S. Marie Harvey

Female sexual behavior: Fluctuations during the menstrual cycle

This longitudinal prospective study was designed to examine the influence of menstrual cycle phase on female sexuality. Sixty-nine normally cycling women monitored their sexual behavior including both heterosexual and autosexual activities and their basal body temperature daily over two or three consecutive menstrual cycles. Temperature charts were used to ascertain five cycle phases (menstrual, postmenstrual, ovulatory, luteal and premenstrual) and data were analyzed using analyses of variance with repeated measures. The results supported a significant cyclic fluctuation in sexual behavior with both female-initiated and male-initiated sexual activities peaking in the ovulatory phase. Moreover, the findings indicated that women experienced increased sexual arousal and sexual pleasure as they progressed from the menses to the premenstruum. These data suggest that human sexual behavior may be influenced by hormonal fluctuations and cognitive factors associated with the menstrual cycle.

Body mass index and sexual behavior.

OBJECTIVE: To characterize the relationship between body mass index and sexual behavior, including sexual orientation, age at first intercourse, ever having had sex with a male partner, number of partners, and frequency of intercourse. METHODS: This study employed the 2002 National Survey of Family Growth, a cross-sectional, nationally representative database in which women between the ages of 15 years and 44 years were surveyed regarding reproductive health outcomes. Sexual behavior was compared between body mass index groups—normal (less than 25 m/kg2), overweight (25–30 m/kg2), and obese (greater than 30 m/kg2)—using self-reported height and weight. Multiple logistic regression with adjustment for the sampling design was used to measure associations of interest. RESULTS: Body mass index was not significantly associated with sexual orientation, age at first intercourse, frequency of heterosexual intercourse, and the number of lifetime or current male partners. Overweight women and obese women were more likely to report ever having male sexual intercourse (P<.001). This difference persisted when we adjusted for age as well as type of residence. CONCLUSION: With the exception of ever engaging in sexual intercourse with a man, sexual behavior differs little between women of different body mass indices. LEVEL OF EVIDENCE: II

A conceptual model of women's condom use intentions: Integrating intrapersonal and relationship factors.

Abstract We developed and tested a multifaceted model of condom use intentions with cross-sectional data from 435 heterosexual women at risk for HIV/STIs. In addition to traditional intrapersonal variables drawn from established models of HIV prevention (e.g. attitudes, norms, self-efficacy), the present study examined the role of relationship factors and dynamics (i.e. relationship commitment, duration, condom use and pregnancy prevention decision-making) in shaping condom use intentions. In some cases, relationship variables were directly associated with condom use intentions. In other cases their effects on condom use intentions were mediated by intrapersonal constructs. The final model accounted for 66% of the variance in condom use intentions and confirmed the importance of integrating intrapersonal variables and relationship characteristics and dynamics in understanding womens intentions to use condoms. These results offer important insights for the design of interventions directed at promoting condom use among young women at risk for HIV/STIs and underscore the need to design prevention programs that address relationship characteristics and dynamics.

Getting your partner to use condoms: Interviews with men and women at risk of HIV/STDs

Data from individual semistructured interviews with 90 young heterosexual couples were analyzed to identify strategies that men and women at risk of HIV/STDs would use to influence their partners to use condoms for the purpose of disease prevention. In addition, we explored whether participants thought influencing strategies would differ for pregnancy prevention. Content analysis of the interview data indicated that participants would use the following verbal strategies: persuading/suggesting, commanding/asserting, and threatening to withhold sex. Several participants, particularly those who had recently used condoms with their partners, reported that they would also use non‐verbal strategies involving condoms themselves (e.g., putting a condom on, buying or getting condoms, or presenting a condom to their partner). Many participants believed that they would use a different strategy for pregnancy prevention because it would be easier to convince a partner to use condoms for that purpose.

Changes in providers views and practices about emergency contraception with education.

Objective To assess changes in the prescribing practices, knowledge, attitudes, and perceptions of health care providers after an educational program about emergency contraception. Methods Health care providers completed self-administered questionnaires before and 1 year after full implementation of the project. The 102 providers who completed both questionnaires were physicians (64%) and mid-level professionals from 13 San Diego County Kaiser Permanente medical offices working in departments such as obstetrics and gynecology, primary care, and emergency medicine. Results The frequency of prescription for emergency contraceptive pills increased significantly from baseline to follow-up. There was an increase of almost 20% in the percentage who prescribed emergency contraception at least once a year. Knowledge also improved significantly, and perceptions of barriers to prescribing emergency contraceptive pills within the health maintenance organization decreased significantly. In contrast, attitudes about emergency contraception showed little change. Conclusion This study suggests that providers who participate in in-service training and other aspects of a demonstration project show changes in perceptions, knowledge, and behavior. However, findings also suggest that significant gaps remain in knowledge about medications, side effects, and mode of action. It is likely that many providers in other health care settings also need additional information and training concerning protocols of emergency contraception provision and its modes of action and effects.

