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Negative Male Partner Influences on Reproductive Health and Contraceptive Use Among Adolescent and Young Adult Women

Jones, Kelley (2016) Negative Male Partner Influences on Reproductive Health and Contraceptive Use Among Adolescent and Young Adult Women. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Intimate partner violence (IPV) and reproductive coercion (RC) are key public health concerns for young women and are associated with poor sexual health outcomes. We studied 1) the pathways between IPV/RC and unintended pregnancy and sexually transmitted infections (STI), 2) partner influence on use of female-controlled contraception (FCC), and 3) discordance between self-report and medical record data for pregnancy/STI and predictors of discordance. A cluster-randomized controlled trial of female family planning clinic patients (ARCHES; 16-24 years) and a nationally representative survey of women in the U.S. (NSFG survey; 15-24 years) were used. Women in the ARCHES study (n=2,363) self-reported IPV, RC, sexual self-efficacy, recent STI, past-year pregnancy, and past-year unintended pregnancy, at enrollment, four months, and twelve months; pregnancy and STI diagnoses were abstracted from medical records. Women in the NSFG survey (n=2,541) self-reported contraceptive use in the past year, whether they had stopped using a contraceptive method because a partner did not like it, and whether their partner wanted a baby but they themselves did not.

In the ARCHES sample, sexual self-efficacy did not mediate the relationship between IPV and RC with unintended pregnancy and STI. In the NSFG sample, current use of FCC was low, with the majority of those on FCC using oral contraceptives. Partner influence was associated with greater current FCC use among young adults, but adolescents both with and without partner influence had poorer contraceptive use. Self-report on confidential surveys and medical record data showed poor agreement, with self-report providing higher prevalence estimates compared to medical records. Women who reported recent IPV or RC, were older, or African-American were more likely to self-report STI and pregnancies that were not in their medical records.

These findings have identified multiple pathways by which partner influence, including IPV and RC, impact young women’s reproductive and sexual health, thus enabling future interventions to target these specific points. Further, best methodologies for this research field were identified. Thus, this dissertation has significant public health relevance as it informs programs to reduce disease burden due to sexual health sequelae associated with IPV/RC, and improve exposure and outcome ascertainment in future research.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Jones, Kelleykaj25@pitt.eduKAJ25
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairCornelius, Mariemdc1@pitt.eduMDC1
Committee MemberMiller, Elizabethelizabeth.miller@chp.eduELM114
Committee MemberDe Genna, Natachadegennanm@upmc.eduDEGENNAN
Committee MemberHaggerty, CatherineHaggertyC@edc.pitt.eduHAGGERTY
Committee MemberTancredi,
Date: 27 January 2016
Date Type: Publication
Defense Date: 13 October 2015
Approval Date: 27 January 2016
Submission Date: 16 November 2015
Access Restriction: 3 year -- Restrict access to University of Pittsburgh for a period of 3 years.
Number of Pages: 138
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Epidemiology
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: intimate partner violence; reproductive coercion; reproductive health; unintended pregnancy; STD
Date Deposited: 27 Jan 2016 21:48
Last Modified: 01 Jan 2019 06:15


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