A research report submitted to the School of Public Health, University of the Witwatersrand in partial fulfilment of the requirements for the degree of Master of Public Health. September 2014 / Introduction: SCT is an interpersonal theory that explains human behaviour as a three-way relationship between personal factors, environmental factors and their behavioural factors (Bandura, 1989). The theory identifies self-efficacy and outcome expectations as part of the five key determinants of behaviour. Condom use still remains one of the most popular forms of HIV prevention, however its effectiveness depends on whether it is used consistently or not. The overall aim of the study was to determine whether condom self-efficacy and outcome expectations are associated with consistent condom use among sexually active 18-34 year olds in Botswana in 2010. Materials and Methods: The study design was a quantitative secondary analysis of nationally-representative cross-sectional survey collected by the PSI Botswana’s Condom Social Marketing TRaC: Tracking Results Continuously, 2010 survey (herein, TRaC). The study population for TRaC was men and women aged 18-34 years old in Botswana who reported being sexually active in the past 12 months and were not practicing abstinence when recruited in 2010. The sample size was 1299 which was randomly selected from 96 enumeration areas (EAs). Results: Self-efficacy to use condoms was positively associated with consistent condom use, while overall condom self-efficacy and self-efficacy to negotiate condom use were not associated with consistent condom use. Social outcome expectations and pleasure outcome expectation were also associated with consistent condom use, although overall outcome expectations and those related to health were not associated with consistent condom use. Males significantly reported significantly lower expectations of pleasure than females. That said, female were significantly less likely to use condoms consistently and some aspects of their self-efficacy and outcome expectations were worse than males, which also was reflected in measures of socio-demographic disadvantage. Conclusions: Overall the study showed that a high percentage of 18-34 year olds in Botswana in 2010 used condoms consistently regardless of their socio-demographic profile or the sexual partner type. Also, encouragingly, a high percentage of 18-34 year olds in Botswana had either moderate or positive condom self-efficacy as well as positive output expectations of condom use. The two constructs of SCT were inconsistent in predicting consistent condom use, which suggests that measures for the constructs must be refined and supplemented with additional explanatory variables. Some constructs can assist health communication practitioners. For instance, the findings suggest that messages the support the notion that sex can be pleasurable with a condom should be targeted towards both sexes, rather than primarily focusing on the health benefits. The lack of self-efficacy to use condoms also needs to be addressed, as well as the need for more messages that portray social support for condom use. Beyond SCT, the findings indicate, there needs to be further research on the specific gender differences in condom use patterns and condom promotion campaigns should produce gender-sensitive messaging.

No description available.

by Cheung Kwok Keung Bobbie. / Thesis (M.Ph.)--Chinese University of Hong Kong, 1988. / Bibliography: leaves 128-147.

Thesis ( MPH ) -- University of Limpopo, 2011.

