Estudio y valoración de la salud sexual y reproductiva en mujeres ingresadas en instituciones penitenciarias españolas

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Justo Aznar
Julia Lozano
Marcelino Pérez

Resumen

En este artículo se evalúa el conocimiento y uso de los métodos contraceptivos y el aborto en una muestra de 528 mujeres internas en distintos centros penitenciarios españoles. Se comprueba que la gran mayoría de ellas tienen un adecuado conocimiento de dichos métodos y que aproximadamente un 90% los han utilizado alguna vez. Igualmente se evalúa la relación entre su uso y diversos parámetros sociodemográficos, así como las razones por las que utilizan un método contraceptivo determinado. Se constata que aproximadamente un 75% de las internas utilizan estos métodos por prescripción médica. Solamente un 21% de las mujeres ha sufrido algún efecto secundario negativo tras el uso de los contraceptivos, pero generalmente de carácter moderado. En cuanto a la percepción de la seguridad del método que utilizan prácticamente el 79% manifiestan que es seguro.

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Aznar, J., Lozano, J., & Pérez, M. (2020). Estudio y valoración de la salud sexual y reproductiva en mujeres ingresadas en instituciones penitenciarias españolas. Medicina Y Ética, 29(4), 1097–1124. Recuperado a partir de https://revistas.anahuac.mx/index.php/bioetica/article/view/423
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Biografía del autor/a

Justo Aznar, Universidad Católica de Valencia

Doctor en Medicina. Director del Instituto de Ciencias de la Vida de la Universidad Católica de Valencia.