Sexual decision making and safer sex behavior among young female injection drug users and female partners of IDUs

Data from interviews with 94 young women who were injection drug users (IDUs) or partners of IDUs were analyzed to examine associations between self‐reported sexual decision making and condom use, contraceptive use, and relationship characteristics. Most women (73–85%) reported participating in decisions about condom use, contraception, and when to have sex. Adjusting for potential covariates, respondents who reported participating in decisions about condom use and when to have sex were 7 and 19 times, respectively, more likely than others to report recently using condoms. Respondents who reported participating in decisions about contraception were 20 times more likely than others to report recently using contraceptives. Longer sexual relationships were associated with decreased likelihood, of condom or contraceptive use.

Emergency contraception: knowledge and attitudes of health care providers in a health maintenance organization.

One hundred sixty-four health care providers in a health maintenance organization were surveyed in 1996 regarding their knowledge of, attitudes toward, and perception of barriers regarding emergency contraceptive pills (ECPs), as well as their ECP prescribing practices. Providers reported primarily positive attitudes regarding ECPs. Only 42% reported having ever prescribed ECPs; those who had prescribed had more positive attitudes about ECPs. Knowledge of ECP provision was incomplete, with 40% believing treatment had to be initiated in 48 hours or less. Barriers identified by providers included lack of a dedicated product, lack of awareness of ECPs among providers, and liability issues.

The new civil war : the psychology, culture, and politics of abortion

Federal Abortion Policy and Politics - 1973-1996 Why is Abortion Such a Controversial Issue in the United States? Barriers to Access to Abortion Services The Impact of Anti-Abortion Activities on Women Seeking Abortions Black Women and the Question of Abortion Latinos and Abortion Abortion and Asian Pacific Islander Americans The Acceptability of Medical Abortion to Women Understanding the Relationship of Violence Against Women to Unwanted Pregnancy and its Resolution Testing a Model of the Psychological Consequences of Abortion Men and Abortion - the Gender Politics of Pregnancy Resolution Abortion Among Adolescents - a Cognitive Approach to Patient-Centred Abortion Care Abortion Issues in Psychotherapy Bringing Lessons Learned to the United States - Improving Access to Abortion Services Abortion Practice, Policy and Research - Recommendations for the 21st Century.

A treatment model for women substance users

This paper sets forth a multifaceted program which consists of drug user women-centered counseling plus ancillary services based on the five basic steps of Freires empowerment theory. The program is designed to increase self-awareness, skills, and knowledge acquisition, to reduce feelings of isolation by broadening interpersonal networks, includes activities to enhance assertiveness and communication skills, and parenting education to counteract inappropriate mother-child interaction as well as to positively influence role modeling. Both transportation and child care are recommended ancillary services.

Who continues using the diaphragm and who doesn't: implications for the acceptability of female-controlled HIV prevention methods

OBJECTIVES This study examines the acceptability of the diaphragm with the aim of facilitating the development of female-controlled human immunodeficiency virus (HIV) prevention methods. More specifically, we assess associations between being a current (vs. former) diaphragm user and characteristics that are hypothesized to influence the acceptability of contraceptive methods; and explore reasons for discontinuing use of the diaphragm among former diaphragm users. DESIGN The study involved a cross-sectional telephone survey with women who were members of a nonprofit health maintenance organization and who were either a current (n = 215) or former (n = 172) diaphragm user. METHODS Participants were interviewed about the importance of contraceptive attributes; perceptions for the diaphragm; diaphragm use self-efficacy; perceived risk of and motivation to avoid pregnancy, HIV, and other sexually transmitted infections; and demographic characteristics, sexual, and contraceptive behavior. RESULTS The likelihood of being a current diaphragm user (vs. former) increased with age, greater confidence in being able to use the diaphragm, greater perceived risk of pregnancy and more positive perceptions of the diaphragm. Women who valued attributes of hormonal contraceptives were less likely to be current users. Former diaphragm users reported that the following reasons were moderately to extremely important in their decision to stop using the diaphragm: difficulty inserting or removing the diaphragm (50.8%), dislike of leaving the diaphragm inside the vagina (46.8%), and wanting a more effective method for preventing pregnancy (44.2%). CONCLUSIONS The findings suggest that specific characteristics of a product influence continued use and have implications for improving the acceptability of existing and new female-controlled HIV prevention methods.