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This study investigated factors that have an influence on sexual activity and subsequent contraceptive use among school-going adolescent girls in Lesotho, focusing on the districts of Berea, Maseru and Mohale’s Hoek. The factors under investigation from a reproductive health survey included demographic variables (age, district, rural urban residence, class and religion), behavioural variables (drinking alcohol, boyfriend status), and attitude and knowledge variables (including attitude toward sex before marriage, contraceptive use before marriage, and communication with a boyfriend about sex). The methodology comprised a secondary analysis of the 1999 Adolescent Reproductive Health Survey of Lesotho. Bivariate analysis and binary logistic regression were used to establish if significant relationships existed between sexual activity and contraceptive use and the independent factors. A limitation of the study is that the survey instrument contained a limited set of indicators. Thus a number of theories of sexual decisionmaking were excluded from the conceptual framework. Prevalence of sexual activity was lower than expected. This research confirmed that the likelihood of adolescents being sexually active increases with age. A somewhat surprising result was that Catholic adolescents were more likely to become sexually active than adolescents of other religions. Adolescents who live in rural areas, as well as those with a boyfriend were also found to be more likely to become sexually active. Contraceptive use was higher for this Lesotho sample than has been reported for research from other African countries. Nevertheless, the proportion of adolescents not using contraceptives is argued to be a matter of concern. Adolescents in the lowest school class were least likely to use contraceptives, which suggests a lack of control over decisionmaking in this group. Contraceptive use was found to be lower among adolescents who were coerced into their first sexual experience. Adolescents from Mohale’s Hoek, designated the least developed area for this research, were the least likely to use contraceptives. Those adolescents who reported having a boyfriend were more likely to use contraceptives, suggesting a regular partner allows the adolescent some control over decision-making. A positive view of use of contraceptives before marriage was associated with higher likelihood of use. Somewhat surprisingly, use of alcohol was associated with higher likelihood of contraceptive use. The findings suggest adolescent girls can be grouped into different risk categories. Some practice abstinence and some who are sexually active appear to have control over sexual decision-making, specifically in being able to negotiate use of contraceptives. However, there is a group which is sexually active but does not use contraception. This group has a higher rate of coercion as the reasons for sexual activity. The analysis suggests a multi-dimensional set of factors explain sexual activity and associated contraceptive use (or non-use) and that beliefs and attitudes do not always predict an expected behaviour. Interventions should target the most at-risk group and must take into account that belief and attitude does not necessarily predict behaviour.A / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2009.

This MA Thesis explores the effect of the armed conflict on modern contraceptive utilisation in Colombia, using a departmental random-effects logistic regression model on novel cross-sectional data from the Uppsala Peace and Conflict Database Georeferenced Event Data and the Colombian Demographic and Health Surveys from 2000, 2005 and 2010. Reproductive health and rights has enormous consequences for women’s lives, but their relationship to conflict in Colombia has barely been analysed. Exploring how armed conflict as context shape individual life choices such as family planning, the results showed that women in departments where conflict had occurred recently had significantly higher odds of using modern contraception on average than women in non-conflict. Women are likely more careful to avoid unwanted pregnancy because of increased impoverishment, insecurity, and emotional and physical stress of armed conflict. Conflict may also have reduced or more firmly decided their demand for children. Adding an interaction term between conflict and type of place of residence revealed that rural women in conflict departments were driving this finding, possibly due to the lack of access to abortion and post-abortion care in rural areas in Colombia.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal.

The study investigates physical, mental and sexual changes in women at the beginning of use or after discontinuation of a combined hormonal contraception. Thirty women were interviewed at least 3 months and at most 2 years after the start of use or discontinuation of combined hormonal contraception. Semi-structured interviews were supplemented by 16- symptom rating scale on which women assessed the results of an imaginary study of side effects of hormonal contraception. Both methods identically demonstrated pronounced effect of combined hormonal contraception on decline in sexual desire and painful menstruation. No clear difference was found in psychical symptoms, although qualitative analysis indicated possible changes. Further research is needed to test subsequent hypothesis.

