Contraceptive Failure Rates in the Developing World

More and via (PDF):    http://goo.gl/KoClzO

Privacy and Confidentiality Practices in Adolescent Family Planning Care at Federally Qualified Health Centers

CONTEXT:

The confidentiality of family planning services remains a high priority to adolescents, but barriers to implementing confidentiality and privacy practices exist in settings designed for teenagers who are medically underserved, including federally qualified health centers (FQHCs).

METHODS:

A sample of 423 FQHCs surveyed in 2011 provided information on their use of five selected privacy and confidentiality practices, which were examined separately and combined into an index. Regression modeling was used to assess whether various state policies and organizational characteristics were associated with FQHCs' scores on the index. In-depth case studies of six FQHCs were conducted to provide additional contextual information.

RESULTS:

Among FQHCs reporting on confidentiality, most reported providing written or verbal information regarding adolescents' rights to confidential care (81%) and limiting access to family planning and medical records to protect adolescents' confidentiality (84%). Far fewer reported maintaining separate medical records for family planning (10%), using a security block on electronic medical records to prevent disclosures (43%) or using separate contact information for communications regarding family planning services (50%). Index scores were higher among FQHCs that received Title X funding than among those that did not (coefficient, 0.70) and among FQHCs with the largest patient volumes than among those with the smallest caseloads (0.43). Case studies highlighted how a lack of guidelines and providers' confusion over relevant laws present a challenge in offering confidential care to adolescents.

CONCLUSIONS:

The organizational practices used to ensure adolescent family planning confidentiality in FQHCs are varied across organizations.

Purchase full article at:   http://goo.gl/yZ6FUV

By:  Beeson T1, Mead KH2, Wood S2, Goldberg DG2, Shin P2, Rosenbaum S2.

• 1Department of Health, Educational Administration and Movement Studies, Central Washington University, Ellensburg, WA. tbeeson@cwu.edu.
• 2Department of Health Policy and Management, Milken Institute School of Public Health, George Washington University, Washington, DC. 
• Perspect Sex Reprod Health. 2016 Feb 17. doi: 10.1363/48e7216.

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Impact of Parental Notification on Illinois Minors Seeking Abortion

PURPOSE:

To describe the impact of the Illinois Parental Notification of Abortion Act on minors presenting for first-trimester abortion at an urban clinic in Chicago, Illinois.

METHODS:

Descriptive, retrospective review looked at minors obtaining a first-trimester abortion at John H. Stroger Jr. Hospital Reproductive Health Services during the 12 months prior (August 15, 2012-August 14, 2013) and after (August 15, 2013-August 14, 2014) the Illinois Parental Notification Act was in effect. Young women, ages 18-21 years, unaffected by the law, served as the control group.

RESULTS:

Before the law, 320 minors of a total of 5,505 patients (5.8%) obtained a first-trimester abortion and after the law went into effect, 311 minors of a total of 6,311 patients (4.9%) obtained an abortion. This constituted a 2.8% decrease in procedures among minors before and after the law went into effect (p = .003). However, this decrease was not significant when compared to an 8.8% growth in procedures among the control group, ages 18-21 years (p = .079). Among minors, there was no difference in race/ethnicity, age, and mean gestational age at the time of abortion before and after the law (p = .189, p = .116, and p = .961). There was a trend toward a larger decline in the youngest minors, aged 12-15 years and in those with at least one prior abortion.

CONCLUSIONS:

The impact of a parental notification law on minors at an urban, public clinic is unclear. The 3% decrease warrants further study of both teen pregnancy rates and legislative barriers to minors' abortion access.

Purchase full article at:   http://goo.gl/qbVRIS

By:  Ramesh S1, Zimmerman L2, Patel A3.

1Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois. Electronic address: Shanthi_Ramesh@med.unc.edu.
2Department of Obstetrics and Gynecology, John H. Stroger, Jr. Hospital of Cook County, Chicago, Illinois.
3Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Obstetrics and Gynecology, John H. Stroger, Jr. Hospital of Cook County, Chicago, Illinois.

J Adolesc Health. 2016 Mar;58(3):290-4. doi: 10.1016/j.jadohealth.2015.11.004. Epub 2016 Jan 13.

