人工流产女青年性行为和避孕现状研究

Cross-sectional research of sexual behavior and contraceptive use among young women seeking abortion in Beijing

目的:了解北京市人工流产女青年的性行为和避孕现状,探讨人工流产、特别是重复流产的影响因素。方法:采用自填式问卷的方法,对北京市1 008名自愿要求人工流产、在1980年8月1日之后出生的女青年进行现状调查。结果:研究对象首次性行为的平均年龄为(20.70±1.95)岁,54%的人在20岁之前就开始了性生活;首次人工流产的平均年龄为(21.96±1.81)岁,首次流产在20岁之前的占17.0%;将近25%的人曾与2名及以上的男性发生过性关系;人流女青年本次怀孕的原因,60.2%是因为没有避孕,39.7%由于避孕失败;没有避孕的主要原因是"在没有准备好避孕药具的情况下同房"(41.5%)和"知道避孕方法但不想用"(39.7%);避孕失败的主要原因是全安期和体外射精(39.0%)、避孕套(32.7%)和紧急避孕(18.5%);过去3个月中,最常用的避孕方法为避孕套(75.5%)、全安期和体外射精(11.0%)、紧急避孕(8.2%);在避孕套使用者中,只有9.3%能坚持每次同房都用;77.2%的人认为口服避孕药对身体不好;32.4%的研究对象有重复流产。单因素分析发现,文化程度低、未婚同居、首次性生活和首次流产的年龄小、多性伴和不能坚持、正确使用避孕措施是重复流产的影响因素。结论:女青年首次性行为开始早、多性伴比例高、避孕药具使用率低或使用低效的避孕方法是非意愿妊娠和人工流产的主要原因,且重复流产现象比较严重;同时,流动人口在人流女青年中占了相当大的比例。因此,应当对未婚人群和流动人口女青年进行人工流产的危害以及避孕知识的宣传教育,提高现代科学的避孕药具使用率,避免不必要的意外妊娠和人工流产。

Objective： To investigate the situation of sexual behavior and contraceptive use of young women who seek abortion in Beijing, thus to explore the influencing factors of induced abortion especially repeated abortion. Methods： A cross - sectional survey was conducted among 1 008 female adolescents seeking abortion in 8 hospitals in Beijing, who were born after August 1, 1980. Results： The average age at first sex was （20. 70 ± 1. 95 ） years old, and 54% experienced first sex before 20. The average age at first induced abortion was （21. 96 ± 1. 81 ） years old, and 17% sought their first abortion before 20. Nearly 25% had sex relationship with two or more male - partners. As to the reasons for the current unwanted pregnancy, 60. 2% were due to unprotected intercourse, 39. 7% were resulted from method failure. The main reasons for non - use of contraception were ＂ Not prepare any contraceptive method＂ （41. 5% ） and ＂ Unwilling to use＂ （ 39. 7% ）. The most common contraceptive methods failures were rhythm, condom, withdrawal and emergency contraception. During last 3 months, the most frequently used methods were condom （75. 4% ）, withdrawal （41%）, rhythm （40. 3% ） and emergency contraception （36. 3% ）. Among condom users, only 3. 9% used every time during sexual behavior, 77. 2% believed pills harmful to health. More than one third respondents had abortion history. The result of univariate analysis indicated that lower education, premarital cohabitation, first sex and abortion at early age, multi - partners, and seldom and incorrect use of contraceptive methods were considered as the risk factors of repeated abortion. Conclusion： First sex at early age, muhi - partners, seldom consistent use of contraception and use contraceptive methods of low effectiveness are more likely to increase the risk of unintended pregnancy and induced abortion. Repeated abortion rate is high among young women. Moreover, migrants account for a large proportion of abortion women. So it is urgent to educate unmarried women and migrants with the harm of abortion and contraceptive knowledge, to increase the use of modern contraceptive methods and to avoid unwanted pregnancy and induced abortion.