TITLE: The family and demographic change in Sri Lanka.
AUTHOR: Caldwell B
AFFILIATION: International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka.
SOURCE: Health Transit Rev 1996;6 Suppl:45-60
ABSTRACT: Sri Lanka has almost completed the demographic transition with low mortality rates and fertility rates approaching replacement levels. Sri Lanka shares these characteristics with the South Indian states of Kerala and Tamil Nadu in contrast to elsewhere in South Asia where mortality and especially fertility rates remain much higher. A key part of the explanation for these differences lies in the nature of the family. The Sri Lankan family is essentially the conjugal unit of husband, wife and dependent children whereas in northern South Asia agnatic relations between son and parents are central to family structure. Related to this family system the position of women in Sri Lankan society was relatively high in South Asian terms. Consequently women had a strong say in health and fertility behaviour. When required, for example, mothers take the initiative in seeking health care for themselves and their children. Importantly family structure has facilitated female education which is associated with both mortality and fertility decline. There are few concerns that the values imparted by secular education are contrary to the values of the family or to women's roles within it. The egalitarian family structure has also contributed to fertility decline by raising the costs of children and reducing the long-run benefits to be gained from them. Sri Lanka is particularly distinctive in the contribution of changes in female age at marriage to its fertility decline, marriage age having risen six years this century. This change has been accompanied in recent times by a shift from family-arranged to self-selected (love) marriage. The explanation lies in changes in the socio-economic system which have reduced the centrality of the family in wider social and economic relations, and placed a greater premium on an individual's own abilities and attributes.
TITLE: The social construction of infertility: the case of the matrilineal Nayars in south India.
AUTHOR: Neff DL
AFFILIATION: Department of Anthropology, University of Wisconsin, Madison 53706.
SOURCE: Soc Sci Med 1994 Aug;39(4):475-85
ABSTRACT: This paper explores the relationship between central Kerala Nayar social constructions of fertility and gender, and the Nayar institution of matrilineality, one of the most extreme cases of matrilineality documented in the anthropological literature. The article shows that social responsibility and consequence are implicated in central Kerala Nayar constructions of infertility and that these are traced matrilineally. It is the duty of matrilineal kin to attend to the family god of fertility and to the needs of females of the matrilineage to see that they foster progeny in the kin group's best interests. When this responsibility is violated, powerful forms of negative consequences may transpire for all lineage members, in the idiom of curses of family fertility gods. In the ritual of pampin tullal performed to propitiate these gods, concepts of fertility are extended to include other, 'auspicious' forms of prosperity. In ritual, unattached Nayar women serve as proxy for the well-being of the matrilineage. These unattached women--infertile, unmarried, 'separated', and widowed--are, for the natal kin group, symbolic virgins (kanya), the life force (sakti) of which lineage members seek to harness for their well-being. The concept of fertility is thus extended to include marriage proposals, job offers, and other health and economic concerns of lineage members.
TITLE: Asian women's use of family planning services.
AUTHOR: Hennink M, Cooper P, Diamond I
AFFILIATION: Department of Social Statistics, University of Southampton, UK.
SOURCE: Br J Fam Plann 1998 Jul;24(2):43-52
ABSTRACT: Detailed research on the family planning needs of Asian women is extremely important in informing public policy in the new purchaser-provider environment of the National Health Service (NHS), which was introduced in 1991. In depth interviews were conducted with Asian women of Indian, Pakistani and Bangladeshi backgrounds in the South and West Regional Health Authority area, to investigate their family planning behaviour and use of family planning services. This research shows significant diversity in the knowledge and use of contraception between married professional women, married non-professional women and unmarried women. This paper examines the different family planning service implications for each group of women. The results show that professional married women and unmarried women are able to meet their family planning needs by utilising existing family planning services. However, married non-professional women experience significant difficulties in using family planning services largely due to communication problems with health professionals and their low levels of personal autonomy. Most Asian women in this study showed a strong preference for a female GP and a non-Asian GP for sexual health and contraceptive services.
