Contraceptive characteristics: the perceptions and priorities of men and women.

CONTEXT: Despite the fact that choosing a contraceptive method is often a decision made by couples, little is known about how men and women differ in their perceptions of the characteristics of various method types, and in the importance that they attach to those characteristics when choosing a contraceptive method. METHODS: The data analyzed here are subsets from two companion surveys conducted in 1991--1,189 men aged 20-27 who were surveyed in the National Survey of Men and 740 women aged 20-27 who were surveyed in the National Survey of Women. Multivariate ordered logit analysis is used to examine how gender is related to both the importance that individuals assign to seven specific contraceptive characteristics when choosing a method, and to perceptions about the extent to which five common method types possess each of these characteristics. RESULTS: Women rank pregnancy prevention as the single most important contraceptive characteristic when choosing a method, with 90% citing it as "very important." The health risks associated with particular methods and protection from sexually transmitted diseases (STDs) are rated as the second most important characteristics by women (each mentioned as "very important" by 77%). In contrast, men consider STD prevention for themselves and their partner to be just as important as pregnancy protection (each mentioned as "very important" by 84-86%), and they rank STD prevention as more important than other health risks (by 72%). Women, but not men, rank both ease of use and the need to plan ahead as being more important characteristics than a method's interference with sexual pleasure. Both men and women have an accurate understanding of the strengths and weaknesses of particular methods, but differ enough in their perceptions to alter the relative attractiveness of each method. In particular, women have more favorable perceptions than men about the pill, being somewhat more likely than men to believe that the pill is "very good" at preventing pregnancy (75% vs. 67%) and to say that it is very good at not interfering with sexual pleasure (82% vs. 76%). In contrast, women have generally less favorable perceptions than men about other reversible methods, including the condom: Women were less likely than men to consider the condom very good at pregnancy prevention (29% vs. 46%) or at having no need for advance planning (22% vs. 38%). Gender differences in perceptions about the specific characteristics of contraceptive methods often vary by marital status. CONCLUSIONS: Men and women have somewhat different priorities when choosing a contraceptive method. Despite many similarities between women and men in their perceptions about the characteristics of each method type, numerous differences between them may have an important influence on how couples make their method choices.

PIP: This paper focuses on the effects of gender on the importance of contraceptive characteristics and on how specific contraceptive methods are evaluated by men and women. In particular, the study examines how gender is related to both the importance that individuals assign to seven specific contraceptive characteristics when choosing a method, and to perceptions on the extent to which the five common method types possess each of these characteristics. The data used were derived from two companion surveys conducted in 1991, which included a sample of 1189 men and 740 women who belong to the 20-27 age group. Findings revealed that 90% of women rank pregnancy prevention as the first and single most important contraceptive characteristic when choosing a method, followed by sexually transmitted disease (STD) protection. Among men, STD prevention for themselves and their partner and pregnancy protection were of equal importance. Furthermore, both men and women have a correct understanding of the strengths and weaknesses of a particular method but differ significantly with their perceptions on the relative attractiveness of each method. Gender differences in perceptions on the specific characteristics of contraceptive methods often vary by marital status. These results clearly indicate that gender greatly affects contraceptive method perceptions and priorities.

Childhood living arrangements and adult children's relations with their parents.

We examine the relationship of childhood living arrangements to adult child-parent relations. Compared with adult children raised in intact families, adult children whose parents divorced have less frequent contact with their parents and report a lower-quality relationship with their parents. We observe these negative effects for both custodial and noncustodial parents, although the effects are larger for noncustodial parents. Remarriage of the custodial parent tends to offset the negative impacts of divorce on relations with the custodial parent and to amplify the negative impacts on relations with noncustodial parents. Further, the longer the adult child lived apart from the parent, the weaker the relations with noncustodial parents.

Adolescent fertility and the educational attainment of young women.

Analyses based on a sample of 2,795 women interviewed annually from 1979 through 1991 in the National Longitudinal Survey of Youth show that early childbearing lowers the educational attainment of young women. After controls for an extensive set of personal and community characteristics are taken into account, having a child before age 20 significantly reduces schooling attained by almost three years among whites, blacks and Hispanics. Having a child before age 18 has a significant effect only among blacks, reducing years of schooling by 1.2 years.

PIP: The authors present new estimates of the relationship between teenage childbearing and educational attainment. The analyses are based upon a sample of 2795 young women interviewed annually over the period 1979-91 in the National Longitudinal Survey of Youth. Subjects were 1445 whites, 906 blacks, and 444 Hispanics aged 14-20 in 1979, except for those in the special military subsample or the oversample of economically disadvantaged whites. Controlling for an extensive set of personal and community characteristics, researchers found that childbearing as a teenager lowers the educational attainment of young women. Schooling attained among whites, blacks, and Hispanics was reduced by almost three years among those who bore a child before age 20. Having a child before age 18, however, has a significant effect among only blacks, reducing years of schooling by 1.2 years. Other recent research has reported that the social and economic effects of teenage childbearing are not as great as early studies of the relationship between teenage childbearing and adult outcomes had suggested. The results of this study, however, suggest that such revisionist findings are open to challenge.

