Province. Self-administered questionnaires were completed by 612 Grade 8 and 332 Grade 12 learners from 24 randomly selected secondary schools. The study found that permissive attitudes prevailed towards sex, characterised by casual sexual activities commencing at 12 years of age. The availability of contraceptive and termination of pregnancy (TOP) services did not enable learners to utilise them, because of social, cultural, financial and service barriers. Most learners were sexually active without being knowledgeable about contraceptives, emergency contraceptives and TOP services. Two workshops conducted with learners produced similar results to those obtained from the completed questionnaires. Semi-structured interviews conducted with nurses, providing contraceptive and TOP services in the Limpopo Province, also substantiated the findings from the questionnaires. Secondary school learners in the Limpopo Province require more knowledge about and ready access to contraceptives to enable them to delay child bearing until they are emotionally, financially and physically ready for these responsibilities. Nurses and teachers in this province can enhance the learners' contraceptive knowledge and utilisation to help learners make better informed decisions about their own and their future children's lives. / Health Studies / D. Litt. et Phil. (Health Studies)

Este trabalho se inscreve no campo dos estudos sobre sexualidade e práticas reprodutivas e contraceptivas, no contexto do Município de Porto Alegre onde muito recentemente passou a ser disponibilizado, na rede pública de saúde, um novo método contraceptivo, o implante subcutâneo Implanon. Partindo de um caso específico de implementação de uma ação governamental na área de saúde reprodutiva, este estudo tem como objetivo compreender, a partir de uma perspectiva antropológica, os significados da prática contraceptiva de implantes subcutâneos para as jovens residentes na região geográfica da cidade, a Restinga e seu entorno, que foi alvo privilegiado desta intervenção pública. Como pano de fundo descreve-se e apresenta-se o processo de idealização, implementação e debate em torno desta política de saúde, assim como o conjunto de atores e agencia que participaram do mesmo. Com a finalidade de conhecer o universo cultural das mulheres que optaram pela tecnologia contraceptiva oferecida pela política municipal, analisam-se as práticas sexuais, reprodutivas e contraceptivas das mulheres entrevistadas, evidenciando algumas categorias e valores imputados a estas práticas e experiências. Discutem-se, a partir do contexto específico pesquisado, os significados e o universo de relações onde se dá a prática contraceptiva de implantes subcutâneos. Enfatiza-se, nesta parte final, como é que tal prática contraceptiva se conecta com as relações afetivo-sexuais, contraceptivas e reprodutivas. A partir desta contextualização foi possível perceber que os eventos envolvidos no processo de gestar e evitar gravidez pode significar e gerar diferentes consequências para os sujeitos neles envolvidos. Igualmente, a abordagem centrada nas especificidades do grupo social "alvo" da ação governamental, evidenciou as diferentes perspectivas e apropriações desta política municipal. / Situated within the field of studies on sexuality and reproductive and contraceptive practices, this study takes as its context the municipality of Porto Alegre, where a new contraceptive method - the subcutaneous implant, Implanon - was recently made available through the public health system. Departing from a specific case of the implementation of a governmental action in reproductive health, the objective of this study is to understand, from an anthropological perspective, what the contraceptive implants mean for young female residents of a particular area of the city - Restinga and its surroundings - that was a target of this public intervention. As background, the process of the health policy's formulation and implementation, and the subsequent debates regarding it, is described, and the collection of participating actors and agencies is presented. With the aim of becoming familiar with the cultural universe of the women who opted for the contraceptive technology proffered by the municipal policy, the sexual, reproductive, and contraceptive practices of interviewed women are analyzed; these data bring to light some of the categories and values ascribed to aforesaid practices and experiences. The meanings and the universe of relationships in which the contraceptive practice of the implants takes place is discussed with specific reference to the research context. The last section emphasizes how such contraceptive practices connect with affective-sexual, contraceptive and reproductive relationships. Through contextualization, it is possible to perceive that the process of both becoming pregnant and avoiding becoming pregnant can mean different things and generate diverse consequences for the subjects involved. Likewise, an approach focused on the specificities of the target population of this governmental action makes plain the different perspectives on and appropriations of municipal policy.