TITLE: Return of fertility following discontinuation of Norplant-II subdermal implants.
AUTHOR: Buckshee K, Chatterjee P, Dhall GI, Hazra MN, Kodkany BS, Lalitha K, Logambal A, Manchanda P, Nanda UK, RaiChoudhury G, et al
AFFILIATION: ICMR Task Force on Hormonal Contraception. Division of Human Resource Development Research, Indian Council of Medical Research, Ansari Nagar, New Delhi.
SOURCE: Contraception 1995 Apr;51(4):237-42
ABSTRACT: A total of 627 women who had discontinued the use of the Norplant-II implants for various reasons and were exposed to the risk of pregnancy were followed-up for two years for return of fertility. The cumulative conception rates in women who had discontinued due to planning pregnancy were 80.3 per 100 women at one year and 88.3 per 100 women at two years. The majority of women who did conceive (90 percent), had full-term normal live births; about 4 percent of women had spontaneous abortions, the remaining 6 percent decided on elective termination of pregnancy (ETP). The cumulative conception rates in women who discontinued due to bleeding irregularities and 'other reasons' were 64.5 and 55.8 per 100 women at one year and 77.9 and 75.1 per 100 women at two years, respectively. These rates were significantly lower as compared to those observed in women who discontinued due to planning pregnancy. A large proportion, about 40 percent, of women who conceived after discontinuation of the method due to bleeding irregularities and "other reasons," opted for ETP indicating that many women in these two groups did not desire another child and that such women need to be counselled for adopting another method of contraception. The spontaneous abortion rates observed in ex-users of Norplant-II implants (1.7 to 4.4% pregnancies) were comparable to the spontaneous abortion rates prior to Norplant-II implant use (3.6% pregnancies) indicating that ex-users of Norplant-II implants were not at a higher risk of spontaneous abortion.
TITLE: Vaginal bleeding patterns of women using different contraceptive methods (implants, injectables, IUDs, oral pills)--an Indian experience. An ICMR Task Force Study. Indian Council of Medical Research.
AUTHOR: Datey S, Gaur LN, Saxena BN
AFFILIATION: Division of Human Resource Development Research Indian Council of Medical Research, New Delhi.
SOURCE: Contraception 1995 Mar;51(3):155-65
ABSTRACT: Irregularity in vaginal bleeding patterns is the most common clinical side effect causing discontinuation of the method reported by the-users of the newer contraceptive methods, especially hormonal ones. An objective assessment of vaginal bleeding pattern is, therefore, critical in evaluation of a new contraceptive method for its acceptance and continued use. The menstrual diary records of women participating in clinical trials of several contraceptive methods undertaken by the Indian Council of Medical Research were analysed. It was observed that the long-acting progestogen-only hormonal contraceptives like levonorgestrel (LNG)-releasing subdermal implants Norplant or intrauterine devices (LNG-IUD) as well as injectable contraceptive NET-EN 200mg given 2 or 3 monthly produced disturbances in bleeding pattern in the majority of their users. Very heavy or prolonged bleeding, a potential health hazard was uncommon and a shift more towards infrequent bleeding was observed. In Norplant-II implants users, 75 to 80% of women had irregularities in bleeding pattern during the first year of use which improved with prolonged use. However, even at 4 years of use, about half of the users of Norplant-II implants continued to have irregular bleeding patterns. The bleeding disturbances occurred in 80% users of 200mg NET-EN injectable contraceptives also during first year of use, however unlike Norplant-II implants users, there was no improvement with prolonged use. Combined monthly injectable contraceptives containing 50mg NET-EN and 5mg estradiol valerate caused less bleeding problems with half of the users experiencing normal pattern during one year of its use. Combined low-dose oral pills, both triphasic and monophasic, produced much better cycle control as compared to any of the other hormonal contraceptive-treated groups; about 90% of combined oral pill users had normal bleeding patterns during one year of method use. The use of copper IUDs was associated with increased bleeding in 18 to 20% of women during the initial period of three months which improved with prolonged use. It was observed that the women having frequent or prolonged bleeding had discontinued the contraceptive method more often as compared to those having delayed bleeding episodes or oligomenorrhoea. However, discontinuation rates due to bleeding irregularities at one year were lower in Norplant-II implants users as compared to other long acting hormonal contraceptive methods such as injectables or IUDs in spite of similar or better bleeding patterns in women using these methods.
