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This study explores the gender differences in how parents exhibit parenting dimensions (control, monitoring, support and warmth) towards sons and daughters and how those dimensions influence contraceptive use. The data analysis uses the Add Health data and the sample includes 918 adolescents within two-parent homes. This study adds to the existing literature in three ways. First, this study investigates four different parenting dimensions whereas previous research focuses on control and communication. Second, this study looks at how each dimension influences contraceptive use. Third, this study examines how parents exhibit parenting dimensions differently towards sons and daughters and whether each dimension influences contraceptive use differently for sons and daughters. The results reveal three significant findings. First, mothers’ and fathers’ parenting dimensions and the dimensions sons and daughters experience are similar. Second, warmth and support influence contraceptive use among sons and daughters. Third, boys are influenced by parenting dimensions more than girls.

Introduction: Over 420,000 women aged 13-44 in Tennessee depend on publicly funded contraceptive services, yet only 42.9% receive them. Lack of access to contraception leads to unintended pregnancies, which are associated with higher rates of maternal and neonatal morbidity and mortality. This study explores perceived barriers to contraception and patient awareness of preexisting resources to mitigate such barriers in a rural region. Methods: Women with a confirmed pregnancy establishing obstetric care at East Tennessee State University’s resident clinic were offered a 20-question survey assessing demographic variables and perspectives to contraceptive care. Results: 141 survey respondents met inclusion criteria. 95.7% denied using contraception prior to conception. Of these, 24.8% reported their pregnancy was unintended. Only 59.6% reported knowing where they could access free long-acting, reversible contraception (LARC) in the community. 50.4% agreed it would be helpful to have a free community clinic providing reproductive health care. Specifically, 73.7% of participants reported they would benefit from free LARCs; 61.0% expressed need for evening hours and 67.4% for weekend hours. Conclusions: One in four women experienced an unintended pregnancy. The known risks of unintended pregnancies to the mother and fetus will likely increase secondary to recent changes in abortion policies. Two in five women reported no awareness of resources for free LARCs in our community, suggesting that knowledge about and access to contraception is lacking at a time which women need autonomy over reproductive choices the most. Initiatives which aim to educate women regarding contraceptive care and to eliminate barriers which hinder access are warranted.

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Sex-differences in cardiometabolic physiology are evident; however, the inclusion of female participants in research studies for the purposes of exploration of sex-specific physiological responses is limited by the perceived complexity due to hormonal cycles. This dissertation examined the prevalence of sex-specific inclusion in human vascular exercise physiology research, investigate the influence of endogenous and exogenous sex hormones on cardiovascular, respiratory, and skeletal muscle metabolism, and consider sex- and gender-differences in peripheral vascular outcomes. The first study confirmed a sex-specific bias towards male inclusion in vascular exercise physiology research, with perceived hormonal complexity noted as one rationale for sex-specific exclusion. To address this perception, we reviewed the literature and identified a small effect of the menstrual cycle, and a more robust influence of oral contraceptive pills, on macrovascular endothelial function, with no influence on smooth muscle function or arterial stiffness. Our next set of studies objectively evaluated the influence of the natural menstrual and two generations of oral contraceptive pills on a comprehensive suite of cardiovascular, respiratory, and metabolic outcomes, and found largely no influence on these outcomes or the underlying vascular cellular regulation, apart from a small effect elevated endogenous and exogenous sex hormones on brachial artery endothelial function. Another area identified in our initial sex-inclusion review was the absence of gender-based research in vascular exercise physiology. Our final study found that biological sex aligned with gender identity, but not gender expression and influenced cardiovascular markers by including elevating systolic blood pressure, central arterial stiffness and endothelial function in males and men compared to females and women. Altogether, this dissertation provides substantial evidence for the lack of hormonal cycle influence of endogenous and exogenous sex hormones on three organ systems, which will open further incorporating females into research study design. / Dissertation / Doctor of Philosophy (PhD) / Females have been historically understudied in basic science and clinical research. This dissertation set out to explore sex-specific prevalence of research participants in human vascular exercise physiology studies and examined how sex hormones (through the menstrual cycle and oral contraceptive pill use) impact the cardiovascular, respiratory, and skeletal muscle metabolism systems. We found that there is an evident male-bias in vascular exercise physiology research, due in part to the perceived complexity of how sex hormones may impact the cardiovascular system. We also found that the menstrual cycle and oral contraceptive pill cycle have minimal influence on the biological systems examined. While there are evident sex-differences in cardiovascular outcomes, gender expression does not appear to have an impact in young adults. This research is foundational to further the inclusion of female participants in human physiology research and encourage future considerations of how sex/gender may influence physiological outcomes.