Thesis (M Med (Family Medicine)) -- University of Limpopo, 2011. / Aim and objectives Challenged by the high incidence of teenage pregnancy and sexually transmitted infections observed among high school students who were attending antenatal care at the clinics in Tswaing Sub-district. The researcher conducted this study to determine the knowledge, attitudes and practices of contraception among high school learners and establish whether the demographic characteristics of the students influenced their knowledge, attitudes and practices towards contraception. Design This study was a cross-sectional descriptive quantitative study. It was conducted among 231 learners who were aged 16 years and above, male and female, between grades 10 and 12. Systematic sampling was employed to select 33 students from 7 high schools selected by random probability sampling technique in Tswaing Sub-district who completed confidential, anonymous self-administrated questionnaires. The questionnaires were in English, Afrikaans and Setswana, so as to ensure clarity and accurate understanding of the content and hence the questionnaire was self-administered in the language of preference for each learner. Data were entered and analyzed using SPSS for windows version 17. A chi-square test was performed to determine the association between predictor's variables and knowledge. A p-value ofless than 0.05 at 95% CI was taken for statistical significance. Results More males 70 % and 60 % of the females indicated that they had a boyfriend or girlfriend. More males (50.3%) than females (49.7%) indicated that they had engaged in sexual intercourse. The average age of first sexual intercourse was 14.9 years for the males and 15.4 years for the females. The modal age for first intercourse for male was below 13 years and 15.4 years for the females. The most common contraceptive used among the males was a condom (89.8%) and among females, it was the combined injectable contraceptives (49.4%). Males (63.6%) and females (68.8%) thought it easy to access contraception. There was a high rate of unprotected sexual activity among the learners, with 34.1 % of the males and 42.1 % of the females' indicated that they had had sex without contraception. Most of the learners obtained contraceptive information from their parents 98 [33%] male, 70 [53.8%] female). The preferred source of information for the male learners was a doctor 59 [59%], and the preferred source of con1raceptive information for the female learners was their parents 57 [43%]. 54 (57.4%) of the males and 75.4% of the 84 female learners indicated that their parents had discussed contraception with them. 64.2% of the males and 68.5% of the females claimed that they were satisfied with the information they received about contraception from their parents. All the learners had the knowledge that condoms can prevent sexually 1ransmitted infections and that a condom cannot be used more than once, with a p< 0.05 and their response according to gender and age, all schools had more than 60% participants. Forty-three percent of the learners in all schools who lived with both parents had the knowledge that condoms can prevent sexually transmitted infections and condom cannot be used more than once, p< 0.05. Among the female learners, only 79 [60.8%] knew that conception could take place if they missed taking their con1raceptive pill once. 51 [39.2%] said that conception could not take place if they had missed taking the pill once. More than 90% learners wanted information on contraception from their primary health care providers. Conclusion This study showed that senior learners had a good knowledge about basic contraception. The high level of sexual activity, early sexual initiation and low contraceptive use put these adolescents at risk of pregnancy and sexually transmitted infections. They indicated that they needed more information on sexuality and contraception from their primary health care providers especially from their doctors. Adolescents should be encouraged to ask about contraception and sexual health at the clinics, and all health workers; nurses and doctors, who consult must see every encounter as an opportunity for health education and counseling in reproductive health

The effect of a number of possible risk factors for stroke were examined in a nested case-control study of participants in the prospective Royal College of General Practitioners' Oral Contraception Study. The case were 253 women who had a first ever stroke or episode of amaurosis fugax between 1968 and 1990. Three age-matched controls were selected for each case. Current users of the pill had an increased risk of total and fatal stroke. Former users had a small elevated risk of total stroke and a stronger risk of fatal stroke. The effects in former users appeared to be restricted to women who smoked. The elevated risk of total stroke among former users appeared to diminish with time although a persisting risk of fatal or haemorrhagic stroke could not be excluded. Smoking increased the case fatality rates of pill users who had a stroke. The effects of the pill in women with other factors for stroke were explored, but were inconclusive. The newer oral contraceptives were associated with a lower risk of stroke than older preparations, a benefit which has occurred because of changes in pill formulation rather than more selective prescribing by doctors. Smoking enhanced the risk of cerebrovascular disease in hypertensive, and possibly diabetic, women. The largest population attributable proportions were associated with smoking (36%), ever use of oral contraceptives (23%), manual social class (21%) and hypertension (19%). The successful elimination of cigarette smoking must remain a public health priority.

Thesis (Ph. D.)--University of Virginia, 2000. / Spine title: Anti-sperm Ab/Ag for contraception. Includes bibliographical references (leaves 182-229). Also available online through Digital Dissertations.

The study aimed at examining the relationship between contraceptive use and fertility in Western region, Uganda, using a sample of 1993 women from the Uganda Demographic Health Survey of 2000-2001. Uganda Demographic Health Survey (UDHS) 2000-2001 is the third survey conducted by the Ugandan Ministry of Health. Chi-square, Logistic regression and multiple regression were used to test and determine factors contributing to the high fertility levels and low contraceptive usage in the region. Results show that the region has a total fertility rate of 6.4, and childbearing is not evenly distributed among age groups. Fertility peaks at ages 20-29, and reduces sharply with women in their late reproduction span. Contraception and fertility are inversely correlated. Though knowledge on contraception is universal, contraceptive prevalence remains low (95% and 16% respectively) among women of reproductive age. Family planning approval is inversely related with contraceptive use. Findings reveal that contraceptive prevalence plays minor role in explaining fertility levels as compared to some socioeconomic factors. Education is significantly and inversely related with fertility, but positively correlated with contraceptive use. The government should revisit the population policy to actively promote family planning activities by promoting and facilitating debates about family size, and the means to achieve. Women education needs to be emphasized in order to promote innovative reproductive behavior. More research to explore whether women are using contraception for spacing rather than limiting is required.