Condom characteristics: the perceptions and preferences of men in the United States.

Perceptions regarding the consequences of condom use, as well as preferred characteristics of condoms, are examined in a nationally representative sample of 3,321 men aged 20-39. The psychological and interpersonal effect most often cited is that using a condom "shows that you are a concerned and caring person." This is particularly the case among black men and men who are young and have low educational attainments. However, the same men usually agree that using a condom sends unwanted messages to one's partner--for example, that doing so "makes your partner think that you have AIDS" and "shows that you think that your partner has AIDS." In contrast, white men and those who are highly educated tend to cite embarrassment when buying condoms as a frequent consequence of condom use. The device-related consequences cited most often, particularly among black, unmarried, young and poorly educated men, are that using a condom results in reduced sensation, that one must be careful during sex or the condom may break and that one must withdraw quickly after sex or the condom may come off. When purchasing condoms, most men look for those that are easy to put on, have the right amount of lubrication and stay on; these preferences are particularly prevalent among black men. Few men identify color, ribbing and partner's preference for condom type as important.

The sexual behavior of men in the United States.

A nationally representative study of the sexual behavior of men aged 20-39 in the United States shows that the prevalence and frequency of sexual acts (vaginal, anal and oral) and sexual orientation vary by social and demographic characteristics. Analysis of data from 3,321 respondents to the 1991 National Survey of Men reveals that 95% of men have had vaginal intercourse; among them, 23% have had 20 or more vaginal sex partners in their lifetime. About one-fifth of never-married and formerly married men had four or more partners over a recent 18-month period. However, 41% of never-married men and 32% of formerly married men did not have coitus during the four weeks preceding the interview. Only 20% of men have ever engaged in anal intercourse. Among these, 51% had not done so during the previous 18 months, and 90% had not done so during the previous four weeks. Seventy-five percent of men have performed oral sex and 79% have received oral sex, although 53% of men who ever performed oral sex had not done so during the four weeks prior to interview, and only 11% had done so six or more times. The frequency of receiving oral sex is similar. Only 2% of sexually active men aged 20-39 have had any same-gender sexual activity during the last 10 years, and only 1% reported being exclusively homosexual during this interval.

Condom use among U.S. men, 1991.

A 1991 study of a nationally representative sample of men aged 20-39 finds that 27% of sexually active men had used a condom in the four weeks before interview. Black men are more likely than white men to report condom use (38% vs. 25%), and men younger than 30 are more likely to do so than are those older than 30 (36% vs. 19%). Among white men, condom use increases with years of education; among black men, however, those with 12 years of education are much less likely to report condom use than are those with more or less than 12 years (28% vs. 43-50%). Condom use is positively related to number of partners. Men who have engaged in anal intercourse, those who have had a one-night stand and those who are bisexual or homosexual are also more likely to report condom use. Among those who reported using a condom in the previous four weeks, 55% of whites and 18% of blacks had done so only for birth control and 7% of whites and 9% of blacks had done so only for protection against infection with the human immunodeficiency virus and other sexually transmitted organisms; the remainder had used a condom for both reasons.

Perceptions of AIDS risk and severity and their association with risk-related behavior among U.S. men.

According to a nationally representative sample of 3,321 men aged 20-39 surveyed in 1991, men appear well aware of the severity of AIDS: Nearly all know that AIDS destroys the immune system and that there is no cure for the disease, but a substantial minority do not think that AIDS will necessarily result in pain and death. Men's perceptions of the disease's severity seem to have little impact on their sexual behavior, with no clear relationship between men's knowledge of AIDS and their recent number of sex acts, their condom use or their participation in anal or casual sex. Men's perceptions of the general risk of human immunodeficiency virus (HIV) transmission also appear to have little impact either on their concerns about AIDS or on their behavior, but their perceptions about the AIDS rate in their local community do affect their concerns and behavior. Men know that certain kinds of behavior place them at risk, and their prior behavior significantly influences their perceptions of their own HIV risk. However, speculation about their own HIV status is only moderately related to their recent sexual behavior.

The influence of community characteristics on the practice of effective contraception.

An analysis combining individual-level data from the National Survey of Family Growth with aggregate-level information provides evidence that the characteristics of communities influence the contraceptive decisions of currently married white women in the United States. The analysis examined the relationship between the average effectiveness level of the contraceptive methods that a woman used over a three-and-a-half-year period and community characteristics such as employment opportunities, the availability of contraceptive and abortion information and services, and the level of religious adherence in communities. Community characteristics associated with higher levels of contraceptive effectiveness were rapid population growth, high rates of unemployment, elevated levels of religious affiliation, high socioeconomic status, and ready access to family planning information and services. Community liberality was negatively associated with effective contraceptive use. The results support arguments that various community characteristics affect a woman's contraceptive choices by increasing or decreasing the costs of an unintended pregnancy.