Articles
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Age at First Sex and HIV Infection in Rural
Zimbabwe / Timothy B. Hallett, James J.C. Lewis, Ben A. Lopman,
Constance A. Nyamukapa, Phyllis Mushati, Mainford Wambe, Geoff P.
Garnett, and Simon Gregson
Beginning sexual activity introduces an individual to the risk of
acquiring sexually transmitted infections. In this study,
cross-sectional behavioral data linked to HIV-status from 4,138 men and
4,948 women interviewed in rural Zimbabwe are analyzed to investigate
the distribution and consequences of early first sex. We find that age
at first sex (at a median age of 19 years for males and 18 years for
females) has declined among males over the past 30 years but increased
recently among females. Those in unskilled employment, those not
associated with a church, and women without a primary education begin to
have sex earlier than others. Early sexual debut before marriage
precedes a lifetime of greater sexual activity but with more consistent
condom use. Women who begin to have sex earlier than others of their age
are more likely to be infected with HIV. This finding can be explained
by their having a greater lifetime number of sexual partners than those
whose first sexual experience occurs later. (Studies in Family Planning
2007; 38[1]: 1–10) (offsite
link*)
- Estimating the Incidence of Abortion in
Pakistan / Zeba A. Sathar, Susheela Singh, and Fariyal F. Fikree
This study applies an indirect estimation method to develop
comprehensive national and provincial estimates of the prevalence of
abortion and abortion-related morbidity in Pakistan. Data from a health
facilities survey and a health professionals survey from 2002 are
analyzed to develop estimates of postabortion hospitalizations and of
the abortion rate, abortion ratio, and unwanted pregnancy rate. We
estimate that 890,000 induced abortions are performed annually in
Pakistan, and estimate an annual abortion rate of 29 per 1,000 women
aged 15–49. The abortion rate is found to be higher in provinces where
contraceptive use is lower and where unwanted childbearing is higher.
The unwanted pregnancy rate is estimated at 77 per 1,000 women, or about
37 percent of all pregnancies. Abortions account for termination of one
in seven pregnancies. An estimated 197,000 women are treated annually in
public hospitals and private teaching hospitals for induced abortion
complications, a number equivalent to an annual rate of 6.4 women
hospitalized as a result of unsafe induced abortions per 1,000 women
aged 15–49. (Studies in Family Planning 2007; 38[1]: 11–22) (offsite
link*)
- Contraceptive Discontinuation and Failure
and Subsequent Abortion in Romania: 1994–99 / Andreea A. Creanga,
Rajib Acharya, Saifuddin Ahmed, and Amy O. Tsui
This study examines the levels and correlates of contraceptive failure
and discontinuation in Romania, together with the consequences of
contraceptive method failure in terms of induced abortion. Of special
interest are women who rely on the traditional method of withdrawal and
the proportion of withdrawal failures resulting in abortion. Our
analysis is based on multiyear calendar data concerning women’s
contraceptive use and monthly reproductive behaviors collected in the
1999 Romanian Reproductive Health Survey. Weibull regression models are
estimated to analyze the determinants of discontinuation and failure for
all methods combined and for withdrawal. Overall, 19 and 28 percent of
women became pregnant within the first year of using any contraceptive
method and of practicing withdrawal, respectively. About 57 and 59
percent of failures from use of all methods and from withdrawal ended in
abortion, accounting for 30 percent and 22 percent, respectively, of all
abortions reported between 1994 and 1999. These findings suggest that
high rates of contraceptive discontinuation and failure contributed
significantly to the widespread reliance on induced abortion among
Romanian women during this period. (Studies in Family Planning 2007;
38[1]: 23–34) (offsite
link*)
Reports
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Couples’ Reports of Women’s Autonomy and
Health-care Use in Nepal / Keera Allendorf
Using data from interviews with matched couples recorded in the 2001
Nepal Demographic and Health Survey, this report explores how
incorporating both spouses’ reports of household decisionmaking may
change the understanding of the determinants and consequences of women’s
autonomy. Results indicate that a substantial proportion of couples
disagree about who makes household decisions, but the determinants of
women’s autonomy are still largely similar according to both spouses’
reports. The assessment of the effects of two important sources of
autonomy—women’s education and employment—differs significantly between
spouses, however. When spouses agree that the wife is autonomous, the
association between her autonomy and her use of health-care services is
found to be substantially stronger than when spouses disagree about her
autonomy. This finding suggests that the association between women’s
autonomy and health-care-service use may be underestimated when only
women’s reports are considered. (Studies in Family Planning 2007; 38[1]:
35–46) (offsite
link*)
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Assessing the Quality of
Cesarean Birth Data in the Demographic and Health Surveys / Sara A.
Holtz and Cynthia K. Stanton
Cesarean section surgery is the clinical response used to prevent
several of the leading causes of maternal and perinatal mortality and
morbidity. Given the deficient state of health-information systems in
most developing countries, nationally representative surveys are
currently the most widely available source of population-based cesarean
birth data. The purpose of this study is to assess the quality and
internal consistency of Demographic and Health Survey cesarean birth
data across countries and time periods. Although these surveys are
highly standardized, the formulation of the question on cesarean birth
and the categories of women who are asked the question often differ
across surveys. A skip pattern that restricts the cesarean question to
women who delivered in a health-care facility improves the internal
consistency of the data, although in some countries cesarean deliveries
are still reported at low-level, presumably nonsurgical facilities.
Recommendations are made for improving data analysis and the future
collection of population-based cesarean birth data. (Studies in Family
Planning 2007; 38[1]: 47–54) (offsite
link*)
Data
Book Reviews (offsite
link*)
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a fee.
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