TITLE: Clinical presentation of gynecologic infections among Indian women.
AUTHOR: Singh V, Sehgal A, Satyanarayana L, Gupta MM, Parashari A, Chattopadhya D
AFFILIATION: Institute of Cytology and Preventive Oncology, Maulana Azad Medical College Campus, New Delhi, India.
SOURCE: Obstet Gynecol 1995 Feb;85(2):215-9
ABSTRACT: OBJECTIVE: To study the clinical presentation of different gynecologic infections among Indian women. METHODS: This was a cross-sectional study of 257 women that included clinical, cytologic, colposcopic, and microbiologic screening for various gynecologic infections. RESULTS: Human papillomavirus (HPV) was the leading infection, affecting 127 (49.4%) women; however, overt warts were only seen in seven (2.7%) patients. Women infected with HPV had a 60.3-fold higher risk of developing a bleeding ectopia compared to those with other infections; women with an unhealthy cervix and cervical ectopias also had an increased risk of HPV infection (7.6- and 2.8-fold, respectively). Bacterial vaginosis, detected in 33.5% of the women studied, had an increased risk of bleeding ectopia (9.3-fold), cervical ectopia (3.1-fold), cervicitis (2.9-fold), vaginitis (6.9-fold), and cervical hypertrophy (2.1-fold). Chlamydial infection, detected in 23.3% of the patient population, was associated with an eightfold increase in the risk of an unhealthy cervix and a fourfold increase in risk of a hypertrophied cervix. Immunoglobulin-A antibodies to the herpes simplex virus were detected in 53 (20.6%) women. More than half (55.2%) of the women had two or more infections, and the mean delay of seeking medical treatment was 7-13 months. CONCLUSION: The specific finding of bleeding cervices was associated with HPV and bacterial vaginosis, hypertrophied cervices with chlamydia and bacterial vaginosis, and unhealthy cervices with chlamydia and HPV infections.
TITLE: Ethnic differences in insulin and glucose response to glucose between white and Indian women with polycystic ovary syndrome.
AUTHOR: Norman RJ, Mahabeer S, Masters S
AFFILIATION: Reproductive Medicine Unit, University of Adelaide, Queen Elizabeth Hospital, Woodville, South Australia.
SOURCE: Fertil Steril 1995 Jan;63(1):58-62
ABSTRACT: OBJECTIVE: To examine different patterns of glucose and insulin secretion in women (of both Indian and white ethnic backgrounds) with polycystic ovary syndrome (PCOS). DESIGN: A 75-g oral glucose tolerance test was performed in 11 subjects from each group. SETTING: Reproductive Medicine and Gynecological Clinics from The Queen Elizabeth Hospital, Woodville, South Australia, and King Edward the VIIIth Hospital, Durban, South Africa. PATIENTS: Couples were grouped as follows: Indian nonobese and obese PCOS, Indian nonobese and obese reference subjects, white nonobese and obese PCOS, white nonobese and obese reference subjects. MAIN OUTCOME MEASURE: Insulin and glucose in plasma after oral glucose testing. RESULTS: Indian PCOS and nonobese reference subjects had higher insulin responses than whites. The ethnic difference was less pronounced in obese women. There were no ethnic differences in glucose response. CONCLUSION: This study demonstrates that the ethnic background of subjects with PCOS needs to be considered in studies on the metabolic parameters in this condition.
