Abstract Study Objective Long-acting reversible contraceptive (LARC) methods can prevent teen pregnancy yet remain underutilized by adolescents in the United States. Pediatric providers are well ...positioned to discuss LARCs with adolescents, but little is known about how counseling should occur in pediatric primary care settings. We explored adolescent womens' attitudes and experiences with LARCs to inform the development of adolescent-centered LARC counseling strategies. Design Qualitative analysis of one-on-one interviews. Setting Participants were recruited from 2 urban school-based, primary care centers. Participants Thirty adolescent women aged 14-18 years, diverse in race/ethnicity, and sexual experience. Interventions Interviews were audio-recorded, transcribed, and coded using inductive and deductive coding. Main Outcome Measure Major themes were identified to integrate LARC-specific adolescent preferences into existing counseling approaches. Results Participants (mean age, 16.2 years; range, 14-18 years) represented a diverse range of racial and/or ethnic identities. Half (15/30) were sexually active and 17% (5/30) reported current or past LARC use. Five themes emerged regarding key factors that influence LARC choice, including: (1) strong preferences about device-specific characteristics; (2) previous exposure to information about LARCs from peers, family members, or health counseling sessions; (3) knowledge gaps about LARC methods that affect informed decision-making; (4) personal circumstances or experiences that motivate a desire for effective and/or long-acting contraception; and (5) environmental constraints and supports that might influence adolescent access to LARCs. Conclusion We identified 5 factors that influence LARC choice among adolescent women and propose a framework for incorporating these factors into contraceptive counseling services in pediatric primary care settings.
More than one-third of women in the U.S. have engaged in heterosexual anal intercourse (HAI), but little is known regarding women’s perceptions of HAI and motivations for engaging in this sexual ...behavior.
This study aimed to explore U.S. women’s motivations for engaging in HAI and to investigate how they navigate HAI in the context of sexual relationships.
Semi-structured interviews were conducted with 20 women, ages 18–50 years old, who had engaged in anal intercourse with a male partner within the past 3 months. The interview guide was developed utilizing a conceptual framework based on the Theory of Planned Behavior.
Thematic content analysis was performed, and salient themes were identified.
Salient themes were identified in all key components of the construct, including attitudes toward the behavior, subjective norms, and perceived behavioral control. Women’s intent to engage in HAI was influenced by their attitudes toward HAI and level of control and trust with their partners. Primary motivators were partner and personal pleasure and sexual curiosity and experimentation.
The Theory of Planned Behavior construct was well suited to explore factors influencing women’s intent to engage in HAI. Most women perceive negative societal norms toward HAI. Although this does not appear to affect intention to engage in HAI, it does affect disclosure of this sexual activity with friends and healthcare providers. It is important for healthcare providers to provide open, non-judgmental counseling regarding HAI to decrease stigma, enhance communication, and improve sexual health.
Benson LS, Gilmore KC, Micks EA, et al. Perceptions of Anal Intercourse Among Heterosexual Women: A Pilot Qualitative Study. Sex Med 2019;7:198–206.
The eight recommendations are: (1) improving expertise and facilities in primary care to strengthen detection of early disease and its treatment, and screening of high-risk patients in the community; ...(2) establishment of acute liver services in district general hospitals linked with 30 regional specialist centres for complex investigations and treatment, and increased provision of medical and nursing training in hepatology; (3) a national review of liver transplantation to ensure better access for patients to increase capacity; (4) specialist paediatric services and continuity of care in transition arrangements for children with liver disease reaching adult life; (5) measures to reduce overall alcohol consumption in the country; (6) promotion of healthy lifestyles to reduce obesity and the burden of non-alcoholic fatty liver disease; (7) elimination of viral hepatitis as a major public health threat by 2030 and a major reduction in the burden of disease for hepatitis B; and (8) increasing awareness of liver disease in the general population and within the National Health Service (NHS), including the work of liver patient support groups. The recently published, comprehensive Global Burden of Disease Study 2015 also includes important data on disease burden for alcohol, obesity, and viral hepatitis in relation to other major non-communicable diseases related to lifestyle issues, including smoking. For many of the recommendations the metrics show little progress in terms of reduced disease burden, although together with the efforts of other bodies and agencies, there has been some movement in that direction.
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