Introduction: Improving the quality of contraceptive care that youth receive improves the patient-provider relationship, satisfaction with care, and contraceptive method use and continuation. In recent years, high-quality contraceptive care for youth has shifted away from tiered effectiveness counseling and toward youth-friendly, person-centered contraceptive counseling (YFPCCC). Rooted in the reproductive justice movement, YFPCCC requires that counseling encourages youth to say what matters to them in their contraceptive method, respects youth’s preferences in their contraceptive method, provides youth with the information necessary to make the best choice for them, and is respectful of youth’s choices. YFPCCC is especially important for minor youth and youth of color who have historically received biased care and for youth in the United States South where restrictive policies may prevent youth from receiving care. This study examined youths’ perspectives of YFPCCC at safety-net clinics in two states in the U.S. South. Methods: Between 2018 and 2022, a survey measuring patient perspectives of their contraceptive counseling was collected from youth (ages 16 to 24) who received care at federally qualified health centers (FQHCs) and health departments (HDs) in Alabama (AL) and South Carolina (SC). A total of 1,052 youth were included in the study (AL n=513 and SC n=539). Four survey items measuring the four components of person-centered counseling and two survey items measuring youth-friendliness (knowledgeable and trustworthy providers) were dichotomized into Yes/No responses and combined to create two new variables measuring PCCC and providers’ youth-friendliness. PCCC and youth friendliness were compared across clinic type, state, age, race/ethnicity, and insurance coverage using logistic regression. P-values less than 0.05 were considered significant. Results: Overall, 56% of youth in the study reported that they received all four components of PCCC and 71% reported that their providers were youth-friendly. Minor youth (ages 16 and 17) were 34% less likely than older youth (ages 20-24) to report receipt of PCCC (aOR 0.66, 95% confidence interval (CI) [0.45, 0.98]). Minor youth were also 39% less likely than older youth to report that their provider was youth-friendly (aOR 0.61, 95% CI [0.40, 0.93]). Non-Hispanic Black youth were 45% less likely than non-Hispanic White youth to report PCCC (aOR 0.55 95% CI [0.40, 0.70]). Similarly, non-Hispanic Black youth were 44% less likely than non-Hispanic White youth to report that their provider was youth-friendly (aOR 0.56 CI [0.41, 0.77]). Discussion: Providing contraceptive care that is both person-centered and youth-friendly is essential in improving the quality of care that youth receive. In this study, minors and non-Hispanic Black youth were the least likely to report that their care was both person-centered and youth-friendly. This gap in the quality of care that non-Hispanic Black youth receive may contribute to lower satisfaction with care which may contribute to lower contraceptive use rates and higher unintended teen birth rates for this group. Clinics can improve their ability to provide YFPCCC by ensuring providers are trained in youth-friendly and person-centered contraceptive care.