Este trabalho se inscreve no campo dos estudos sobre sexualidade e práticas reprodutivas e contraceptivas, no contexto do Município de Porto Alegre onde muito recentemente passou a ser disponibilizado, na rede pública de saúde, um novo método contraceptivo, o implante subcutâneo Implanon. Partindo de um caso específico de implementação de uma ação governamental na área de saúde reprodutiva, este estudo tem como objetivo compreender, a partir de uma perspectiva antropológica, os significados da prática contraceptiva de implantes subcutâneos para as jovens residentes na região geográfica da cidade, a Restinga e seu entorno, que foi alvo privilegiado desta intervenção pública. Como pano de fundo descreve-se e apresenta-se o processo de idealização, implementação e debate em torno desta política de saúde, assim como o conjunto de atores e agencia que participaram do mesmo. Com a finalidade de conhecer o universo cultural das mulheres que optaram pela tecnologia contraceptiva oferecida pela política municipal, analisam-se as práticas sexuais, reprodutivas e contraceptivas das mulheres entrevistadas, evidenciando algumas categorias e valores imputados a estas práticas e experiências. Discutem-se, a partir do contexto específico pesquisado, os significados e o universo de relações onde se dá a prática contraceptiva de implantes subcutâneos. Enfatiza-se, nesta parte final, como é que tal prática contraceptiva se conecta com as relações afetivo-sexuais, contraceptivas e reprodutivas. A partir desta contextualização foi possível perceber que os eventos envolvidos no processo de gestar e evitar gravidez pode significar e gerar diferentes consequências para os sujeitos neles envolvidos. Igualmente, a abordagem centrada nas especificidades do grupo social "alvo" da ação governamental, evidenciou as diferentes perspectivas e apropriações desta política municipal. / Situated within the field of studies on sexuality and reproductive and contraceptive practices, this study takes as its context the municipality of Porto Alegre, where a new contraceptive method - the subcutaneous implant, Implanon - was recently made available through the public health system. Departing from a specific case of the implementation of a governmental action in reproductive health, the objective of this study is to understand, from an anthropological perspective, what the contraceptive implants mean for young female residents of a particular area of the city - Restinga and its surroundings - that was a target of this public intervention. As background, the process of the health policy's formulation and implementation, and the subsequent debates regarding it, is described, and the collection of participating actors and agencies is presented. With the aim of becoming familiar with the cultural universe of the women who opted for the contraceptive technology proffered by the municipal policy, the sexual, reproductive, and contraceptive practices of interviewed women are analyzed; these data bring to light some of the categories and values ascribed to aforesaid practices and experiences. The meanings and the universe of relationships in which the contraceptive practice of the implants takes place is discussed with specific reference to the research context. The last section emphasizes how such contraceptive practices connect with affective-sexual, contraceptive and reproductive relationships. Through contextualization, it is possible to perceive that the process of both becoming pregnant and avoiding becoming pregnant can mean different things and generate diverse consequences for the subjects involved. Likewise, an approach focused on the specificities of the target population of this governmental action makes plain the different perspectives on and appropriations of municipal policy.

