Changes in Use of Long-Acting Reversible Contraceptive Methods Among U.S. Women, 2009-2012.
Changes in Use of Long-Acting Reversible Contraceptive Methods Among U.S. Women, 2009-2012.
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2009 年至 2012 年美国女性长效可逆避孕方法使用情况的变化。
DOI：
10.1097/aog.0000000000001094
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发表时间：
2015-11
影响因子：
7.2
通讯作者：
Finer LB
中科院分区：
文献类型：
--
作者：
Kavanaugh ML;Jerman J;Finer LB
检查2008-2010年和2011-2013年期间使用避孕措施的15-44岁女性中长效可逆避孕药（LARC）使用的当前水平、当前相关性和变化，包括宫内节育器和植入物，特别关注种族、收入和年龄与LARC使用之间的关联。我们分析了两轮全国家庭成长调查的数据，这些调查是全国15-44岁女性的代表性样本，包括2008-2010年的6，428名女性和2011-2013年的5，601名女性。我们进行了简单和多变量的逻辑回归分析，并对抽样设计进行了调整，以确定预测LARC使用的人口统计特征以及两个时间段之间这些模式的变化。在这项横断面描述性研究中，我们主要关注的结果是在访谈时所有避孕药具使用者中LARC的使用率。美国避孕女性中LARC的使用率从2009年的8.5%上升到2012年的11.6%（P<0.01）。最显著的增加发生在西班牙裔女性（从8.5%到15.1%），有私人保险的女性（7.1-11.1%），前一年性伴侣少于两个的女性（9.2-12.4%），以及未经产的女性（2.1-5.9%）（所有P<0.01）。在调整关键人口统计学特征的多变量分析中，2012年与LARC使用的最强关联是奇偶性（调整后的比值比[OR] 4.3-5.5）和有停止使用非LARC激素的历史（调整后的OR 1.9）。年龄在35-44岁之间的女性（调整OR 0.3）比同龄人更不可能成为LARC使用者（所有P<0.001）。贫困状况与LARC的使用无关。少数民族妇女和非西班牙裔白色妇女之间的不满导致LARC方法的中断没有差异。在最近的调查期间，LARC方法，特别是宫内避孕器的使用在使用者人群中几乎均匀增加。
To examine current levels, current correlates of, and changes in long-acting reversible contraceptive (LARC) use, including intrauterine devices and implants, among females aged 15–44 years using contraception between 2008–2010 and 2011–2013 with specific attention to associations between race, income, and age and their LARC use. We analyzed data from two rounds of the National Survey of Family Growth, nationally representative samples of females aged 15–44 years, consisting of 6,428 females in 2008–2010 and 5,601 females in 2011–2013. We conducted simple and multivariable logistic regression analyses with adjustments for the sampling design to identify demographic characteristics predictive of LARC use and changes in these patterns between the two time periods. In this cross-sectional, descriptive study, our primary outcome of interest was current prevalence of LARC use among all contraceptive users at the time of the interview. The prevalence of LARC use among contracepting U.S. females increased from 8.5% in 2009 to 11.6% in 2012 (P<.01). The most significant increases occurred among Hispanic females (from 8.5% to 15.1%), those with private insurance (7.1–11.1%), those with fewer than two sexual partners in the previous year (9.2–12.4%), and those who were nulliparous (2.1–5.9%) (all P<.01). In multivariable analyses adjusting for key demographic characteristics, the strongest associations with LARC use in 2012 were parity (adjusted odds ratios [ORs] 4.3–5.5) and having a history of stopping non-LARC hormonal use (adjusted OR 1.9). Women aged 35–44 years (adjusted OR 0.3) were less likely to be LARC users than their counterparts (all P<.001). Poverty status was not associated with LARC use. There were no differences in discontinuation of LARC methods resulting from dissatisfaction between minority women and non-Hispanic white women. During the most recent time period surveyed, use of LARC methods, particularly intrauterine devices, increased almost uniformly across the population of users.