OBJECTIVES: The perceptions of family-planning (FP) acceptors regarding contraception influence the reasons for which they choose to switch their method of contraception. The objective of this study was to analyze the perceptions of contraception and rationales for switching contraceptive methods among female FP acceptors in West Nusa Tenggara, Indonesia. METHODS: This study involved the analysis of secondary data from the Improve Contraceptive Method Mix study, which was conducted in 2013 by the Center for Health Research, University of Indonesia. The design of the study was cross-sectional. We performed 3 stages of sampling using the cluster technique and selected 4819 women who were FP acceptors in West Nusa Tenggara Province, Indonesia as the subjects of this study. The data were analyzed using multiple logistic regression. RESULTS: The predominant pattern of switching contraceptive methods was switching from one non-long-term method of contraception to another. Only 31.0% of the acceptors reported a rational pattern of switching contraceptive methods given their age, number of children, and FP motivations. Perceptions of the side effects of contraceptive methods, the ease of contraceptive use, and the cost of the contraceptives were significantly associated (at the level of α=0.05) with rational patterns of switching contraceptive methods. CONCLUSIONS: Perceptions among FP-accepting women were found to play an important role in their patterns of switching contraceptive methods. Hence, fostering a better understanding of contraception through high-quality counseling is needed to improve perceptions and thereby to encourage rational, effective, and efficient contraceptive use.
Child ; Contraception ; Contraceptive Agents ; Counseling ; Family Planning Services ; Female ; Foster Home Care ; Humans ; Indonesia ; Logistic Models ; Methods ; Patient Acceptance of Health Care

The levonorgestrel-releasing intrauterine system (LNG-IUS) was originally developed as a method of contraception and was first marketed in Finland in 1990. In Korea, the only LNG-IUS approved for non-contraceptive use is Mirena, a T-shaped device with a vertical stem containing a reservoir of 52 mg of levonorgestrel, which releases 20 µg of levonorgestrel per day. The device's strong local effects on the endometrium benefit women with gynecological conditions such as heavy menstrual bleeding, dysmenorrhea, leiomyoma, adenomyosis, and endometriosis. There is also evidence to support its role in endometrial protection during postmenopausal estrogen therapy and in the treatment of endometrial hyperplasia without atypia and, possibly, early endometrial cancer. Because of its effectiveness, safety, and high patient satisfaction, the LNG-IUS will continue to provide important benefits in women's reproductive health.
Adenomyosis ; Contraception ; Dysmenorrhea ; Endometrial Hyperplasia ; Endometrial Neoplasms ; Endometriosis ; Endometrium ; Estrogens ; Female ; Finland ; Genital Diseases, Female ; Hemorrhage ; Humans ; Korea ; Leiomyoma ; Levonorgestrel ; Menorrhagia ; Methods ; Patient Satisfaction ; Reproductive Health

OBJECTIVE: This study attempts to gauge the necessity of contraceptive education for women defecting from North Korea (NKDWs). METHODS: We conducted in-depth interviews with six NKDWs who had lived in the Republic of Korea (ROK) for more than three years, to understand the subjects' perceptions, experiences, and opinions regarding contraception. Thematic analyses were performed using qualitative data provided in the survey results. RESULTS: Before their defections from North Korea, none of the NKDWs had received any sex education. Loop is the only contraceptive method available to married women in ROK. After defection, NKDWs were provided information about contraceptive options available in China, but they could not fully understand this information. Furthermore, the information they received was not accurate. Thus, NKDWs had a high need for contraceptive sex education. As per our survey, their preferred education method was at least 3 lessons plus 1 : 1 counseling, as necessary. CONCLUSION: This study indicates that a necessity exists for development of a sex education program for NKDWs to enhance their contraceptive knowledge. Thus, government and health managers have a role to play in developing such a program.
China ; Contraception ; Contraceptives, Oral ; Counseling ; Democratic People's Republic of Korea ; Education ; Female ; Humans ; Methods ; Republic of Korea ; Sex Education ; Women's Health

