Condoms for Dual Protection: Patterns of Use with Highly Effective Contraceptive Methods
Condoms for Dual Protection: Patterns of Use with Highly Effective Contraceptive Methods
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DOI：
10.1177/003335491012500209
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发表时间：
2010-03-01
影响因子：
3.3
通讯作者：
Hogue, Carol J.
中科院分区：
文献类型：
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作者：
Pazol, Karen;Kramer, Michael R.;Hogue, Carol J.
目标。美国女性经历了计划外怀孕和性传播感染(STI)的高比率，但她们很少将避孕套与高效避孕措施结合起来，以获得最佳保护。由于口服避孕药(OCS)在美国已经成为高效避孕的主要形式，目前尚不清楚避孕套的使用率是否与日益推广的独立于使用者的方法一样低。我们使用来自全国家庭增长调查的加权数据来评估依赖OCS和用户独立方法(即注射器、宫内节育器和植入物)的女性使用避孕套的几率。我们还估计了如果目前使用单一高效方法的一半或所有女性也使用避孕套，意外怀孕和堕胎的预期减少。在基于年龄、伴侣地位、种族/民族、家庭收入和教育程度的每个人口子组中，依赖用户独立方法的女性的避孕套使用率低于OCS。针对成年女性的多变量模型还显示，与OCS相比，在大多数人口统计亚组中，依赖用户独立方法的女性使用避孕套的几率显著降低。人口估计表明，如果仅使用高效方法的所有妇女中有一半也使用避孕套，这些妇女中约40%的计划外怀孕和堕胎可以得到预防，每年减少39.3万例计划外怀孕和近7.6万例堕胎。如果所有高效的方法使用者也使用避孕套，这些妇女中大约80%的计划外怀孕和堕胎可以得到预防，每年减少78.6万例计划外怀孕和近15.2万例流产。在其他方法中添加避孕套应该被认真考虑作为预防意外怀孕和性传播感染的第一道防线。这一分析可用于针对最需要双重方法促进的干预措施。
Objectives. U.S. women experience high rates of unplanned pregnancy and sexually transmitted infections (STIs), yet they seldom combine condoms with highly effective contraceptives for optimal protection. Because oral contraceptives (OCs) have been the predominant form of highly effective contraception in the U.S., it is unknown whether condom use is similarly low with increasingly promoted user-independent methods.Methods. We used weighted data from the National Survey of Family Growth to assess condom use odds among women relying on OCs vs. user-independent methods (i.e., injectibles, intrauterine devices, and implants). We also estimated the expected reduction in unplanned pregnancies and abortions if half or all of the women currently using a single highly effective method also used condoms.Results. Across every demographic subgroup based on age, partner status, race/ethnicity, household income, and education, condom use prevalence was lower for women relying on user-independent methods vs. OCs. Multivariable models for adult women also revealed a significant reduction within most demographic subgroups in the odds of condom use among women relying on user-independent methods vs. OCs. Population estimates suggested that if half of all women using highly effective methods alone also used condoms, approximately 40% of unplanned pregnancies and abortions among these women could be prevented, for an annual reduction of 393,000 unplanned pregnancies and nearly 76,000 abortions. If all highly effective method users also used condoms, approximately 80% of unplanned pregnancies and abortions among these women could be prevented, for an annual reduction of 786,000 unplanned pregnancies and nearly 152,000 abortions.Conclusions. Adding condoms to other methods should be considered seriously as the first line of defense against unplanned pregnancy and STIs. This analysis can serve to target interventions where dual-method promotion is needed most.