Este trabalho se inscreve no campo dos estudos sobre sexualidade e práticas reprodutivas e contraceptivas, no contexto do Município de Porto Alegre onde muito recentemente passou a ser disponibilizado, na rede pública de saúde, um novo método contraceptivo, o implante subcutâneo Implanon. Partindo de um caso específico de implementação de uma ação governamental na área de saúde reprodutiva, este estudo tem como objetivo compreender, a partir de uma perspectiva antropológica, os significados da prática contraceptiva de implantes subcutâneos para as jovens residentes na região geográfica da cidade, a Restinga e seu entorno, que foi alvo privilegiado desta intervenção pública. Como pano de fundo descreve-se e apresenta-se o processo de idealização, implementação e debate em torno desta política de saúde, assim como o conjunto de atores e agencia que participaram do mesmo. Com a finalidade de conhecer o universo cultural das mulheres que optaram pela tecnologia contraceptiva oferecida pela política municipal, analisam-se as práticas sexuais, reprodutivas e contraceptivas das mulheres entrevistadas, evidenciando algumas categorias e valores imputados a estas práticas e experiências. Discutem-se, a partir do contexto específico pesquisado, os significados e o universo de relações onde se dá a prática contraceptiva de implantes subcutâneos. Enfatiza-se, nesta parte final, como é que tal prática contraceptiva se conecta com as relações afetivo-sexuais, contraceptivas e reprodutivas. A partir desta contextualização foi possível perceber que os eventos envolvidos no processo de gestar e evitar gravidez pode significar e gerar diferentes consequências para os sujeitos neles envolvidos. Igualmente, a abordagem centrada nas especificidades do grupo social "alvo" da ação governamental, evidenciou as diferentes perspectivas e apropriações desta política municipal. / Situated within the field of studies on sexuality and reproductive and contraceptive practices, this study takes as its context the municipality of Porto Alegre, where a new contraceptive method - the subcutaneous implant, Implanon - was recently made available through the public health system. Departing from a specific case of the implementation of a governmental action in reproductive health, the objective of this study is to understand, from an anthropological perspective, what the contraceptive implants mean for young female residents of a particular area of the city - Restinga and its surroundings - that was a target of this public intervention. As background, the process of the health policy's formulation and implementation, and the subsequent debates regarding it, is described, and the collection of participating actors and agencies is presented. With the aim of becoming familiar with the cultural universe of the women who opted for the contraceptive technology proffered by the municipal policy, the sexual, reproductive, and contraceptive practices of interviewed women are analyzed; these data bring to light some of the categories and values ascribed to aforesaid practices and experiences. The meanings and the universe of relationships in which the contraceptive practice of the implants takes place is discussed with specific reference to the research context. The last section emphasizes how such contraceptive practices connect with affective-sexual, contraceptive and reproductive relationships. Through contextualization, it is possible to perceive that the process of both becoming pregnant and avoiding becoming pregnant can mean different things and generate diverse consequences for the subjects involved. Likewise, an approach focused on the specificities of the target population of this governmental action makes plain the different perspectives on and appropriations of municipal policy.

Indiana University-Purdue University Indianapolis (IUPUI) / The Catholic Church is widely known for its opposition to birth control. Yet statistics show that the vast majority of American Catholics use birth control. While multiple studies have been conducted on a larger quantitative scale about the use or attitudes of American Catholics toward birth control, there have not been qualitative studies to understand the experiences of Catholics who use contraception. This study is particularly timely given the recent Catholic opposition to the Affordable Care Act’s mandate of employee healthcare provided birth control as well as, the extraordinary synod of bishops to discuss pastoral challenges to family life in October 2015. Fourteen married Catholic women were interviewed about their religious identities and experiences using contraception. Analysis demonstrated how these women constructed a religious identity by maximizing certain aspects, such as prayer and service, while minimizing other aspects, such as individual autonomy and denominational distinctions, of their religious identity. However in order to cope with the tension between their salient religious identity and their contraceptive decision making women utilizing multiple mechanisms. Specifically, they made boundaries around which types of contraception were acceptable and limits to church or individual authority; they justified their decisions based on medical necessity or betrayal they felt from the church; they legitimated their decisions by discussing God’s control and their husband’s perceptions of NFP; and they normalized their decisions through their desire to care for their children and be sexually intimate with their husbands. This research illuminates unique challenges that religious women face in their sexual decision making and sexual health practices that can help sex educators and health care providers care for women. Additionally, the Catholic Church and American Catholics make up huge forces in education, health care, charity, politics, and employment. However, not all Catholics follow the rules of the church. Those members who remain an active part of the Catholic Church, such as the practicing Catholics in this study can influence the way the church changes. By better understanding the experience of these dissenters, social researchers may be able to better understand the future of the Catholic Church.