Suchergebnisse

The teenage fertility rate fell precipitately in Sweden after 1966 and is now one of the lowest in Europe. This decline can be seen in the context of major reforms enacted in 1975 whereby the school sex‐education curriculum was revised, contraceptive services were improved, and abortion was provided free and on demand. By means of microsimulation, the possible roles of contraception and induced abortion in causing teenage fertility to fall are examined. Before 1975, the decline appears to have been caused primarily by an increase in the number of induced abortions. After that date, however, an increase in the use of highly efficient methods of contraception led to a decline in the pregnancy rate in such a way that, even though the proportion of teenagers who sought abortion increased, the abortion rate declined. Parallels are drawn with the experience of other European countries, and contrasts with that of the United States, where no such developments have occurred, are noted.

In this study, a microsimulation model is used to assess the potential impact of condom use on women's lifetime risk of acquiring HIV in rural southern Malawi. The model draws on survey data for information on sexual activity, marriage and divorce, and on the biomedical literature for input parameters governing the transmission and spread of HIV and other sexually transmitted diseases (STDs). We show that lifetime risk could be as high as 42 percent with no condom use and as low as 8 percent if everyone consistently uses condoms with nonmarital partners. Next, we examine the impact of more realistic, intermediate strategies of condom use, varying men's propensity to use a condom with nonmarital partners, varying the per‐coitus probability of condom use, varying probabilities of slippage or breakage, and finally, examining the effect of condom use in the presence of STD symptoms. We demonstrate profound effects of consistent condom use and of condom use prompted by symptomatic STDs.