TITLE: Lipoprotein lipids in androgen excess--a study among Indian women.
AUTHOR: Maitra A, Meherji PK, Desai MP, Gokral JS, Donde UM, Joshi UM
AFFILIATION: Institute for Research in Reproduction (ICMR) Parel, Bombay, India.
SOURCE: Int J Fertil Menopausal Stud 1994 Jul-Aug;39(4):218-22
ABSTRACT: OBJECTIVE--To assess changes in lipoprotein-lipid profile vis-a-vis putative risk of atherosclerotic diseases, among a group of hyperandrogenic women. SUBJECTS AND METHODS--Women studied were among those being screened for polycystic ovarian disease (PCOD) at the Reproductive Endocrinology Clinic of the institute. They all had oligomenorrhea/chronic anovulation as their problem and had clinical or laboratory evidence of hyperandrogenism, viz., hirsutism or elevated serum testosterone levels. Lipoprotein-lipid profiles obtained in 51 such women were compared with those of 11 controls with normal menstrual cycles and no evidence of hyperandrogenism. RESULTS--No significant changes were observed in any of the lipoprotein-lipid variables which could be attributed to hyperandrogenism per se. However, a combined effect of obesity and raised circulating androgens in causing a significant change in the lipoprotein-lipid profile (increased cholesterol, LDL-C/HDL-C, and cholesterol/HDL-C) was clearly discernible from the study. CONCLUSIONS--Hyperandrogenism by itself may not signal a risk for atherosclerotic diseases. However, the potential of such risk would be significantly enhanced if obesity is associated with high circulating levels of androgens.
TITLE: Self-reported symptoms of gynecological morbidity and their treatment in south India.
AUTHOR: Bhatia JC, Cleland J
AFFILIATION: Indian Institute of Management, Bangalore, India.
SOURCE: Stud Fam Plann 1995 Jul-Aug;26(4):203-16
ABSTRACT: This article presents an analysis of self-reported symptoms of gynecological problems among 3,600 recent mothers in Karnataka State, India. Approximately one-third of all women reported at least one current symptom; the most common were a feeling of weakness and tiredness (suggestive of anemia); menstrual disorders; white or colored vaginal discharge (suggestive of lower reproductive tract infection); and lower abdominal pain and discharge with fever (suggestive of acute pelvic inflammatory disease). Obstetric morbidity, associated with the last live birth, was strongly predictive of current gynecological symptoms. Women who delivered their last child in a private institution were significantly less likely to report symptoms than were those who delivered at home or in a government hospital. Nonusers or users of reversible contraceptive methods were also less likely to report symptoms of morbid conditions than were sterilized women. These associations persisted in analyses controlling for potentially confounding economic and demographic characteristics, and have far-reaching policy implications.
TITLE: A controlled assessment of the in vitro fertilization performance of British women of Indian origin compared with white women.
AUTHOR: Mahmud G, Lopez Bernal A, Yudkin P, Ledger W, Barlow DH
AFFILIATION: Nuffield Department of Obstetrics and Gynaecology, Oxford Radcliffe Hospital, Headington, United Kingdom.
