Hlongwa Mbuzeleni, Mashamba-Thompson Tivani, Makhunga Sizwe, Hlongwana Khumbulani
Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.
Medicine (Baltimore). 2020 Mar;99(12):e19490. doi: 10.1097/MD.0000000000019490.
Contraceptive use and sexual health behavior remain a prominent public health concern in South Africa (SA). Despite many government interventions, unintended pregnancies and termination of pregnancies remain relatively high. This review aimed to map evidence on factors influencing contraceptive use and sexual behavior in SA.
We conducted a scoping review guided by Arksey and O'Malley's framework. We searched for articles from the following databases: PubMed/MEDLINE, American Doctoral Dissertations via EBSCO host, Union Catalogue of Theses and Dissertations (UCTD) and SA ePublications via SABINET Online and World Cat Dissertations, Theses via OCLC and Google Scholar. Studies published from January 1990 to March 2018 were included. We used the Population, Concept, and Context (PCC) framework and the PRISMA chart to report the screening of results. The Mixed Method Appraisal Tool (MMAT) version 11 and ACCODS tools were used to determine the quality of the included studies.
A total of 2030 articles were identified by our search criteria for title screening. Only 21 studies met our inclusion criteria and were included in quality assessment stage. We found that knowledge of a contraceptive method, length of a relationship, sexual debut, age difference between partners availability of a contraceptive method, long waiting hours, and nurse's attitudes toward human immunodeficiency virus (HIV) positive or younger clients predict whether or not women use a contraceptive method or improve sexual behavior.
There remains a necessity for improving educational programs aimed at transferring knowledge on contraceptives and sexual behavior to both women and their male counterparts, alongside the public health systems' improvements.
在南非，避孕措施的使用和性健康行为仍然是一个突出的公共卫生问题。尽管政府采取了许多干预措施，但意外怀孕和终止妊娠的比例仍然相对较高。本综述旨在梳理影响南非避孕措施使用和性行为的因素的相关证据。
我们在阿克西和奥马利的框架指导下进行了一项范围综述。我们从以下数据库搜索文章：PubMed/MEDLINE、通过EBSCO主机获取的美国博士论文、论文联合目录（UCTD）以及通过SABINET Online和World Cat Dissertations获取的南非电子出版物、通过OCLC和谷歌学术搜索获取的论文摘要。纳入了1990年1月至2018年3月发表的研究。我们使用人口、概念和背景（PCC）框架以及PRISMA图表来报告结果筛选情况。使用混合方法评估工具（MMAT）第11版和ACCODS工具来确定纳入研究的质量。
根据我们的搜索标准，共识别出2030篇文章用于标题筛选。只有21项研究符合我们的纳入标准并进入质量评估阶段。我们发现，对避孕方法的了解、恋爱关系的时长、首次性行为、伴侣之间的年龄差异、避孕方法的可获得性、长时间等待以及护士对人类免疫缺陷病毒（HIV）阳性或年轻客户的态度，能够预测女性是否使用避孕方法或改善性行为。
除了改善公共卫生系统外，仍有必要改进教育项目，向女性及其男性伴侣传授关于避孕和性行为的知识。