INTRODUCTION: This study explored attitudes towards vasectomy and its acceptance as a method of contraception among clinical-year medical students, and determined the association between their demographic characteristics, and attitudes and acceptance. METHODS: A cross-sectional survey was conducted among clinical-year medical students from a Malaysian private medical college using a self-administered questionnaire. RESULTS: There were 330 participants with a female preponderance and a mean age of 22.0 ± 1.1 years. The largest proportion of respondents were from Year 3. The vast majority were ethnically Malay (91.8%) and followed Islam (92.4%). Overall, 60.9% of participants had a positive attitude towards vasectomy and 76.0% showed good acceptance. Gender, academic year, ethnicity and religion variables were not associated with attitudes and acceptance (p > 0.05). A significantly higher proportion of male respondents thought that vasectomy was religiously forbidden and would give a bad impression. A significantly higher proportion of Year 5 students agreed to the statement 'I would recommend vasectomy to relatives, friends and people close to me' compared to Year 3 and 4 students. CONCLUSION Students' perception of vasectomy as a contraceptive method was encouraging. Our results suggest that their knowledge improved as medical training progressed, and attitudes evolved for the better irrespective of their traditional, cultural and religious beliefs - highlighting the importance of providing students with evidence-based learning about male sterilisation, which is more cost-effective and is associated with lower morbidity than female sterilisation. A qualitative study involving students from different ethnicities and religions would provide a better understanding of this subject.
Adult ; Attitude of Health Personnel ; Contraception ; methods ; psychology ; Cross-Sectional Studies ; Female ; Humans ; Malaysia ; Male ; Religion and Medicine ; Schools, Medical ; Students, Medical ; psychology ; Surveys and Questionnaires ; Vasectomy ; psychology ; Young Adult

PURPOSE: Aims of the researchers were to develop an birth control empowerment program (BCEP) designed to help married immigrant women in Korea to plan their pregnancies. METHODS: This study was as a randomized controlled trial to verify the effects of the BCEP. The BCEP was developed based on Falk-Rafael (2001)'s Empowerment caring model. The program was offered once a week, for 90 minutes per session, for a total of 10 weeks. The BCEP incorporated group instruction, group discussion, and counseling. The eligible participants were randomly assigned to either experimental group (n=23) or control group (n=23). RESULTS: Participants in the intervention group had significantly better outcomes in contraceptive knowledge (p<.001), contraceptive self-efficacy (p=.014), perceived contraceptive control (p<.001), sex-related spousal communication (p<.001), and sexual autonomy (p=.009). CONCLUSION: The BCEP was effective intervention method, which can promote family planning practices among married immigrant women.
Asian Continental Ancestry Group* ; Contraception* ; Counseling ; Emigrants and Immigrants* ; Family Planning Services ; Female ; Humans ; Korea* ; Methods ; Parturition* ; Power (Psychology)* ; Pregnancy

PURPOSE: The purpose of this study was to explore essences and meanings of using oral contraceptives among adult women. METHODS: The interview was conducted with 20 adult women who lived in Seoul, Gyeongi Province, Jeolla Province, Chungcheong Province, and Gangwon Province. Participants with the experience of using oral contraceptives for contraception were selected by convenience sampling. Semi-structured interviews were conducted for data collection. The data were analyzed using Colaizzi's method. RESULTS: Five themes revealed: ‘Lack of information and knowledge regarding oral contraceptives’, ‘Inconvenient and difficult purchase process of oral contraceptives’, ‘Pressure and fear regarding other people's reaction’, ‘Self-centered thinking toward the use of oral contraceptives’, ‘A need for a change in public awareness and policy’. CONCLUSION: A change in society's perception about oral contraceptives is required for safe contraceptives use. Therefore, it is necessary to educate the correct usage of oral contraceptives, and to develop a program for changing the paradigm of sex education.
Adult* ; Contraception ; Contraceptive Agents ; Contraceptives, Oral* ; Data Collection ; Female ; Gangwon-do ; Humans ; Methods ; Qualitative Research ; Seoul ; Sex Education ; Thinking

BACKGROUND: Cervical cancer is still the second most frequent cancer among Indonesian women, thus screening program is still critically important to prevent it. Visual inspection with acetic acid (VIA) was introduced as a method which is most suitable with Indonesia's condition compared with the other screening methods. The Female Cancer Program from Jakarta Regional collaborated with Leiden University in 2007 to 2011 has done cervical cancer screening using VIA method, involving 25,406 women spreading across several primary health centers in Jakarta. By using these data, we found out the prevalence, age distribution, and risk factor of VIA positive in Jakarta as a basis to predict the budget and logistics for the next cervical cancer screening and to do an advocating to the Jakarta's government. METHODS: A secondary data analysis was conducted from several areas in Jakarta from 2007 to 2011. VIA test was used as the screening method, and performed by doctors and midwives with technical supervision by gynecologists. RESULTS: From 25,406 women, there were 1,192 cases (4.7%) of VIA test positive. The risk factors that can significantly influence the result of VIA positive were number of marriage, parity, smoking habits, and the use of hormonal contraception with OR 1.51, 1.85, 1.95, and 0.68, respectively. CONCLUSIONS: Prevalence of VIA test-positive is 4.7% in Jakarta population. The findings of precancerous lesions and cervical cancers are not only between thirty and fifty years old, but also below the thirty years old and after fifty years old. We suggest that VIA test should be performed to all reproductive age and elder women who are not screened yet.
Acetic Acid ; Age Distribution* ; Budgets ; Contraception ; Female ; Humans ; Marriage ; Mass Screening ; Methods ; Midwifery ; Organization and Administration ; Parity ; Prevalence* ; Risk Factors* ; Smoke ; Smoking ; Statistics as Topic ; Uterine Cervical Neoplasms

INTRODUCTIONThe study aimed to assess the level of awareness and knowledge of contraception among women in Singapore, and identify the factors that influence contraception choice.