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Comprehensive Assessment of Health Needs of Young Minority Males Attending a Family Planning Clinic

The objective of this study was to assess the overall health, including sexual and reproductive health (SRH) knowledge and needs, sexual behaviors, and testicular health practices among young minority males. 

Anonymous questionnaires were administered to 18- to 25-year-old males receiving services at health clinics in a large southwestern U.S. city. The survey was completed by 258 males with a mean age of 20.8 years. Most young males (67.1%) identified as African American, and 32.9% as Hispanic. 

Results suggest study participants lack SRH knowledge related to pregnancy and condom effectiveness, and engage in risky sexual behavior including not using birth control at their last sexual encounter. 

Although 21.6% of participants had a sexually transmitted infection (STI) in the past year, approximately 80% perceived their STI/HIV risk as very low or low. Respondents had low engagement and lack of knowledge of testicular health practices. The majority of respondents (71.1%) reported having been in a physical fight one or more times and 18.1% reported being victims of intimate partner violence. 

These data support a need for comprehensive health services for minority young males.

Purchase full article at:   http://goo.gl/UKHrSF

By:  Pastuszak AW1, Wenker EP2, Smith PB2, Abacan A2, Lamb DJ2, Lipshultz LI2, Buzi R2.

• 1Baylor College of Medicine, Houston, TX, USA pastusza@bcm.edu.
• 2Baylor College of Medicine, Houston, TX, USA. 
• Am J Mens Health. 2016 Feb 4. pii: 1557988316629627.

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

United States Family Planning Providers’ Knowledge of & Attitudes Towards Pre-Exposure Prophylaxis for HIV Prevention

Objectives

The Centers for Disease Control and Prevention defines HIV prevention as a core family planning service. The HIV community identified family planning visits as key encounters for women to access pre-exposure prophylaxis (PrEP) for HIV prevention. No studies explore United States family planning providers’ knowledge of and attitudes towards PrEP. We conducted a national survey of clinicians to understand barriers and facilitators to PrEP implementation in family planning.

Study Design

Family planning providers recruited via website postings, national meetings, and email completed an anonymous survey in 2015. Descriptive statistics were performed.

Results

Among 604 respondents, 495 were eligible for analysis and 342 were potential PrEP prescribers (physicians, nurse practitioners, midwives, or physicians assistants). Among potential prescribers, 38% correctly defined PrEP (95% CI 32.5 – 42.8), 37% correctly stated the efficacy of PrEP (95% CI 32.0 – 42.4), and 36% chose the correct HIV test after a recent exposure (95% CI 30.6 – 40.8). Characteristics of those who answered knowledge questions correctly included age less than 35, practicing in the Northeast or West, routinely offering HIV testing, providing rectal sexually transmitted infection screening, or having seen any PrEP guidelines. Even among providers in the Northeast and West, the proportion of respondents answering questions correctly was less than 50%. Thirty-six percent of respondents had seen any PrEP guidelines. Providers identified lack of training as the main barrier to PrEP implementation; 87% wanted PrEP education.

Conclusions

To offer comprehensive HIV prevention services, family planning providers urgently need training on PrEP and HIV testing.

Implications

U.S. family planning providers have limited knowledge about HIV pre-exposure prophylaxis (PrEP) and HIV testing, and report lack of provider training as the main barrier to PrEP provision. Provider education is needed to ensure family planning clients access comprehensive HIV prevention methods.

Purchase full article at:   http://goo.gl/NtQ8CW

By:  Dominika Seidman, Kimberly Carlson, Shannon Weber, Jacki Witt, Patricia J. Kelly

University of California, San Francisco,1001 Potrero Ave Ward 6D,San Francisco,CA, 94110, United States

Dominika.seidman@ucsf.edu

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Prevalence & Correlates of Intimate Partner Violence among Family Planning Clients in Conakry, Guinea

BACKGROUND:

Intimate partner violence (IPV) is a global public health problem that affects women's physical, mental, sexual and reproductive health. Very little data on IPV experience and FP use is available in resource-poor settings, such as in West Africa. The aim of this study was to describe the prevalence, patterns and correlates of IPV among clients of an adult Family Planning clinic in Conakry, Guinea.

