Beyond safety and efficacy: sexuality-related priorities and their associations with contraceptive method selection.
Beyond safety and efficacy: sexuality-related priorities and their associations with contraceptive method selection.
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DOI：
10.1016/j.conx.2020.100038
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发表时间：
2020-01-01
期刊：
影响因子：
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通讯作者：
Sanders, Jessica N
中科院分区：
文献类型：
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作者：
Higgins, Jenny A;Wright, Kelsey Q;Sanders, Jessica N
避孕措施：在避孕选择和使用方面，与性有关的偏好没有得到充分研究。研究人员致力于评估在计划生育诊所选择新方法的患者的避孕偏好，并评估两种与性有关的偏好（a）受到重视和（B）与方法选择相关的程度。数据来自HER盐湖避孕倡议，一个纵向队列嵌套在一个准实验，在盐湖县的四个计划生育健康中心招募18-45岁患者的观察性研究。在选择新方法时，参与者报告了避孕方法选择中9个因素的重要性，其中包括两个与性有关的偏好：一种方法对性欲缺乏影响，以及缺乏性中断。分析涉及多项逻辑回归，选择方法作为结果，性相关因素作为主要解释变量，以及一系列控制和协变量。在2188名寻求新的避孕方法的人中，最常提到的相当或极其重要的因素是安全性（98%），有效性（94%），不中断性生活（81%），不影响性欲（81%）和无副作用（80%）。较少被提及的因素包括伴侣可接受性（46%），缺乏激素（39%），朋友推荐（29%）和与宗教信仰一致（11%）。多变量模型记录性相关优先级和方法selection.CONCLUSIONS：许多避孕寻求者将性相关优先级与安全性和有效性并列为非常重要，但一系列方法与人们的性优先级一致。由于患者认可性相关避孕因素的重要性（对性欲的影响，对性中断的影响）除了安全性和有效性之外，避孕研究、咨询和护理还应该关注人们的性行为。
OBJECTIVES: Sexuality-related preferences have been understudied in contraceptive selection and uptake. Investigators endeavored to assess contraceptive preferences among patients selecting new methods at family planning clinics and to evaluate the degree to which two sexuality-related preferences are (a) valued and (b) associated with method selection.STUDY DESIGN: Data were derived from the HER Salt Lake Contraceptive Initiative, a longitudinal cohort nested in a quasi-experimental, observational study enrolling 18-45-year-old patients at four family planning health centers in Salt Lake County. At the time of selecting the new method of their choice, participants reported the importance of nine factors in contraceptive method selection, including two sexuality-related preferences: a method's lack of impact on libido and its lack of sexual interruption. Analyses involved multinomial logistic regression with method selected as the outcome, sexuality-related factors as the main explanatory variables, and a range of controls and covariates.RESULTS: Among 2188 individuals seeking new contraceptive methods, the factors most frequently cited as quite or extremely important were safety (98%), effectiveness (94%), not interrupting sex (81%), not impacting libido (81%) and lack of side effects (80%). Less frequently cited factors included partner acceptability (46%), lack of hormones (39%), friend recommendation (29%) and alignment with religious beliefs (11%). Multivariate models documented no significant associations between sexual-related priorities and method selection.CONCLUSIONS: Many contraceptive seekers rank sexual-related priorities alongside safety and efficacy as very important, but a range of methods align with people's sexual priorities.IMPLICATIONS: Since patients endorse the importance of sexual-related contraceptive factors (impact on libido, impact on sexual interruption) alongside safety and efficacy, contraceptive research, counseling and care should attend to people's sexuality.