Citas

1. GENERAL SECRETARIAT OF PENITENTIARY INSTITUTIONS. Prison population distribution
by gender…
2. STATE OFFICIAL NEWSLETTER. Organic Law 1/1979, September 26, General Penitentiary.
October 5, 1979, nº 239.
3. GENERAL SECRETARIAT OF PENITENTIARY INSTITUTIONS. Prison regulations.
4. STATE OFFICIAL NEWSLETTER. Organic Law 14/1986, of April 25, General Health.
April 29, 1986, nº 102.
5. STATE OFFICIAL NEWSLETTER. Organic Law 13/1995, of December 18 about
the modification of the General Penitenciary Organic Law. December 19,1995,
nº 302.
6. STATE OFFICIAL NEWSLETTER. Organic Law 10/1995, November 23, of the Penal
Code. November 24, 1995, nº 281.
7. STATE OFICIAL NEWSLETTER. 2/2006, of May 3, of Education. May 4, 2006,
nº 106.
8. RAINE T, MINNIS AM, PADIAN NS. Determinants of contraceptive method among
Young women at risk for unintended pregnancy and sexually transmitted infections.
Contraception. 2003; 68: p. 19-25.
9. FROST JJ, SINGH S, FINER LB. Factors associated with contraceptive use and
nonuse, United States, 2004. Perspect Sex Reprod Health. 2007; 39: p. 90-9.
10. JONES J, MOSHER W, DANIELS K. Current contraceptive use in the United
States, 2006-2010, and changes in patters of use since 1995. National health
statistics reports. 2012; 18: p. 1-25.
11. WU J, MELDRUM S, DOZIER A, STANWOOD N, FISCELLA K. Contraceptive nonuse
among US women at risk for unplanned pregnancy. Contraception. 2008; 78:
p. 284-9.
12. DEHLENDORF C, PARK SY, EMEREMNI CA, COMER D, VINCETT K, BORRERO S. Racial/
ethnic disparities in contraceptive use: variation by age and women’s reproductive
experiences. Am J Obstet Gynecol. 2014; 210: p. 526.e1-e.9.
13. DEHLENDORF C, RODRÍGUEZ MI, LEVY K, BORRERO S, STEINAUER J. Disparities
in family planning. Am J of Obstet Gynecol. 2010; 202: p. 214-20.
14. KAYE K, SUELLENTROP K, SLOUP C. The Fog Zone: how misperceptions,
magical thinking, and ambivalence put young adults at risk for unplanned pregJ.
Lozano, M. Pérez, J. Aznar
1120 Medicina y Ética 2018/4
nancy. Washington DC: National campaign to prevent teen and unintended
pregnancy; 2009.
15. GUENDELMAN S, DENNY C, MAULDON J, CHETKOVICH C. Perceptions of hormonal
contraceptive safety and side effects among low-income Latina and non-Latina
women. Mater child health J. 2000; 4: p. 233-9.
16. SANGI-HAGHPEYKAR H, ALI N, POSNER S, POINDEXTER AN. Disparities in contraceptive
knowledge, attitude and use between Hispanic and non-Hispanic whites.
Contraception. 2006; 74: p. 125-32.
17. UNDERSTAND, INSTITUTE OF MEDICINE (US) COMMITTEE ON; STITH, A Y; NELSON, AR;
EDS. Unequal treatment: confronting racial and ethnic disparities in health. 2003.
18. TODD S, SOMMERS B. Overview of the uninsured in the United States: a summary
of the 2012 current population survey report. ASPE. Office of the assistant
secretary for planning and evaluation, Department of health and human services;
2012.
19. ARMSTRONG K, RAVENELL KL, MCMURPHY S, PUTT M. Racial/ethnic differences
in physician distrust in the United States. Am J Public Health. 2007; 97: p. 1283-9.
20. BECKER D, TSUI AO. Reproductive health service preferences and perceptions
of quality among low-income women: racial, ethnic and language group differences.
Perspectives on Sex Reprod Health. 2008; 40: p. 202-11.
21. FORREST JD, FROST JJ. The family planning attitudes and experiences of lowincome
women. Fam Plann Perspec. 1996; 28: p. 246-55, 77.
22. DOWNING RA, LAVEIST TA, BULLOCK HE. Intersections of ethnicity and social
class in provider advice regarding reproductive health. Am J Publ Health. 2007;
97: p. 1803-7.
23. WINNER B, PEIPERT JF, ZHAO Q, ET AL. Effectiveness of long-acting reversible
contraception. N Engl J Med. 2012; 366: p. 1998-2007.
24. HATCHER RA TJNACWSFKD. Contraceptive technology. 19th ed. New York: Ardent
Media; 2007.
25. KAUNITZ AM, DARNEY PD, ROSS D, WOLTER KD, SPEROFF L. Subcutaneous
DMPA vs intramuscular DMPA: a 2-year randomized study of contraceptive efficacy
and bone mineral density. Contraception. 2009; 80: p. 7-17.
26. TRUSSELL J. Contraceptive failure in the United States. Contraception. 2011;
83: p. 397-404.
27. KOST K, SINGH S, VAUGHAN B, TRUSSELL J, BANKOLE A. Estimates of contraceptive
failure from the 2002 National survey of family growth. Contraception. 2008;
77: p. 10-21.
28. AMERICAN COLLEGE OF OBSTETRICIANS AND GYNECOLOGISTS. Increasing use of
contraceptive implants and intrauterine devices to reduce unintended pregnancy.
ACOG Committee Opinion no. 450. Obstet Gynecol. 2009; 114: p. 1434-8.
29. AMERICAN COLLEGE OF OBSTETRICIANS AND GYNECOLOGISTS. Adolescents and
long-acting reversible contraception: implants and intrauterine devices. ACOG
