Bearss N, Santelli J S, Papa P
Sussex Technical High School Wellness Center, Georgetown, Delaware 19947, USA.
J Adolesc Health. 1995 Sep;17(3):178-83. doi: 10.1016/1054-139X(94)00189-L.
Few school-based health centers (SBHC) in the United States dispense contraceptives on-site and little is known about contraceptive continuation in these health centers.
An 11-month contraceptive continuation pilot project offering monthly reproductive health assessment and counseling to students enrolled in Baltimore school clinics was evaluated. One hundred-forty-three women voluntarily enrolled in the study over a seven month period. A monthly contraceptive calendar was developed to collect data on contraceptive use, pregnancy and STD risk, sexual behavior and parental support for contraceptive use. Physical assessment was provided as needed to assess the presence of STD's or pregnancy. Data were analyzed for the month prior to enrollment in the program and eleven months after entry into the program.
Both contraceptive (OCP) use and abstinence increased over the course of the program. Condom use remained at approximately 30% with frequent use of OCP's and condoms, condoms or abstinence. Program drop-out was common. Thirteen students became pregnant while enrolled in the program and 35% of the students were diagnosed with one or more sexually transmitted diseases. Partner-switching was common, although two or more partners within any one month was rare.
Monthly follow-up provided through SBHCs can improve contraceptive use although dropout rate and contraceptive failure remain high.
美国很少有校内健康中心（SBHC）在现场发放避孕药具，且对这些健康中心的避孕措施持续情况了解甚少。
对一个为期11个月的避孕措施持续试点项目进行了评估，该项目为巴尔的摩学校诊所的学生提供每月一次的生殖健康评估和咨询。在七个月的时间里，有143名女性自愿参加了该研究。制定了每月避孕日历，以收集有关避孕措施使用、怀孕和性传播疾病风险、性行为以及父母对避孕措施使用的支持等数据。根据需要进行身体评估，以评估是否存在性传播疾病或怀孕情况。对参加该项目前一个月以及进入项目后11个月的数据进行了分析。
在项目过程中，避孕药（口服避孕药）的使用和禁欲情况均有所增加。避孕套的使用率保持在约30%，同时经常使用口服避孕药和避孕套、仅使用避孕套或禁欲。项目退出情况很常见。13名学生在参加项目期间怀孕，35%的学生被诊断患有一种或多种性传播疾病。性伴侣更换很常见，尽管在任何一个月内有两个或更多性伴侣的情况很少见。
通过校内健康中心提供的每月随访可以改善避孕措施的使用，尽管退出率和避孕失败率仍然很高。
