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Today there are more than one billion 10-19 year olds 70% of whom live in developing nations. They are growing up with greater access to formal education an increasing need for computer skills and Internet literacy different job opportunities and more exposure to new ideas through media telecommunications and other avenues. The environment in which young people are making decisions related to sexual and reproductive health is also rapidly evolving. Rates of sexual initiation during young adulthood are rising or remaining unchanged in many developing countries; childbearing and marriage are increasingly unlinked; and in many countries high HIV prevalence adds to the risks associated with early sexual activity.

CONTEXT: A wealth of data exist on knowledge attitudes and practice related to contraceptive use; however emotional aspects of relationships that may influence reproductive decision making are often overlooked. METHODS: Data from the 2010 Family Health and Wealth Survey were used in bivariate and multinomial logistic regression analyses to identify associations between relationship quality and current contraceptive use among 698 married or cohabiting couples in Kumasi Ghana. Four scales measuring commitment trust constructive communication and destructive communication as well as a question about relationship satisfaction were the indicators of relationship quality. Current contraceptive use was divided into three categories: no use reliance on a method that can be used without the partners awareness (the injectable pill IUD implant and diaphragm) and use of a method that both partners are typically aware of (periodic abstinence withdrawal condoms and spermicide). RESULTS: Overall contraceptive use was low-22% of women said they were currently using any method. In general respondents reported high levels of relationship quality. Womens relationship satisfaction scores were positively associated with use of awareness methods rather than nonuse (relative risk ratio 1.2). Mens trust scores were positively associated with use of nonawareness methods rather than nonuse (1.1) and mens constructive communication scores were associated with use of both types of method rather than nonuse (1.1 for each). CONCLUSIONS: Couples relationship quality appears to be an important element in their decision making regarding contraceptive use and should be taken into consideration in the design and implementation of family planning programs and policy.

CONTEXT: The literature on intimate partner violence in resource-poor contexts relies primarily on cross-sectional studies. Because changes in women’s status and empowerment are hypothesized to influence violence vulnerability, longitudinal studies are needed to determine the potential benefits and harms associated with such changes. METHODS: Data were collected prospectively from a representative cohort of 4,749 married women in rural areas of four socially and demographically diverse states in India in 1998–1999 and 2002–2003. A multinomial regression model including social and demographic characteristics and intersurvey changes and events related to functional autonomy and reproduction was fitted to a categorical outcome measuring the absence (reference), initiation, cessation and continuation of intimate partner violence. RESULTS: Continued freedom of movement, increased freedom of movement and continued financial autonomy between baseline and follow-up were associated with a lower risk of violence initiation rather than no violence (relative risk ratio, 0.7 for each). Having a first child was associated with lower risk of violence initiation and continuation rather than no violence (0.6 and 0.2, respectively). Women who reported that their relative economic contribution to the household decreased or increased and women who experienced an unwanted pregnancy had a higher risk of violence continuation rather than no violence (1.8, 1.8 and 1.5, respectively). The death of a child was associated with higher risk of violence initiation rather than no violence (1.4). CONCLUSION: Future research to inform interventions to reduce intimate partner violence should consider how changes in women’s reproductive experiences and functional autonomy may be linked to changes in intimate partner violence.

Despite restrictive social norms, there is increasing evidence that youth in India engage in premarital romantic and sexual partnerships. However, information on how they initiate and build these relationships is scarce, even though it is vital for addressing the needs of young people.Attitudes toward and behavior within romantic partnerships were examined using data collected in 2004 from unmarried youth (583 males and 475 females, aged 15-19) living in economically disadvantaged neighborhoods in Delhi, India. Associations between specific attitudes or behaviors and age, gender and sexual experience were determined using Fisher's exact tests.Sixty-two percent of males and 53% of females reported that someone of the opposite sex had expressed an interest in them; 86% of males and 63% of females reported feeling good about it. In addition, 67% of males and 47% of females reported that they liked someone from the opposite sex. Compared with females, males were more likely to seek information about the person they were interested in (76% vs. 61%), and to engage in heterosexual premarital sex (32% vs. 6%). Females were less likely than males to report that it is okay to engage in premarital sex if the male and female love one another (14% vs. 33%). For both males and females, television and films were the most popular source of information on issues related to sexual health.Gender disparities in premarital romantic partnership formation and the experience of sexual relations make a strong case for sexuality education programs tailored to the different experiences and circumstances of young men and women.