title: Targeting sexual health services in primary care: A systematic review of the psychosocial correlates of adverse sexual health outcomes reported in probability surveys of women of reproductive age.
abstract: BACKGROUND
  Women using primary care vary in need for sexually transmitted infections (STIs) testing and contraception. Psychosocial correlates of these needs may be useful for targeting services. We undertook a systematic review to identify psychosocial correlates of STI acquisition, unplanned pregnancy (UP), abortion and risky sexual behaviours in general population samples of women of reproductive age.
  
  
  METHODS
  We searched bibliographic databases for probability surveys of women aged 16-44 years in the European Union, USA, Canada, Australia, UK or New Zealand undertaken January 1994-January 2014.
  
  
  RESULTS
  Eleven papers were included. Unplanned pregnancy was associated with smoking, depression, being single and sexual debut <16 years. Abortion was associated with lack of closeness to parents, leaving home at an early age, and relationship break-up. Multiple partnerships were associated with intensity of marijuana and alcohol use, and smoking. STI diagnosis was associated with relationship break-up and younger partners. Non-use of contraception was associated with smoking, obesity, relationship status, sedentary lifestyles, fatalistic pregnancy attitudes and lower alcohol use. Condom non-use was higher (at first sex) with partners 5+years older and lower (at last sex) in less stable partnerships.
  
  
  CONCLUSIONS
  Psychosocial variables, particularly relationship status and smoking, may help identify women in primary care for STI testing and contraception advice and supply.
authors.affiliation: Division of Primary Care and Public Health, Brighton & Sussex Medical School, Mayfield House, Village Way, Falmer, East Sussex BN1 9PH, UK; Centre for Health Research, University of Brighton, Mayfield House, Village Way, Falmer, East Sussex BN1 9PH, UK. Electronic address: N.Edelman@bsms.ac.uk.
authors.forename: Natalie L
authors.initials: NL
authors.lastname: Edelman
authors.affiliation: School of Psychology, Pevensey 1, University of Sussex, Brighton BN1 9RH, UK.
authors.forename: Richard O
authors.initials: RO
authors.lastname: de Visser
authors.affiliation: Centre for Sexual Health and HIV Research, University College London, 3rd Floor, Mortimer Market Centre, London WC1E 6JB, UK.
authors.forename: Catherine H
authors.initials: CH
authors.lastname: Mercer
authors.affiliation: Department of Obstetrics and Gynaecology, Leeds Teaching Hospitals NHS Trust, Beckett Street, Leeds LS9 7TF, UK.
authors.forename: Lucy
authors.initials: L
authors.lastname: McCabe
authors.affiliation: Division of Primary Care and Public Health, Brighton & Sussex Medical School, Mayfield House, Village Way, Falmer, East Sussex BN1 9PH, UK; Centre for Sexual Health and HIV Research, University College London, 3rd Floor, Mortimer Market Centre, London WC1E 6JB, UK.
authors.forename: Jackie A
authors.initials: JA
authors.lastname: Cassell
mesh_terms: D000293:Adolescent; D000328:Adult; D003267:Contraception / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D014943:Global Health; D006801:Humans; D011247:Pregnancy; D049168:Pregnancy, Unplanned / Q000523:psychology; D011320:Primary Health Care; D060728:Reproductive Health / Q000193:education*; D012309:Risk-Taking; D012725:Sexual Behavior; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000523:psychology*; D012907:Smoking; D011795:Surveys and Questionnaires
keywords: Contraception pregnancy; Review; Sexually transmitted diseases; Systematic primary health care; Unplanned psychosocial factors