SOURCE: Fertil Steril 1995 Jul;64(1):103-6
ABSTRACT: OBJECTIVE: To compare the reproductive performance of Indian versus white women in IVF. DESIGN: Controlled comparative clinical study. SETTING: In vitro fertilization center based in university department in large tertiary level hospital. PATIENTS: Results from first IVF treatment cycles in 44 Indian patients were compared with results from 88 white patients, matched by age and body mass index, over the same treatment year. The patients were selected from a prospectively collected IVF databank. INTERVENTIONS: Standard luteal-phase start long GnRH analogue regime. Ovarian stimulation with FSH and hMG. Transvaginal ultrasound-guided oocyte recovery. In vitro fertilization and ET following established protocols. MAIN OUTCOME MEASURES: Rates of abandoned cycles, egg retrievals, ETs, clinical pregnancies, miscarriages, and live births were compared in the first IVF treatment cycle. Cumulative pregnancy rates (PRs) over three cycles in the two groups of patients were also compared. RESULTS: More cycles were abandoned in the Indian than in the white group: 22.7% versus 9.1%. The Indian live birth rate per cycle was worse: 9.1% versus 22.7%. The performance of the two groups was otherwise similar: ovarian stimulation with hMG and FSH required 26.0 required 26.0 ampules in the Indian group versus 24.6 ampules in the white group, mean number of follicles on the day of egg retrieval 8.7 versus 8.7, mean number of eggs 5.9 versus 5.8, fertilization rate 82.4% versus 82.5%; ET rate 73.5% versus 82.5, mean number of embryos transferred 2.1 versus 1.8, and clinical PR per cycle started 18.2% versus 27.3%. CONCLUSIONS: Under the same IVF regime, Indians performed worse than whites at the stage of ovarian stimulation (higher rate of abandoned cycles for poor response) and in live birth rate. Cumulative conception and live birth rates also tended to be worse in Indians than in whites.
TITLE: Genital tuberculosis--a major pelvic factor causing infertility in Indian women.
AUTHOR: Parikh FR, Nadkarni SG, Kamat SA, Naik N, Soonawala SB, Parikh RM
AFFILIATION: Department of Infertility Management and Assisted Reproduction, Jaslok Hospital and Research Centre, Bombay, India.
SOURCE: Fertil Steril 1997 Mar;67(3):497-500
ABSTRACT: OBJECTIVE: To study the effect of tuberculosis, a common infectious disease in the Indian subcontinent, on the female pelvic factor and its subsequent effect on female fertility. DESIGN: Retrospective case studies. SETTING: Department of Infertility Management and Assisted Reproduction, Jaslok Hospital and Research Centre, Bombay, India. PATIENT(S): Three hundred women, between the ages of 25 and 35 years, with tubal factor as a cause of their infertile state. RESULT(S): One hundred seventeen women with a tubal factor were found to have tuberculosis as the cause of tubal blockage. On laparoscopy, 49.5% were found to have simple tubal blockage, 15.3% showed tubo-ovarian masses, and 23.9% had a frozen pelvis. Seventy-five percent complained of menstrual irregularities, thus indicating endometrial involvement; 25.6% of these women underwent an IVF procedure. The pregnancy rate after IVF-ET was 16.6% per transfer. CONCLUSION(S): This study highlights the fact that tuberculosis, a chronic infectious disease, is one of the major etiologic factors of female tubal infertility, especially on the Indian subcontinent.
TITLE: The ecology of low natural fertility in Ladakh.
AUTHOR: Wiley AS
AFFILIATION: Department of Anthropology, Binghamton University (SUNY) 13902-6000, USA.
SOURCE: J Biosoc Sci 1998 Oct;30(4):457-80
ABSTRACT: The existence of very low rates of fertility among non-contracepting human populations has intrigued researchers in demography and reproductive ecology. Long inter-birth intervals, driven primarily by the lactational amenorrhoea associated with breast-feeding, have been shown to be important determinants of low natural fertility in several populations. Other reports have suggested that sterility brought about by sexually transmitted diseases (STDs) might also explain low fertility in some populations, especially in Africa. This report presents an analysis of 1981 Indian census data that documents low natural fertility in Ladakh, a high-altitude region of the Himalaya in north India. In Ladakh, there is evidence for low rates of marriage among women that may be attributable to the practice of polyandry, but also high rates of primary and secondary sterility within marriage, resulting in low completed parities for post-reproductive age married women. Age-specific fertility rates derived from the number of current births are also unexpectedly low. Hypotheses to explain very low fertility in Ladakh are considered from among the likely proximate determinants and evaluated using two supplementary sources of information derived from fieldwork in Ladakh in the early 1990s. The most likely explanations for low marital fertility include sterility from STDs, high rates of fetal loss, and possibly nutritional contraints on ovarian hormone status.