<p>Sub-Saharan Africa (SSA) continues to be disproportionately burdened by the HIV/AIDS epidemic. In 2011, the region saw 1.8 million new infections, contributing to a prevalence of 4.9% among adults, or 23.5 million people living with HIV/AIDS. This thesis uses data collected by the Demographic and Health Surveys (DHS) to answer questions about risk factors and behaviours associated with HIV acquisition. I use logistic regression models to assess the impact of purported risk factors on sexual behaviours and HIV status. In Chapter One, I evaluate the association between respondents' condom use and their awareness of their own \local" epidemic. In Chapter Two, the association between hormonal contraceptives and risk of HIV infection is examined. The purpose of these analyses is to contribute to the body of literature that identifes factors that mitigate or contribute to risk for HIV infection, and help to inform public health policy.</p> / Master of Science (MSc)

À partir d’une enquête qualitative menée auprès de femmes ayant avorté dans les dixdernières années en France et au Québec, cette recherche met en évidence la normecontraceptive dans ces deux sociétés et révèle l’opposition forte faite par l’ensemble desfemmes – et même celles qui avortent plusieurs fois – entre les « bonnes » pratiques enmatière de contrôle des naissances – la contraception – et la « mauvaise » pratique –l’avortement. Bien qu’il soit une donnée structurelle des trajectoires reproductives desfemmes, une pratique aujourd’hui sans risque pour leur santé et un acte ordinaire lorsqu’on ledéfait de la charge morale qui lui est associé, l’IVG continue d’être l’objet d’un ensemble dereprésentations sociales stigmatisantes. Aussi, l’analyse des expériences des femmes rendcompte de l’ensemble des éléments qui teintent le vécu d’une ou de plusieurs interruptions degrossesse. Si la décision d’avorter est une évidence pour l’ensemble des femmes, lorsqu’ellessont impliquées dans des activités concurrentes (études, carrière ou élevage et allaitementd’un enfant en bas âge), elle peut devenir plus difficile lorsqu’elle correspond au refus de leurpartenaire d’investir un projet parental qu’elles portent seules. Enfin, la mise en perspectivedes modalités de la prise en charge énoncée par les femmes à Paris et à Montréal, révèle lesnombreux obstacles qui peuvent rendre cet épisode plus compliqué voire douloureux,témoignant des réticences dans ces deux sociétés à penser cette pratique comme un acteordinaire de planification des naissances relevant principalement du champ de la santé. / Based on a sociological survey about women who had an abortion during the last ten years inFrance and Quebec, this research reveals the weight of contraceptive norm in both societies,especially the strong opposition that all women make – even those who aborted several times– between “good” birth control practices (contraception) and “bad” ones (abortion). Abortionis a structural element of women’s reproductive trajectories, that is to say without today riskto their health; moreover, it is an ordinary act when the moral burden that is currentlyassociated with is defeated. Nevertheless, termination of pregnancy continues to be subject toa set of social representations which still stigmatize it. That’s why the analysis of women'sexperiences accounts for the set of elements that influence the experience of one or moreabortions. Even if the decision to abort is obvious to all women, especially as they areinvolved in competing activities (education, career or breeding and feeding of a child), it canbecome more difficult when it corresponds to the partner’s refusal to invest a parental projectwomen thus carry up alone. Finally, by putting into perspective the terms of the support thatwomen receive in Paris and Montreal, the thesis reveals the numerous obstacles that can makeabortion a more complicated or painful episode. These impediments show the reluctance ofboth societies to think this practice as an ordinary act of birth planning that falls mainly withinthe health field.

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This study investigated factors contributing to adolescent mothers' non-utilisation of contraceptives in the Piet Retief (Mkhondo) area. Contraceptives, emergency contraceptives and termination of pregnancy services are available free of charge. Nevertheless the number of adolescent mothers continues to increase in this area. Structured questionnaires were completed by 107 adolescent mothers. Most respondents (70,0%) received no sex education prior to their pregnancies, and were not knowledgeable about contraceptives. Subsequent to the birth of their babies, only 59,81% used contraceptives, risking further pregnancies. Adolescents, from the age of 12, should receive sex education. Availability of contraceptives during weekends could help adolescents to postpone their pregnancies. Health education should be given to the mothers in the Piet Retief (Mkhondo) area so that they can provide more effective sex education (including contraception) to their daughters. / Health Studies / M.A. (Health Studies)