METHODSWe conducted a cross-sectional survey of 259 female patients, aged 21-49 years, who attended the Obstetrics and Gynaecology Clinic at National University Hospital, Singapore. An original questionnaire on nine contraceptive methods was used. Respondents who had ≥ 2 correct answers for a method (out of four questions) were considered to have good knowledge of the method. Participants were asked to rate factors known to influence contraceptive choice as important or not important.

RESULTSAwareness of the following methods was high: condom (100.0%), oral contraception pill (89.2%), tubal ligation (73.0%) and copper intrauterine device (IUD) (72.2%). The women were least aware of hormonal IUD (24.3%). Women who were parous, had a previous abortion, had completed their family or used contraception previously were more likely to have a higher awareness of contraception. 89.2% of the women had good knowledge of the condom; among those aware of hormonal IUD, only 46.0% had good knowledge of it. Women who had used hormonal IUD and the condom were more likely to have good knowledge of them. Many rated efficacy (90.5%) and a healthcare professional's advice (90.1%) as important in contraceptive choice. Few considered peer influence (21.0%) and cultural practices (16.3%) to be important.

CONCLUSIONWomen in Singapore have poor awareness and knowledge of contraception, especially long-acting reversible methods. More effective ways are needed to educate women about contraceptive methods.

Abortion, Induced ; Adult ; Choice Behavior ; Condoms ; Contraception ; methods ; Contraceptives, Oral ; Cross-Sectional Studies ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Intrauterine Devices ; Middle Aged ; Parity ; Patient Education as Topic ; Singapore ; Social Class ; Sterilization, Tubal ; Surveys and Questionnaires ; Young Adult

OBJECTIVE: To assess the association between condom use and oral contraceptive consumption and the risk of cervical intraepithelial neoplasia (CIN). METHODS: A cross-sectional study was conducted in Perth clinics. A total of 348 women responded to the structured questionnaire. Information sought included demographic and lifestyle characteristics such as the use of condom for contraception, consumption of oral contraceptive, and duration of oral contraceptive usage. Crude and adjusted odds ratio (OR) and associated 95% confidence interval (CI) were calculated using unconditional logistic regression models and reported as estimates of the relative risk. RESULTS: The prevalence of CIN was found to be 15.8%. The duration of oral contraceptive consumption among women with abnormal Papanicolaou (Pap) smear result indicating CIN was significantly shorter than those without abnormal Pap smear result (mean+/-SD, 5.6+/-5.2 years vs. 8.2+/-7.6 years; p=0.002). Comparing to < or =3 years usage, prolonged consumption of oral contraceptive for > or =10 years reduced the risk of CIN (p=0.012). However, use of condom for contraception might not be associated with a reduced risk of CIN after accounting for the effects of confounding factors (adjusted OR, 0.52; 95% CI, 0.05 to 5.11; p=0.577). CONCLUSION: Use of oral contraceptives, but not condoms, for contraception appeared to be inversely associated with CIN. Prolonged use of oral contraceptive demonstrated its benefits of reducing the risk of CIN.
Adult ; Cervical Intraepithelial Neoplasia/epidemiology/*prevention & control ; Condoms/*utilization ; Contraception Behavior/*statistics & numerical data ; Contraceptives, Oral/*administration & dosage ; Cross-Sectional Studies ; Drug Administration Schedule ; Drug Utilization/statistics & numerical data ; Female ; Humans ; Middle Aged ; Prevalence ; Risk Assessment/methods ; Socioeconomic Factors ; Western Australia/epidemiology

OBJECTIVETo assess the long-term effect and safety of non-occlusive intra-vas device (IVD) for male contraception in comparison with no-scalpel vasectomy (NSV).

METHODSWe conducted a follow-up investigation on 100 males who had received IVD and another 50 who had undergone NSV 6 years before. We compared the rates of sperm absence and complications between the two groups.

RESULTSFollow-up visits were successfully performed on 95 males (95%) of the IVD group and 44 (88%) of the NSV group. Pregnancy was not found in any of the cases. Spermatozoa (> or = 5 x 10(6)/ml) were not detected in 87 cases (91.58%) in the IVD group and in 44 cases (95.45%) in the NSV group, with no significant differences between the two groups (P > 0.05). The rate of postoperative complications in the IVD group (11.58%) showed no significant difference from that of the NSV group (4.55%) (P > 0.05).

CONCLUSIONIVD is as effective and safe as NSV for male contraception.

Adult ; Contraception ; methods ; Follow-Up Studies ; Humans ; Male ; Vas Deferens ; Vasectomy