Current Reproductive and Health Knowledge - Essay Sample

Introduction

The main research question of the study was to explore current reproductive and health knowledge, attitudes and practices among the HIV-infected adolescents and young adults receiving medical care at an HIV clinic in Atlanta, GA. What factors were associated with contraception, condom, and dual-method use at last coitus within a social-ecological framework to determine the possible correlation between less effective contraceptive practices and the future of reproductive health interventions?

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The cross-sectional study design was used in the research to answer the question. It involved recruitment of prenatally and horizontally HIV-infected women of ages 14-30 years to complete an audio computer-assisted self-interview. The design was the most appropriate one for the study as it aimed since the research was a traverse or prevalence study which aimed at understanding the current state or prevalence of reproductive and health knowledge, attitudes and practices among the HIV-infected young women. It is an observational study that analyses data from the population which is a representative subset of the entire population in the region since only a number participated in the study. Moreover, the research aimed at providing data on the entire population under study, as opposed to case-control studies which would include only individuals with specific characteristics within a sample. It is, therefore, the most appropriate design that would answer the question more efficiently since it describes a feature of the population, i.e., the prevalence of HIV infection among the young adults as well as inferences of cause and effect.

The study involved a sample of patients. The population of interest was women who were receiving care at any of the HIV clinics in the region, aged between 14-30 years and able to read English. The authors did enough to ensure that the sample was representative of the population. They did this by obtaining a partial HIPAA waiver that enabled them to review the daily clinic schedule and identify the potential participants who were women within their inclusion criteria. Moreover, the potential participants were approached by a research assistant (RA) located in the clinic waiting room thereby ensuring the accuracy of the sample used.

Data was gathered using questionnaires where the participants answered questions about the study, audio computer-assisted self-interview (ACASI), 30-minute ACASI survey that assessed their contraceptive practices, sexual behaviors, knowledge, beliefs and attitudes towards pregnancy and STI/HIV prevention and medical charts that provided abstract information on the more recent HIV viral load and CD4+ and STIs diagnosis within the last year. The data collected and measurements used were consistent with the research questions. Possible biases exist on the accuracy of answers provided by the participants as well as those included since there were some that did not meet the eligibility criteria which provides a loophole for errors.

The findings of the study in line with the research question showed that:

On contraceptive use and knowledge, 18.9% reported moderately effective contraceptive use, 35.1% reported condom use only, and 27% reported the dual method use and 18.9% used no method during their last coitus. Most women had received some of the moderately effective contraception in the past with 63.1% using primarily DMPA, 42.7% on oral contraceptive pills, and 9.7%, 8.7%, and 2.9% had a lifetime history of ever using the Lng-IUD, Eng-Implant, and Cu-IUD respectively.

On the factors associated with effective contraceptive use during last coitus, 45% of the women used some contraceptive method either most or moderately effective form of birth control at last coitus due to being younger, enrolled in school, employed, an undetectable HIV viral load and higher CD4+ T-cell count among others.

On the factors associated with condom use during last coitus, 62.2% of the women reported using a condom due to younger age, not desiring a baby in the next year, not having had anal sex among others. Antiretroviral medication was not associated with condom use.

On the factors associated with dual method use during last coitus, 27.0% of the women reported using dual methods due to being younger, enrolled in school, having an undetectable HIV viral load, not having a prior pregnancy and less frequent coitus. These findings are similar to what has already been found in the field. However, it is among the first studies to examine the potential factors that influence the use of contraceptive and condom use from a social-ecological framework. The graphs, tables, and figures in the study clarified the results appropriately.

The strength of the study is that it involved an evaluation of a broad range of potential influences. However, the limitations include the chances of Type 1 error, the small sample size limits the power of the findings to detect potential existing associations that may exist. Moreover, due to the cross-sectional study, we cannot comment on the causality of the factors.

Conclusion

From this study, future studies should focus on individual-level interventions and their relation to pregnancy and STI/HIV prevalence and prevention among young HIV-infected adults. This is because, while provider-level, societal- and community-level factors may be vital to other aspects of an individual's well-being, they were not a strong influence on behaviors. I would design a follow-up study in a prospective manner, with the aims, the population and the outcomes being defined before the collection of data begins. The study is of high quality and provides strong evidence regarding the need to enhance individual-level interventions to improve pregnancy and STI/HIV preventions practices among the young HIV-infected women in the United States.