TITLE: Polycystic ovaries and associated metabolic abnormalities in Indian subcontinent Asian women.
AUTHOR: Rodin DA, Bano G, Bland JM, Taylor K, Nussey SS
AFFILIATION: Division of Gastroenterology, Endocrinology and Metabolism, St. George's Hospital Medical School, London, UK.
SOURCE: Clin Endocrinol (Oxf) 1998 Jul;49(1):91-9
ABSTRACT: OBJECTIVES: To determine the prevalence of polycystic ovaries (PCO) in Asian women living in England who are of Indian subcontinent origin or ancestry and to investigate the relationship between the presence of PCO and/or non-insulin dependent diabetes mellitus (NIDDM) and insulin sensitivity and other metabolic parameters. DESIGN: A random sample of Indian subcontinent Asian women was obtained from the lists of local General Practitioners and a translating service. These women were invited to attend for a medical history questionnaire, examination, venous blood sample for hormonal assessment and transvaginal ovarian ultrasonography. Groups of women without PCO or NIDDM, with NIDDM but not PCO, with PCO but not NIDDM and with both NIDDM and PCO were drawn at random from this population and from Indian subcontinent Asian women attending the Diabetes Unit. They underwent further studies, including measurement of insulin sensitivity using a short intravenous insulin tolerance test. SUBJECTS: 212 Indian subcontinent Asian women aged 18-40 took part in the initial study. Insulin sensitivity was measured in 13 women without PCO or NIDDM, 13 women with NIDDM but not PCO, 15 women with PCO but not NIDDM and 12 women with both NIDDM and PCO. MEASUREMENTS: The main outcome measures were prevalence of polycystic ovaries, clinical features of hyperandrogenism, fertility, blood pressure, serum gonadotrophins, testosterone and sex hormone binding globulin, fasting blood lipids, glucose and insulin, and insulin sensitivity. RESULTS: The prevalence of PCO in Indian subcontinent Asian women was 52% (110/212). There were significant associations between PCO and menstrual irregularity; infertility; the Ferriman and Gallwey score for body hair distribution; the presence of acanthosis nigricans and the fasting blood glucose concentration. There were no differences between women with PCO and those with normal ovarian morphology with respect to systolic and diastolic blood pressure, fasting total, HDL and LDL cholesterol and triglyceride concentrations. The subgroup of women without PCO or NIDDM had the highest insulin sensitivity (189.1 +/- 46.4 mumol glucose/l/min, mean +/- SD) and the women with both PCO and NIDDM had the lowest insulin sensitivity (80.5 +/- 30.9 mumol glucose/l/min). There was no significant difference in insulin sensitivity between those with PCO but not NIDDM (125.0 +/- 59.5 mumol glucose/l/min) and those with NIDDM but not PCO (120.8 + 38.0 mumol glucose/l/min). The effects of NIDDM and PCO on insulin sensitivity were independent; the effect of PCO on insulin sensitivity was -60 mumol glucose/l/min (95% confidence interval -100 to -21, P = 0.004) and the effect of NIDDM was -68 mumol glucose/l/min (95% confidence interval -105 to -31, P < 0.001). There were no significant relationships between insulin sensitivity and fasting plasma insulin, systolic or diastolic blood pressure, fasting serum cholesterol or triglyceride. CONCLUSIONS: The prevalence of polycystic ovaries in Indian subcontinent Asian women is very high and it has significant clinical associations. Polycystic ovaries and non-insulin dependent diabetes mellitus are associated with similar degrees of reduced insulin sensitivity in this population. Their effects are independent suggesting that these changes in insulin sensitivity involve different mechanisms. Polycystic ovaries unlike non-insulin dependent diabetes mellitus, are not associated with a defect in the secretion of insulin.