Committee Opinion no. 539. Obstet Gynecol. 2012; 120: p. 938-8.
30. CHAMPION CB, BEHLILOVIC B, AROSEMENA JM, RANDIC L, COLE LP, WILKENS LR.
Study of sexual health in women in spanish penitentiary institutions
Medicina y Ética 2018/4 1121
A three-year evaluation of TCu 380 Ag and multiload Cu 375 intrauterine devices.
Contraception. 1988; 38: p. 631-9.
31. ROSENBERG MJ, WAUGH MS. Oral contraceptive discontinuation: a prospective
evaluation of frequency and reasons. American J Obstet Gynecol. 1998; 179: p.
577-82.
32. VAUGHAN B, TRUSSELL J, KOST K, SINGH S, JONES R. Discontinuation and
resumption of contraceptive use: results from the 2002 National survey of family
growth. Contraception. 2008; 78: p. 271-83.
33. NAESS IA, CHRISTIANSEN SC, ROMUNDSTAD P, CANNEGIETER SC, ROSENDAAL FR,
HAMMERSTROM J. Incidence and mortality of venous thrombosis: a population-based
study. J Thromb Haemos. 2007; 5: p. 692-9.
34. VANDENBROUCKE JP, KOSTER T, BRIËT E, REITSMA PH, BERTINA RM, ROSENDAAL
FR. Increased risk of venous thrombosis in oral-contraceptive users who are carriers
of factor V Leiden mutation. Lancet. 1994; 344: p. 1453-7.
35. VAN HYLCKAMA VLIEG A, HELMERHORST FM, VANDENBROUCKE JP, DOGGEN CJ,
ROSENDAAL FR. The venous thrombotic risk of oral contraceptives, effects of oestrogen
dose and progestogen type: results of the MEGA case-control study. Brit
Med J. 2009; 339: p. b2921.
36. LIDEGAARD Ø, LØKKEGAARD E, SVENDSEN AL, AGGER C. Hormonal contraception
and risk of venous thromboembolism: national follow-up study. Brit Med J.
2009; 339: p. b2890.
37. PARKIN L, SHARPLES K, HERNANDEZ RK, JICK SS. Risk of venous thromboembolism
in users of oral contraceptives containing drospirenone or levonorgestrel:
nested case-control study based on UK General Practice Research Database. Brit
Med J. 2011; 342: p. d2139.
38. JICK SS, HERNANDEZ RK. Risk of non-fatal venous thromboembolism in women
using oral contraceptives containing drospirenone compared with women using
oral contraceptives containing levonorgestrel: case-control study using United States
claims data. Brit Med J. 2011; 342: p. d2151.
39. LIDEGAARD Ø, NIELSEN LH, SKOVLUND CW, SKJELDESTAD FE, LØKKEGAARD E.
Risk of venous thromboembolism from use of oral contraceptives containing different
progestogens and oestrogen doses: Danish cohort study, 2001-9. Brit Med J.
2011; 343: p. d6423.
40. STEGEMAN BH, DE BASTOS M, ROSENDAAL FR, ET AL. Different combined oral
contraceptives and the risk of venous thrombosis: systematic review and network
meta-analysis. Brit Med J. 2013; 347: p. f5298.
41. VINOGRADOVA Y, COUPLAND C, HIPPISLEY-COX J. Use of combined oral contraceptives
and risk of venous thromboembolism: nested case-control studies using
the QResearch and CPRD databases. Brit Med J. 2015; 350: p. h2135.
42. PERAGALLO URRUTIA R, COEYTAUX RR, MCBROOM AJ, GIERISCH JM, HAVRILESKY
LJ, MOORMAN PG, ET AL. Risk of acute thromboembolic events with oral contraceptive
use: a systematic review and meta-analysis. Obstet Gynecol. 2013; 122: p.
380-9.
J. Lozano, M. Pérez, J. Aznar
1122 Medicina y Ética 2018/4
43. SITRUK-WARE R. Hormonal contraception and thrombosis. Fertil Steril. 2016;
106: p. 1289-1294.
44. VAN HYLCKAMA VLIEG A, HELMERHORST FM, VANDENBROUKE JP, DOGGEN CJ,
ROSENDAAL FR. The venous thrombosic risk of oral contraceptives, effects of oestrogen
dose and progestogen type: results of the MEGA case-control study. Brit
Med J. 2009; 339: p. b2921.
45. VINOGRADOVA Y, COUPLAND C, HIPPISLEY-COX J. Use of combined oral contraceptives
and risk of venous thromboembolism: nested case-control studies using
the QResearch and CPRD databases. Brit Med J. 2015; 350: p. h2135.
46. WEILL A, DALICHAMPT M, RAGUIDEAU F, RICORDEAU P, BLOTIÈRE PO, RUDANT J,
ET AL. Low dose oestrogen combined oral contraception and risk of pulmonary
embolism, stroke, and myocardial infarction in five million French women: cohort
study. Brit Med J. 2016; 353: p. i2002.
47. HEIT JA, SPENCER FA, WHITE RH. The epidemology of venous thromboembolism.
J Thromb Thrombolysis. 2016; 41: p. 3-14.
48. AZNAR J, MIRA Y, VAYÁ A. Oral contraceptives and thrombosis. Clin Appl
Thromb Haemost. 2004; 10: p. 189-190.
49. SHORTRIDGE E, MILLER K. Contraindications to oral contraceptive use among
women in the United States, 1999-2001. Contraception. 2007; 75: p. 355-60.
50. XU H, EISENBERG DL, MADDEN T, SECURA GM, PEIPERT JF. Medical contraindications
in women seeking combined hormonal contraception. Am J of Obstet Gynecol.
2014; 210: p. 210.e1-5.
51. AZNAR J, VAYÁ A, ESTELLÉS A, MIRA Y, SEGUÍ R, VILLA P, ET AL. Risk of venous