Introduction This was a secondary data analysis of a prospective cohort of women enrolled in a phase III microbicide trial between October 2005 and August 2008. The study aimed to assess the pregnancy incidence rates and factors associated with pregnancy in women using barrier method and hormonal contraception, enrolled in the trial. Methods A total of 2508 participants were enrolled in the trial and followed up for up to 12 months. Of these 2437 were included in the pregnancy incidence analysis and 2171 participants were included in the multivariate analysis. Data on the main exposure, contraception, were collected by structured interview. The main outcome of interest was pregnancy, which was measured by detection of human chorionic gonadotrophin in urine using Quick Vue® test and confirmed by laboratory based testing. The incidence rate of pregnancy was calculated as number of pregnancies per 100 women years of follow up. Kaplan Meier Survival analysis was used to determine average time to first pregnancy. Univariate and multivariate analyses were conducted using Cox regression models to asses the factors associated with incident pregnancies. Data was analysed using Stata® version 10. Results A total of 2248 women years of follow up were recorded. A total of 238 pregnancies occurred resulting in pregnancy incidence of 11 per 100 women-years of follow up (95% CI: 9.32 to 12.02). The incidence of pregnancy increased with time in the study; 98 per 100 women years of follow up (95% CI: 85.09 to 112.35) in the last 3 months compared to 2 per 100 women-years of follow up (95% CI: 0.94 to 2.92) in the first 3 months of follow up. Older age and hormonal contraception use were significantly associated with a decreased risk of pregnancy. Women 35 years and older were 49% less likely to fall pregnant compared to those who were younger than 25 years, adjusted hazard ratio (AHR) 0.51(95% CI: 0.30 to 0.88, p=0.016). Women who used hormonal contraception had a reduced risk of falling pregnant AHR 0.66(95% CI: 0.46 to 0.94, p=0.02). There was no difference between the two types of hormonal contraception (injectable vs oral) with respect to pregnancy risk. Conclusion: The incidence of pregnancy increased with time in the study. Women who used hormonal contraception and who were older were less at risk of pregnancy. There was no significant difference in pregnancy risk by type of hormonal contraception (i.e. oral contraception vs injectable contraception) used.

Contraceptive non-use by women has been linked to negative reproductive health outcomes such as obstetric complications, abortions, and maternal morbidity and mortality. These poor outcomes mostly arise from unintended pregnancies. With focus on married women non-users, this study examined the factors influencing non-use of contraception in Nigeria. The research identified a number of important characteristics which could predispose married women in Nigeria to non-use of contraceptive. Data from the 2008 Nigeria Demographic and Health Survey (NDHS) was utilized. The target population comprised all females aged 15-49 years who were interviewed and responded to questions on contraceptive use. The sample size was 23,954 which were made up of all married women in the country except for infecund, pregnant and sterilized women. The outcome variable was measured using current contraceptive use which was dichotomized: not using contraceptive coded as (1) and using contraceptive coded as (0). Logistic regression was used for the analysis. 20,983 married women (88% of the study population) reported that they are contraceptive non-users. Of these, the following characteristics of married women had higher odds of contraceptive non-use. Women who want more children within 2years, unsure of timing and undecided had higher odds (2.17) of contraceptive non-use, women who are 35 years and above (1.80), women who are from North West, North East and North Central (5.35, 2.95, 1.64, respectively), women who are Muslims (1.43) had higher odds of contraceptive non-use in Nigeria. The association remained statistically significant for women’s wealth index, number of living children, occupation, and place of residence, partner’s education and educational level of women. And all these were also observed to have effect on the non-use of contraceptive. Non-use of contraceptive among married women in Nigeria differs between women possibly because of region, religion, fertility intention, and age difference. These findings indicate areas that reproductive health policies and programmes should focus on in order to increase contraceptive uptake among married women in Nigeria. .