TITLE: A controlled comparison of ovarian response to controlled stimulation in first generation Asian women compared with white Caucasians undergoing in vitro fertilisation.
AUTHOR: Lashen H, Afnan M, Sharif K
AFFILIATION: Department of Obstetrics and Gynaecology, Solihull Hospital, West Midlands, UK.
SOURCE: Br J Obstet Gynaecol 1999 May;106(5):407-9
ABSTRACT: OBJECTIVE: To compare ovarian response to controlled stimulation among Asian women from the Indian sub-continent and white Caucasian women undergoing in vitro fertilisation (IVF). DESIGN: Nested case-control study. SETTING: Assisted Conception Unit, Birmingham Women's Hospital. SAMPLE: One hundred and eight first generation Asian patients (born in the Indian sub-continent) and 216 white Caucasian controls, all of whom received IVF treatment in the period 1994 to 1997, were selected for the study. The two groups were matched for age to within one year, early follicular phase follicle stimulating hormone, indication for treatment, gonadotrophin dose and year of treatment. The outcome of treatment was not known when the controls were selected. RESULTS: There was no statistically significant difference between the two groups in the duration of stimulation, egg number, number of embryos produced, fertilisation rate, clinical pregnancy rate, miscarriage rate, cycle cancellation rate and implantation rate. CONCLUSION: Under the same IVF protocol Asian women's response to controlled ovarian stimulation and IVF outcome are comparable to their white Caucasian peers.
TITLE: Women in a south Indian fishing village: role identity, continuity, and the expe rience of menopause.
AUTHOR: George T
SOURCE: Health Care Women Int 1996 Jul-Aug;17(4):271-9
ABSTRACT: A study was conducted of the experience of menopause among middle-aged women in a fishing village on the southwest coast of India. These women live in a harsh environment with a standar d of living that would be considered economically deprived by an outsider. The women have established their identity as fish sellers. Although they reported experiencing some of the physiological symptoms of menopause typically reported in Western literature, the symptoms were not cause for complaint, and none of them sought medical treatment for them . Nor did these women go through an identity crisis at midlife; they continued to identify themselves as well-establ ished fish sellers, not as redundant, aging housewives. Furthermore, menopause gave them much more time and freedom to pursu e their fish-selling business. This paper posits that their continuity in identity accounts for their freedom f rom the psychological symptoms some Western women experience at midlife.
TITLE: Study in sexuality of medical college students in India
AUTHOR: Aggarwal O; Sharma AK; Chhabra P
SOURCE: JOURNAL OF ADOLESCENT HEALTH 2000, Vol 26, Iss 3, pp 226-229
ABSTRACT: Purpose: In India, talking about sex is taboo. Little is known about the knowledge, attitude, and sexual behavior of adolescents. This study was carried out with the purpose of examining: (a) the knowledge of medical students about sex, (b) the sources of learning about sex, and (c) the sexual behavior and practices of young adults.Methods: This study was carried out among the undergraduate students of a medical college in Delhi. A pretested, semiclosed-type questionnaire was voluntarily filled out by the students. Confidentiality and secrecy was assured.Results: Of 500 students, 73% participated in the study. Knowledge regarding sexual intercourse, masturbation, contraception, and sexually transmitted diseases was satisfactory among 70%, 74.8%, 83.5%, and 92.6% of the respondents, respectively. Common source of knowledge about sex were friends (74.5%), pornographic films (56.2%), and books and magazines (55.1%). Only one fifth could communicate with teachers, parents, and persons of the other gender about sex. About 417 of the students viewed homosexuality as normal behavior. Sexual intercourse had been experienced by 11.8% of respondents. The mean age of first sexual intercourse was 17.5 years. Eighty-five percent strongly favored introduction of sex education at school level.Conclusion: Evidence is provided for the need to improve knowledge about different aspects of sex among a sample of Indian medical students. (C) Society for Adolescent Medicine, 2000.