thrombosis in carriers of the prothrombin G20210A variant and factor V Leiden
and their interaction with oral contraceptives. Haematologica. 2000; 85: p. 1271-
1276.
52. BELLER JP, MCCARTNEY CR. Cardiovascular risk and combined oral contraceptives:
clinical decisions in settings od uncertainty. Am J Obstet Gynecol. 2013;
208: p. 39- 41.
53. WORLD HEALTH ORGANIZATION. Medical eligibility for contraceptive use. In 3rd ,
editor. ; 2004; Geneva.
54. AMERICAN COLLEGE OF OBSTETRICIANS AND GYNECOLOGISTS. ACOG practice bulletin
no.73: use of hormonal contraception in women with coexisting medical conditions.
Obstet Gynecol. 2006; 107: p. 1453-72.
55. KELLY T, SUDDES J, HOWEL D, HEWISON J, ROBSON S. Comparing medical versus
surgical termination of pregnancy at 13-20 weeks of gestation: a randomised
controlled trial. Brit J Obstet Gynecol. 2010; 117: p. 1512-20
56. COWETT AA, GOLUB RM, GROBMAN WA. Cost-effectiveness of dilation and evacuation
versus the induction of labor for second-trimester pregnancy termination.
Am J Obstet Gynecol. 2006; 194: p. 768-73.
57. WHITLEY KA, TRINCHERE K, PRUTSMAN W, QUIÑONES JN, ROCHON ML. Midtrimester
dilation and evacuation versus prostaglandin induction: a comparison of
composite outcomes. Am J Obstet Gynecol. 2011; 205: p. 386.
Study of sexual health in women in spanish penitentiary institutions
Medicina y Ética 2018/4 1123
58. BRYANT AG, GRIMES DA, GARRETT JM, STUART GS. Second-trimester abortion
for fetal anomalies or fetal death: labor induction compared with dilation and evacuation.
Obstet Gynecol. 2011; 117: p. 788-92.
59. GROSSMAN D, BLANCHARD K, BLUMENTHAL P. Complications after second
trimester surgical and medical abortion. Reprod Health Matt. 2008; 16 (31 Suppl):
p. 173-82.
60. GRIMES DA, SMITH MS, WHITAM AD. Mifepristone and misoprostol versus dilation
and evacuation for midtrimester abortion: a pilot randomised controlled trial.
Brit J Obstet Gynecol. 2004; 111: p. 148-53.
61. NIINIMÄKI M, SUHONEN S, MENTULA M, HEMMINKI E, HEIKINHEIMO O, GISSLER M.
Comparison of rates of adverse events in adolescent and adult women undergoing
medical abortion: population register based study. Brit Med J. 2011; 342:
p. d2111.
62. DEPARTMENT OF HEALTH. Abortion statistics, England and Wales: 2009.2010.
2009-2010.
63. SOCIALSTYRELSEN. Statistics.2010. ; 2010.
64. NATIONAL INSTITUTE FOR HEALTH AND WELFARE. Induced abortions. 2010.
65. GOMPERTS RJ, JELINSKA K, DAVIES S, GEMZELL-DANIELSSON K, KLEIVERDA G.
Using telemedicine for termination of pregnancy with mifepristone and misoprostol
in settings where there is no access to safe services. Brit J Obstet Gynecol. 2008;
115: p. 1171-1178.
66. VON HERTZEN H, PIAGGIO G, WOJDYLA D, HUONG NTM, MARIONS L, OKOEV G, ET
AL. Comparison of vaginal and sublingual misoprostol for second trimester abortion:
randomized controlled equivalence trial. Hum Reprod. 2009; 24: p. 106-112.
67. GARY MM, HARRISON DJ. Analysis of Severe Adverse Events Related to the
Use of Mifepristone as an Abortifacient. Ann Pharmacoth. 2006; 40: p. 191-197.
68. BORGATTA L, KAPP N. Society of family planning. Clinical guidelines. Labor
induction abortion in the second trimester. Contraception. 2011; 84: p. 4-18.
69. HOLMES LB. Teratogen-induced limb defects. Am J Med Genet. 2002; 112: p.
297-303.
70. FONSECA W, ALENCAR AJC, MOTA FSB, COELHO HLL. Misoprostol and congenital
malformations. Lancet. 1991; 338: p. 56.
71. GONZALEZ CH, MARQUES-DIAS MJ, KIM CA, SUGAYAMA SMM, DA PAZ JA, HUSON
SM, ET AL. Congenital abnormalities in Brazilian children associated with misoprostol
misuse in first trimester of pregnancy. Lancet. 1998; 351: p. 1624.
72. BARNETT AA. Mifepristone clears US regulatory hurdle. Lancet. 1996; 348:
p. 256.
73. BOS-THOMPSON MA, HILLAIRE-BUYS D, ROUX C, FAILLIE JL, AMRAM D. Möbius
Syndrome in a Neonate After Mifepristone and Misoprostol Elective Abortion Failure.
Ann Pharmacoth. 2008; 42: p. 888-892.
74. COELHO KE, SARMENTO M, VEIGA CM, SPECK-MARTINS CE, SAFATLE HPN, CASTRO
CV, ET AL. Misoprostol embryotoxicity: Clinical evaluation of fifteen patients
with arthrogryposis. Am J of Med Genet. 2000; 95: p. 297-301.
J. Lozano, M. Pérez, J. Aznar
1124 Medicina y Ética 2018/4
75. BLANCHARD K, WINIKOFF B, ELLERTSON C. Use of Misoprostol during Pregnancy
and Möbius’ Syndrome in Infants. N England J Med. 1998; 339: p. 1553-1554.
76. FISCHER M, BHATNAGAR J, GUARNER J, REAGAN S, HACKER JK, VAN METER SH,
ET AL. Fatal Toxic Shock Syndrome Associated with Clostridium sordellii after Medical
Abortion. N England J Med. 2005; 353: p. 2352-2360.
77. IN BRIEF. FDA reports that two US women died after abortion pill regimen. Brit
Med J. 2006; 332: p. 684