Diana Lara

Measuring induced abortion in Mexico. A comparison of four methodologies.

The authors compare four methods of collecting information on abortion through survey research to measure the levels of induced abortion in Mexico: face-to-face interview (FTF), audio computer-assisted self-interview (ACASI), self-administered questionnaire (SAQ), and a random-response technique (RRT). They tested all methods in three samples: (1) hospital patients in Mexico City, (2) rural women in Chiapas, and (3) women randomly chosen as part of a house-to-house survey in Mexico City. In each sample, RRT found the highest rate of attempted induced abortion in the hospital, rural, and household samples (21.7, 36.1, and 17.9 percent, respectively), followed by the SAQ (19.3, 10.1, and 10.8 percent, respectively). The ACASI and FTF interviews yielded fewer reported abortion attempts. The RRT seems the most promising methodology to measure the levels of induced abortion. With SAQ, detailed information was obtained, and the reported frequency rates were slightly lower than the RRT rates in urban areas.

The Measure of Induced Abortion Levels in Mexico Using Random Response Technique

The authors used the random response technique (RRT) to measure frequency of induced abortion in Mexico, where its practice is illegal under most circumstances. They applied RRT to a national, multistage probabilistic sample of 1,792 women ages 15 to 55. The distribution of women who reported having had an induced abortion was analyzed by sociodemographic characteristics. Bivariate and multiple logistic regression analyses were performed to identify factors associated with having had an induced abortion. Overall prevalence of induced abortion was 16.3 percent. Three factors were associated with reported induced abortion: having grown up in the city (bivariate odd ratio [OR] 2.16, multiple logistic OR 2.24), having never given birth (bivariate OR 1.60, multiple logistic OR 2.06), and having had an unwanted pregnancy (bivariate OR 2.09, multiple logistic OR 2.81). RRT produced a better estimation of induced abortion compared with other methodologies. This technique works best with urban and educated women.

Acceptability and use of the female condom and diaphragm among sex workers in Dominican Republic: results from a prospective study.

To assess the acceptability and use of the female condom and diaphragm among female sex workers in the Dominican Republic, 243 participants were followed for 5 months. Participants received female and male condoms and a diaphragm along with proper counseling at monthly visits. Seventy-six percent reported used of female condom at least once during the final month of the study, compared with 50% that used the diaphragm with male condoms and 9% that used the diaphragm alone. The proportion of women reporting every sex act protected with some barrier method increased from 66% at first month to 77% at final month (p < 0.05). Participants reported higher acceptability and use of the female condom than the diaphragm. The introduction of female-controlled barrier methods resulted in the use of a wide range of prevention methods and a significant reduction in unprotected sex.

Opinions of decision-makers on the liberalization of abortion laws in Mexico

OBJECTIVE In the last decade, important advances were made in the struggle for reproductive rights in Mexico. The goal of this study was to discover the opinions of decision-makers about the grounds for legal abortion as well as to explore their perceptions about further liberalization of abortion laws countrywide. MATERIAL AND METHODS In-depth interviews were conducted with eight prominent decision-makers working in governmental health, law and social institutions as well as representatives of political parties. RESULTS Six decision-makers favored a further liberalization of abortion laws. They proposed several strategies to move forward with liberalization. Two decision-makers were against abortion under all circumstances. CONCLUSIONS Three factors seem to play a key role in the liberalization of abortion: a liberal party governing at the state level, a favorable public opinion and the pressure of NGOs promoting reproductive rights. A state-by-state approach seems more effective for generating changes in abortion laws.

A Lifetime of Violence: Results From an Exploratory Survey of Mexican Women With HIV

&NA; Despite recognition that traditional Mexican gender norms can contribute to the twin epidemics of violence against women and HIV, there is an absence of published literature on experiences of violence among Mexican women with HIV. We conducted a cross‐sectional survey with 77 HIV‐infected women from 21 of Mexicos 32 states to describe experiences of violence before and after HIV‐diagnosis. We measured lifetime physical, sexual, and psychological violence; physical violence from a male partner in the previous 12 months; and physical and psychological violence related to disclosing an HIV diagnosis. Respondents reported ever experiencing physical violence (37.3%) and sexual violence (29.2%). Disclosure of HIV status resulted in physical violence for 7.2% and psychological violence for 26.5% of the respondents. This study underlines the need to identify and address past and current gender‐based violence during pre‐ and post‐HIV test counseling and as a systematic and integral part of HIV care.

Exploring how residential mobility and migration influences teenage pregnancy in five rural communities in California: youth and adult perceptions.

Abstract Teenage birth rates among young people aged 15–19 years in California, USA, have declined from 47 births per 1000 in 2000 to 24 per 1000 in 2013. Nevertheless, the US counties with the highest teenage birth rates are predominantly rural and have a high proportion of Latinos/as. We conducted 42 interviews with key stakeholders and 12 focus groups with 107 young people in five rural communities to better understand local migration patterns and their influence on intermediate and proximate variables of pregnancy, such as interaction with role models and barriers to access contraception. The migration patterns identified were: residential mobility due to seasonal jobs, residential mobility due to economic and housing changes and migration from other countries to California. These patterns affect young people and families’ interactions with school and health systems and other community members, creating both opportunities and barriers to prevent risky sexual behaviours. In rural areas, residential mobility and migration to the USA interconnect. As a result, young people dually navigate the challenges of residential mobility, while also adapting to the dominant US culture. It is important to promote programmes that support the integration of immigrant youth to reduce their sense of isolation, as well as to assure access to sexual health education and reproductive health services.

Gender-Based Violence among Married Women in Debre Tabor Town, Northwest Ethiopia: A Qualitative Study

Gender-based violence is one of the major public health problems in Ethiopia. This study aimed to assess the perception and attitude of the community towards gender-based violence among married women in Northwest Ethiopia. A qualitative study was conducted using the purposive sampling technique for the three focus group discussions and ten in-depth interviews among married women. Data was analyzed thematically using version 3.4 of the Open Code Software. Most of the participants perceived that gender-based violence was acceptable in the community, violent acts needed to be considerably tolerated rather than condemned. Additionally, participants perceived that the consequences of gender-based violence were mild, and its elimination was difficult. Domestic violence was found to be common, marital rape was not clearly understood, and there was no tendency to disapprove it. This study revealed that the attitude of people and traditional norms played the major role in determining the acceptability of gender-based violence on married women. Increasing awareness on the consequences of gender-based violence, strengthening of women empowerment, involving different stakeholders on the provision of education, amending and enforcing the existing laws, and providing professional help to stop or reduce violence against women are recommended.

Exploring the Influence of Neighborhood-Level Factors on Adolescent Birth Rates in California: A Social-Ecological Approach

This article examines neighborhood-level factors to help explain why adolescent birth rate trajectories differ in certain communities in California, with rates in some areas remaining elevated or increasing while rates in other areas with similar demographic characteristics declined. Researchers conducted in-depth interviews with 94 community stakeholders and 22 focus groups with 186 adolescents from five “promising” communities (with declining adolescent birth rates) and five “struggling” communities (persistently elevated or increasing rates). Promising communities had more employment prospects, better neighbor interactions, and greater educational opportunities for youth. Parent–child communication around sex and youth knowledge of clinics were also more common. In contrast, struggling communities tended to have higher perceived levels of crime and poverty and more negative attitudes toward youth. These findings illustrate the complexity of factors that influence adolescents’ lives and decision-making. Synergistic community-based approaches to adolescent health and development are critical to promote positive health outcomes.