Reproductive science plays an important role in conservation biology. Quantitative studies of basic reproductive biology in wildlife are critical for the development of successful assisted reproductive technologies. Investigation of the volume regulatory mechanism of spermatozoa could produce options to improve the cryopreservation of spermatozoa and provide a non-hormonal contraceptive option for men, both of which could have significant impacts on global biodiversity preservation. Volume regulation of somatic cells involves the movement of osmolytes through various channels, including potassium channels. The potassium channels involved in volume regulation of human, monkey, and murine spermatozoa were investigated. Flow cytometry was used to gauge the sensitivity of the volume regulatory process of spermatozoa to various potassium channel inhibitors and a simultaneous hypotonic challenge. Channels potentially involved in regulatory volume decrease of spermatozoa varied with species but included voltage-gated (Kv) channels 1.4, 1.5, 1.7, 4.1, 4.2 and 4.3 as well as TWIK1, TWIK2, TASK1, TASK2, TASK3, TREK2 , and minK. The presence of some of these channels was confirmed by western blotting and immunocytochemistry. Changes in the motility patterns of human and monkey spermatozoa in the presence of potassium channel inhibitors during hypotonic stress were also observed, suggesting a relationship between volume regulation and motility. To evaluate potential organic osmolytes involved in, and compare effects of CPAs on, volume regulation, the isotonicity of murine epididymal spermatozoa was measured using a null point method. Spermatozoa were then exposed to high concentrations of various osmolytes and cryoprotective agents in isotonic medium to evaluate which compounds were able to penetrate the sperm plasma membrane. The osmotic responses of spermatozoa from strains of mice known to have spermatozoa of high (B6D2F1) and low (C57BL6) post-thaw fertility were compared during various osmotic challenges in various media. These experiments indicated that spermatozoa from B6D2F1 mice may have better volume regulation capabilities than spermatozoa from C57BL6 mice, suggesting that better post-thaw fertility of murine spermatozoa could be influenced by the volume regulatory process. The knowledge gained from these experiments could contribute to improved sperm handling and preservation techniques and be used to develop non-hormonal male contraceptives based on inhibiting volume regulation.

MSc (Med), Epidemiology and Biostatistics, University of the Witwatersrand / Introduction This secondary data analysis of a prospective cohort study set out to describe the association between the use of hormonal contraception and sexually transmitted infection (STI) acquisition in a cohort of 752 HIV negative women who were followed up for a year. Methods Outcome variables were measured by standard laboratory tests (PCR for Chlamydia trachomatis (CT) and Neiserria gonorrhoea (NG), culture for Trichomonas vaginalis (TV) and gram stain with Nugent score for Bacterial Vaginosis (BV). Exposure variable information was collected by structured interview. Basic descriptive statistics were applied to describe the characteristics of the cohort, including a comparison of women who used contraception and those who did not. A time series analysis including incidence rates for the outcomes (CT, NG, TV and BV), Kaplan Meier curves for time to event measurement and Cox regression models (univariate and multivariate), for the estimation of risk were applied. Results The analysis found no significant difference between women who use hormonal contraception and those who did not with respect to baseline demographic characteristics. Incidence rates per 100 women years to follow up with 95% confidence intervals were: CT 13 (7 to 17), NG 2 (1 to 4), TV 6 (4 to10), BV 72 (63 to 83). Kaplan Meier curves showed no significant difference in time to event between women who used contraception and those who did not. Adjusted hazard ratios for women who used contraception was 1.12 (0.69 to1.82) for CT, 0.47 (0.17 to 1.30) for NG, 1.06 (0.48 to 2.34) for TV and 0.27 (0.05 to 1.52) for BV. Conclusion This analysis did not reveal any significant associations between the use of hormonal contraception and the acquisition of STIs, however the trends in risks follow those reported in the literature.

Thesis advisor: Joellen W. Hawkins / African American women represent a unique group of women in the United States and have a long history of lack of reproductive freedom. Slavery and forced procreation, sterilization abuses, the Eugenics movement, and federally mandated contraception have all impacted on African American women’s independence in contraceptive decision-making. Given this population’s history, it is important for healthcare providers to understand African American women’s contraceptive decision-making, as women often seek their guidance. The purpose of this dissertation research was to discover the intergenerational influences on African American women’s contraceptive decision-making. The specific aims of this study were to: 1) develop an understanding of African American women’s contraceptive decision-making process; 2) identify the factors that influence their decision-making; and 3) develop knowledge that can be used to influence nursing practice. Included in this exploration were questions on the role of mothers and grandmothers in adolescents’ decision-making, familial beliefs about contraceptive choices and whether societal and social factors continue to influence contraceptive decisionmaking in the 21st Century. For this work, I used a qualitative descriptive approach to develop an understanding of the phenomenon from the participants’ worldview. I recruited a purposive sample of 7 triads from a metropolitan community in the northeast United States. I conducted an individual interview, using a semi-structured guide, with each participant. Six themes emerged from the data: 1) southern influences; 2) a worldview of relationships; 3) communication: key to preparedness; 4) seeking information from Mom; 5) "I got caught up in the game"; and 6) contraceptive use and beliefs. African American women's contraceptive decision making is influenced by a variety of factors including familial beliefs, attitudes, culture, and ethnicity. These patterns are transferred to each succeeding generation. Nurses have a significant role to play in providing appropriate contraceptive information and education in a culturally competent context that will meet the needs of these women and their families. / Thesis (PhD) — Boston College, 2008. / Submitted to: Boston College. Connell School of Nursing. / Discipline: Nursing.