Missed conceptions or misconceptions: perceived infertility among unmarried young adults in the United States.

CONTEXT: Perceived infertility is an individual's belief that she or he is unable to conceive or impregnate, regardless of whether this belief is medically accurate. This perception may lead to contraceptive nonuse, which may, in turn, lead to unintended pregnancy. Little research has examined perceived infertility among young adults, including potential associations with contraceptive behaviors. METHODS: The frequency of perceived infertility among young adults was assessed using 2009 data from a nationally representative telephone survey of 1,800 unmarried men and women aged 18-29. Multinomial regression analyses assessed associations between respondents' perceived infertility and selected background, reproductive knowledge, sexual experience and contraceptive use characteristics. RESULTS: Overall, 19% of women and 13% of men believed that they were very likely to be infertile. Hispanic women and women who had received public assistance in the past year had elevated odds of perceived infertility (odds ratios, 3.4 and 3.0, respectively), as did Hispanic men and men of other racial or ethnic minorities, except blacks (2.5 and 6.1, respectively). Men who had some college education, had received sex education or were not in a current relationship had decreased odds of thinking they were very likely to be infertile (0.3-0.4). Among men, perceived infertility was associated with the belief that they were likely to have sex without using a contraceptive in the next three months (2.6). CONCLUSIONS: A substantial proportion of young adults believe they are infertile. Improved provider counseling and sex education may be useful in helping them to better understand their actual probability of infertility, and this knowledge may lead to improved contraceptive use.

Cigarette smoking and drinking behavior of migrant adolescents and young adults in Hanoi, Vietnam.

PURPOSE: There has been a large migration from rural to urban areas in much of the developing world. In the past, this was less true in Vietnam, which remains largely agricultural; however, since the 1990s, economic reforms and loosening of government policies that had previously limited movement have led to a large increase in this rural to urban population movement. Risky health behaviors have been found among migrants in many other settings. The purpose of this research was to determine whether migrant adolescents and young adults in the city of Hanoi are more or less likely than local ones to engage in cigarette smoking and alcohol drinking health risk behaviors, to identify factors associated with these behaviors, and to suggest interventions to reduce these health risk behaviors among the study population. METHODS: A cross-sectional survey of 4,550 adolescents and young adults aged 15-24 years was conducted in urban Hanoi in 2006. This study examines current use of cigarettes and alcohol by migration status using multivariate logistic regressions. RESULTS: Cigarette smoking and drinking alcohol are male phenomena. The prevalence of cigarette smoking and alcohol drinking is high among adolescents and young adults in Hanoi and is more common among migrants who came from rural areas of other provinces than nonmigrants in the city. However, multivariate analysis revealed that migrants were neither more likely to smoke cigarettes nor drink alcohol than nonmigrants after controlling for other factors, such as age, full-time worker status, depression, and having close friends who smoke and/or drink. CONCLUSIONS: The results suggest that interventions aiming at smoking and/or drinking reduction should pay more attention to adolescents, especially males, changing health risk behaviors at school and at work, and peer influence than their migration status.

A randomized community trial of enhanced family planning outreach in Rakai, Uganda.

A randomized community trial of a family planning outreach program was conducted in Rakai District, Uganda. Five communities received standard services; six intervention communities received additional family planning information, counseling, and contraceptive methods from government service providers and community-based volunteer agents using social marketing and other strategies. Condom use was promoted in all of the communities. The community-based family planning outreach program was implemented in two phases--1999-2000 (early) and 2001(late)--and its impact was evaluated by means of population surveys in 2002-03. At follow-up, hormonal contraceptive prevalence was 23 percent in the intervention communities, compared with 20 percent in the control communities. The differential was greater in the early-intervention communities than the late-intervention communities. Pregnancy rates at follow-up were 15 percent in the control and 13 percent in the intervention communities. No differentials in condom use were found between study arms. Family planning outreach via social marketing can significantly increase hormonal contraceptive use and decrease pregnancy rates, but the impact of this outreach program was modest.

Levels of change in adolescent sexual behavior in three Asian cities.

Considerable change in the romantic and sexual behaviors of Asian young people may be occurring as traditionally Confucian societies modernize and increase outside contacts. This study explores the dimensions and context of this change in three sites at different stages in the process of modernization: Hanoi (early), Shanghai (intermediate), and Taipei (later stage). A survey was conducted of 17,016 males and females aged 15-24 in urban and rural settings in three large metropolitan areas. Survival analysis and Cox regressions were performed to explore ages of respondents at key transitions and the significance of differences between two age cohorts: 15-19 and 20-24. Significant differences are found in levels of sexual and other transitions, even within the narrow time span reflected by the age cohorts. The findings highlight the differential impact of modernization on adolescent sexual behavior as traditional societies undergo social change, and they underline the importance of context in exploring youthful transitions.

Childhood sexual abuse and early menarche: the direction of their relationship and its implications.

PURPOSE: A relationship between childhood sexual abuse (CSA) and early menarche previously has been proposed and psychobiological mechanisms for the association have been suggested. Because it has serious implications for many disciplines, we attempted to confirm that association and explore its direction, first with hypothesis 1: the negative relationship between pubertal age and CSA is based on victims' increased target gratifiability at ages of high target vulnerability, and then with hypothesis 2: CSA and circumstances surrounding it are related causally to early menarche. METHODS: African-American and multi-ethnic Caucasian women (N = 323) were interviewed at several women's clinics at Johns Hopkins Bayview Medical Center; 64 women reported premenarcheal abuse. We assessed (1) ages of CSA and menarche to determine their relationships, (2) household characteristics and their relationships with CSA, (3) variables associated with CSA, to determine the independent effect of CSA and explore potential dose response (i.e., effects of increased stress). RESULTS: CSA and menarcheal age are related negatively (p < .05). Hypothesis 1 need not be rejected totally, but with most CSA events occurring long before puberty, hypothesis 2 is supported. Theoretically, stressful CSA characteristics increase victim/nonvictim differences in menarcheal age. Stress may derive from household characteristics often related to CSA but, even controlling for them, CSA has independent effects on menarcheal age. CONCLUSIONS: Hypothesis 1 may apply when CSA occurs within 2 years premenarche but, because hypothesis 2 is supported, continuing psychobiological effects and stress engendered by CSA are underscored. Mechanisms through which they impact the developing child require further exploration, and medical and psychological attention.