Intimate Partner Violence and Effectiveness Level of Contraceptive Selection Post-Abortion
Intimate Partner Violence and Effectiveness Level of Contraceptive Selection Post-Abortion
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DOI：
10.1089/jwh.2018.7612
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发表时间：
2019-11-14
影响因子：
3.5
通讯作者：
Steinberg, Julia R.
中科院分区：
文献类型：
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作者：
Drew, Laura B.;Mittal, Mona;Steinberg, Julia R.
背景资料：我们研究了经历更多类型的终身亲密伴侣暴力（IPV）是否与堕胎后妇女选择的避孕方法的有效性水平独立相关。材料与方法：使用245名参加城市医院堕胎诊所的妇女的数据，我们评估了妇女是否经历过情感，身体或性IPV。妇女流产后避孕方法选择的有效性分为高（宫内节育器[IUD]和植入），中度（药丸，贴片，戒指和射击）和低（避孕套，紧急避孕，和没有）有效性。使用多项逻辑回归，我们研究了IPV经历的类型和流产后避孕方法有效性之间的关系，调整了社会人口统计学，流产前，有孩子，流产三个月，避免怀孕的重要性，在未来一年，流产前的心理困扰，以及避孕方法的有效性水平妇女计划在避孕咨询前使用。结果：27%的女性经历了两种或三种类型的IPV，35%经历了一种IPV类型，38%没有经历过IPV。与没有IPV病史的妇女相比，在其一生中经历过两种或两种以上IPV的妇女更有可能选择效果中等的避孕方法（校正比值比[AOR] = 5.23，95%置信区间[CI]：1.13-24.23，p = 0.035）和高有效性（AOR = 5.01，95%CI：1.12-22.39，p = 0.035）。结论：一生中经历过两种或两种以上IPV的妇女在流产后选择更有效的避孕方法。获得不依赖于伴侣的避孕药具，包括长效可逆避孕药具（LARC），对于经历过多种类型IPV的妇女可能特别重要。
Background: We examined whether experiencing more types of lifetime intimate partner violence (IPV) was independently associated with the effectiveness level of the contraceptive method women chose following an abortion. Materials and Methods: Using data on 245 women who were attending an urban hospital abortion clinic, we assessed whether women had ever experienced emotional, physical, or sexual IPV. Effectiveness of women's post-abortion contraceptive method selection was categorized into high (intrauterine device [IUD] and implant), moderate (pill, patch, ring, and shot), and low (condoms, emergency contraception, and none) effectiveness. Using multinomial logistic regression, we examined the relationship between number of types of IPV experienced and post-abortion contraceptive method effectiveness, adjusting for sociodemographics, prior abortion, having children, abortion trimester, importance of avoiding pregnancy in the next year, pre-abortion psychological distress, and effectiveness level of the contraceptive method women were planning to use before contraceptive counseling. Results: Twenty-seven percent (27%) of women experienced two or three types of IPV, 35% experienced one IPV type, and 38% experienced no IPV. Compared to women with no histories of IPV, women who experienced two or more types of IPV during their lifetimes were more likely to choose contraceptive methods with moderate effectiveness (adjusted odds ratio [AOR] = 5.23, 95% confidence interval [CI]: 1.13-24.23, p = 0.035) and high effectiveness (AOR = 5.01, 95% CI: 1.12-22.39, p = 0.035) than those with low effectiveness. Conclusion: Women who experienced two or more types of lifetime IPV selected more effective contraceptive methods post-abortion. Access to contraceptives that are not partner dependent, including long-acting reversible contraceptives (LARC), may be particularly important for women who have experienced multiple types of IPV.