METHODS:

The study data was collected for four months (March to June 2014) from women's family planning charts and from an IPV screening form at the Adult Family Planning and Reproductive Health Clinic of "Association Guinéenne pour le Bien-Etre Familial", a non-profit organization in Conakry, Guinea. 232 women out of 245 women who attended the clinic for services during the study period were screened for IPV and were included in this study.

RESULTS:

Of the 232 women screened, 213 (92 %) experienced IPV in one form or another at some point in their lifetime. 169 women reported psychological violence (79.3 %), 145 reported sexual violence (68.1 %) and 103 reported physical violence (48.4 %). Nearly a quarter of women reported joint occurrence of the three forms of violence(24 %).Half of the IPV positive women were current users of family planning (51.2 %) and of these, 77.9 % preferred injectable contraceptives. The odds of experiencing IPV was higher in women with secondary or vocational level of education than those with higher level of education (AOR: 8.4; 95 % CI 1.2-58.5). Women residing in other communes of Conakry (AOR: 5.6; 95 % CI 1.4-22.9) and those preferring injectable FP methods (AOR: 4.5; 95 % CI 1.2-16.8) were more likely to experience lifetime IPV.

CONCLUSIONS:

IPV is prevalent among family planning clients in Conakry, Guinea where nine out of ten women screened in the AGBEF adult clinic reported having experienced one or another type of IPV. A holistic approach that includes promotion of women's rights and gender equality, existence of laws and policies is needed to prevent and respond to IPV, effective implementation of policies and laws, and access to quality IPV services in Guinea and countries with higher rates of IPV.

Below:  Venn diagram illustrating overlaps between lifetime experiences of psychological, physical and sexual violence reported by FP clients in Conakry, Guinea, March to June 2014

Full article at:   http://goo.gl/Mq1M02

By:  Alexandre Delamou, Ghazaleh Samandari, Bienvenu Salim Camara, Pernamou Traore, Fatoumata Guilinty Diallo, Sita Millimono, Defa Wane, Maimouna Toliver, Kira Laffe, and Fabio Verani

Centre National de formation et de recherche en santé rurale de Maferinyah, Forécariah, Guinea

Department of Public Health, Faculty of Medicine, University of Conakry, Conakry, Guinea

EngenderHealth, New York, USA

Association Guinéenne pour le Bien-Etre Familial, Conakry, Guinea

Ministry of Health, Conakry, Guinea

EngenderHealth, Conakry, Guinea

Alexandre Delamou, Email: moc.liamg@uomaleda.

BMC Res Notes. 2015; 8: 814.

Published online 2015 Dec 23. doi:  10.1186/s13104-015-1811-7

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Predictors of Consistent Condom Use among Portuguese Women Attending Family Planning Clinics

Women account for 30% of all AIDS cases reported to the Health Ministry in Portugal and most infections are acquired through unprotected heterosexual sex with infected partners. This study analyzed socio-demographic and psychosocial predictors of consistent condom use and the role of education as a moderator variable among Portuguese women attending family planning clinics. 

A cross-sectional study using interviewer-administered fully structured questionnaires was conducted among 767 sexually active women (ages 18-65). Logistic regression analyses were used to explore the association between consistent condom use and the predictor variables. 

• Overall, 78.7% of the women were inconsistent condom users. 
• The results showed that consistent condom use was predicted by marital status (being not married), having greater perceptions of condom negotiation self-efficacy, having preparatory safer sexual behaviors, and not using condoms only when practicing abstinence. 
• Living with a partner and having lack of risk perception significantly predicted inconsistent condom use. 
• Less educated women were less likely to use condoms even when they perceive being at risk. 
• The full model explained 53% of the variance in consistent condom use. 

This study emphasizes the need for implementing effective prevention interventions in this population showing the importance of taking education into consideration.

Via:  http://ht.ly/SGfUb Purchase full article at: http://goo.gl/xv3jsI

By: Costa EC1, Oliveira R, Ferreira D, Pereira MG.

• 1a Department of Psychology, Portuguese Catholic University, Braga , Portugal.

More at:  https://twitter.com/hiv_insight