Targeting sexual health services in primary care: A systematic review of the psychosocial correlates of adverse sexual health outcomes reported in probability surveys of women of reproductive age

Prev Med. 2015 Dec:81:345-56. doi: 10.1016/j.ypmed.2015.09.019. Epub 2015 Oct 24.

Abstract

Background: Women using primary care vary in need for sexually transmitted infections (STIs) testing and contraception. Psychosocial correlates of these needs may be useful for targeting services. We undertook a systematic review to identify psychosocial correlates of STI acquisition, unplanned pregnancy (UP), abortion and risky sexual behaviours in general population samples of women of reproductive age.

Methods: We searched bibliographic databases for probability surveys of women aged 16-44 years in the European Union, USA, Canada, Australia, UK or New Zealand undertaken January 1994-January 2014.

Results: Eleven papers were included. Unplanned pregnancy was associated with smoking, depression, being single and sexual debut <16 years. Abortion was associated with lack of closeness to parents, leaving home at an early age, and relationship break-up. Multiple partnerships were associated with intensity of marijuana and alcohol use, and smoking. STI diagnosis was associated with relationship break-up and younger partners. Non-use of contraception was associated with smoking, obesity, relationship status, sedentary lifestyles, fatalistic pregnancy attitudes and lower alcohol use. Condom non-use was higher (at first sex) with partners 5+years older and lower (at last sex) in less stable partnerships.

Conclusion: Psychosocial variables, particularly relationship status and smoking, may help identify women in primary care for STI testing and contraception advice and supply.

Keywords: Contraception pregnancy; Review; Sexually transmitted diseases; Systematic primary health care; Unplanned psychosocial factors.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Adolescent
  • Adult
  • Contraception / psychology
  • Contraception / statistics & numerical data
  • Female
  • Global Health
  • Humans
  • Pregnancy
  • Pregnancy, Unplanned / psychology
  • Primary Health Care*
  • Reproductive Health / education*
  • Risk-Taking
  • Sexual Behavior*
  • Sexual Partners
  • Sexually Transmitted Diseases / diagnosis
  • Sexually Transmitted Diseases / psychology*
  • Smoking
  • Surveys and Questionnaires