title: Factors influencing young Malians' reluctance to use hormonal contraceptives.
abstract: During a qualitative evaluation of three peer-education programs in urban Mali, young people stated that they were wary of using either the pill or injectable contraceptives because they believed that these methods would make them sterile. Unmarried women's contraceptive decisionmaking was not primarily driven by a current need to limit fertility, but rather by a future need to maximize it in order to gain status through childbearing in their marital households. Further interviews explored notions of conception, menstruation, and the perceived action of hormonal methods on the reproductive system. Findings revealed that menstrual disruption (in the form of amenorrhea or prolonged bleeding) appeared to have dire repercussions, including accusations of witchcraft and immoral behavior that could result in a woman's being divorced or in her husband's acquiring an additional wife. The social consequences of side effects were perceived to be more important than their biological manifestations, and together with the fear of sterility, resulted in a preference for the condom.
authors.affiliation: Centre for Population Studies, London School of Hygiene & Tropical Medicine, 49-51 Bedford Square, London WC1B 3DP. sarah.castle@lshtm.ac.uk
authors.forename: Sarah
authors.initials: S
authors.lastname: Castle
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000208:ethnology* / Q000523:psychology; D000328:Adult; D000568:Amenorrhea / Q000523:psychology; D001291:Attitude of Health Personnel; D017280:Condoms / Q000706:statistics & numerical data; D003267:Contraception / Q000379:methods* / Q000523:psychology; D003268:Contraception Behavior / Q000208:ethnology* / Q000523:psychology; D003271:Contraceptive Agents, Female / Q000627:therapeutic use; D003278:Contraceptives, Oral, Hormonal / Q000627:therapeutic use; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007246:Infertility / Q000523:psychology; D007267:Injections; D007407:Interviews as Topic; D008297:Male; D008302:Mali; D017258:Medroxyprogesterone Acetate / Q000627:therapeutic use; D008598:Menstruation / Q000523:psychology
chemical_list: D003271:Contraceptive Agents, Female; D003278:Contraceptives, Oral, Hormonal; D017258:Medroxyprogesterone Acetate