Contraceptive needs and practices among women attending an inner-city STD clinic.

Abstract

To assess the potential need, interest, and benefits of provision of contraceptive services in sexually transmitted disease (STD) clinics, we surveyed 516 women attending an inner-city STD clinic regarding contraceptive and sexual practices. STD prevalence, knowledge of contraceptive-related STD prophylaxis, and interest in contraceptive services within the STD clinic setting. The study population was at high risk for unintended pregnancy and STDs; at time of interview 46 per cent of women were not contracepting and 59 per cent were treated for STD or STD exposure. Two-thirds of women had at least one prior pregnancy and 50 per cent had at least one living child. Only 26 per cent of women knew that some contraceptive methods may reduce the risk of STD acquisition; however, 62 per cent expressed interest in contraceptive methods which would reduce their risk of STD acquisition. This study suggests that provision of contraceptive services in STD clinic settings may address dual needs in a group at high risk for both unintended pregnancy and STD. (Am J Public Health 1987; 77:1427-1430 IntroduictionUnintended pregnancy and sexually transmitted diseases (STDs) are recognized as major public health concerns by national and international health policy makers.`'' In the United States, women at risk for unintended pregnancy and for acquisition of STDs are often one and the same: women under age 25 account for two-thirds of STD morbidity and unintended pregnancy with highest rates for each occurring among non-White, inner-city, lower-income women.4± Although both family planning and STD services are concerned with the unplanned consequences of sexual activity, little coordinated programmatic effort currently exists at federal, state, or local levels.9'0 Integrated contraceptive and STD services for high-risk women could provide convenient reproductive health care in a cost efficient manner without duplication of efforts. " Since some methods of contraception may also reduce the risk of STD acquisition and complications,12-24 women might receive overlapping benefits from combined services.Despite proposals for combined services, no data are available substantiating that women at risk for STD are also at increased risk for unintended pregnancy. To obtain the necessary baseline information and to assess the potential need of providing contraceptive services in an inner-city STD clinic, we surveyed 516 women attending a Baltimore, Maryland STD clinic regarding contraceptive and sexual practices, levels of STDs, knowledge of and interest in STD-related prophylaxis, and willingness to utilize contraceptive services within a STD clinic setting. MethodsIn survey. The questionnaire was administered by clinic health assistants trained to conduct interviews in a non-coercive manner. The health assistants were of similar age, race, and ethnic background as patients attending the clinic.Women attending the STD clinic are evaluated according to a standardized STD clinic protocol which includes a directed medical history, pel...

Contraceptive needs of women seeking care from a publicly funded sexually transmitted infection clinic

“…In our sample, 15% of respondents stated they had not used any contraception within the prior 6 months, while 33% reported only intermittent use. While the majority of women in Upchurch’s study reported using oral contraceptive pills (34%) [12], the most commonly used methods in our study were condoms (61%), followed by withdrawal (24%); only 10% of our respondents reported oral contraceptive use. The prevalence of condom use reported by this population is similar to women attending a Denver-based public health STI clinic [2], but is substantially higher than the 11% of women who report condom use in a nationally representative survey (2002 NSFG) [22].…”

“…However, a study conducted in 1987 by Upchurch et al[12] found that almost half (46%) of women at a Baltimore STI clinic were not using contraception. In our sample, 15% of respondents stated they had not used any contraception within the prior 6 months, while 33% reported only intermittent use.…”

Family Planning, Sexually Transmitted Diseases and Contraceptive Choice: A Literature Update--Part II

“…202 In STD clinics, up to half of reproductiveaged, sexually active women report using no method of contraception, although most have histories of both STDs and unintended pregnancy. 203 In developing countries, the need for integrated care is even more acute. Since so few health care facilities exist, services should not be fragmented.204 Moreover, because access to health services is usually more cumbersome and time-consuming in resource-poor settings, patients who make the effort to obtain one type of service should have access to the full range of clinical preventive care.…”

Sexual behaviour of women attending an inner-city STD clinic before and after a general campaign for safer sex in Denmark.

“…The frequency of intercourse on a weekly 56/979 (6) 14/677 (2) 21-50 269/978 (28) 191/678 (28) 21/979 (2) 5/677 (1) 51-100 71/978 (7) 58/678 (9) The number of women reported to have had chlamydia was significantly higher in 1988 (p < 0-01), whereas the number of women reported to have had gonorrhoea was lower (p < 0-01). A history of genital warts was more common in 1988 than in 1984 (p < 0-05).…”