title: Young women and their reproductive health needs in a family practice setting: factors influencing care seeking in Vitoria, Brazil.
abstract: BACKGROUND
  Young women often have diverse options for addressing their reproductive health and other health needs in urban settings. In Brazil, they may access care through the government-run Family Health Program (FHP). Understanding factors associated with service utilization can enhance access to and delivery of appropriate services.
  
  
  OBJECTIVE
  To describe demographic, behavioural and clinical characteristics of young women accessing services through FHP in Vitória, Brazil.
  
  
  METHODS
  From March to December 2006, women aged 18-29 years were recruited into a population-based, household survey. Responses were analysed to assess previous 6 months utilization of FHP services in this population and characteristics associated with accessing care through this public family practice model.
  
  
  RESULTS
  Of 1200 eligible women identified, 1029 enrolled (85.7%). Median age was 23 (interquartile range 20-26) years, 42.7% were married or cohabitating with a male partner. A majority (72%) accessed FHP services in the preceding 6 months, principally for routine and gynaecological visits. Factors independently associated with seeking FHP included: ever tested for human immunodeficiency virus, using anal sex as contraceptive method and reporting a current vaginal discharge. Prior commercial sex work, previous diagnosis with an sexually transmitted infection or using oral sex as a contraceptive method were associated with less use of FHP services.
  
  
  CONCLUSIONS
  A public option for delivery of FHP has attracted wide utilization across a cross-section of young women in Vitoria, Brazil. Greater sensitization to specific practices and needs of this population, especially around reproductive health, could further enhance the services provided by family practitioners.
authors.affiliation: Medicina Social, Universidade Federal do Espirito Santo, Vitoria, Espirito Santo 29040-091, Brazil. espinosa@ndi.ufes.br
authors.forename: Angelica E
authors.initials: AE
authors.lastname: Miranda
authors.forename: Michael E
authors.initials: ME
authors.lastname: St Louis
authors.forename: Ninive C
authors.initials: NC
authors.lastname: Figueiredo
authors.forename: Ildes
authors.initials: I
authors.lastname: Milbratz
authors.forename: Kimberly
authors.initials: K
authors.lastname: Page-Shafer
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil; D005194:Family Practice; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D020380:Needs Assessment / Q000458:organization & administration*; D010342:Patient Acceptance of Health Care; D018456:Reproductive Medicine; D014505:Urban Population; D055815:Young Adult