Frost Jennifer J, Singh Susheela, Finer Lawrence B
Guttmacher Institute, New York, USA.
Perspect Sex Reprod Health. 2007 Jun;39(2):90-9. doi: 10.1363/3909007.
Each year, nearly one in four U.S. women at risk of unintended pregnancy experience one or more months of contraceptive nonuse. Understanding what factors are associated with risky contraceptive use patterns can inform programs and policies designed to reduce levels of unintended pregnancy.
A nationally representative sample of 1,978 adult women at risk for unintended pregnancy was surveyed over the telephone in 2004. Respondents provided information on contraceptive use over the past 12 months. Multiple logistic regressions were used to identify factors associated with different contraceptive use patterns.
Ambivalence about avoiding pregnancy was strongly associated with both contraceptive nonuse and having a gap in use while remaining at risk of unintended pregnancy (odds ratios, 2.4 and 2.0, respectively). Other significant predictors of either of these risky contraceptive behaviors were having less than a college education, being black, being 35-44 years old, having infrequent sexual intercourse, not being in a current relationship, being dissatisfied with one's method and believing that contraceptive service providers were not available to answer method-related questions (1.7-3.8).
Providers could better help women avoid unintended pregnancy by initiating regular assessments of method use difficulties, improving counseling on method choice and pregnancy risk, and identifying and assisting women at higher risk for inconsistent method use because of disadvantage, relationship characteristics or ambivalence about pregnancy prevention. In addition to providers' efforts, broader societal commitment is critical for increasing contraceptive knowledge and expanding access to contraceptive care for all women who are at risk of having an unintended pregnancy.
在美国，每年有近四分之一有意外怀孕风险的女性会经历一个或多个月未使用避孕措施的情况。了解哪些因素与危险的避孕使用模式相关，可为旨在降低意外怀孕发生率的项目和政策提供参考。
2004年，通过电话对1978名有意外怀孕风险的成年女性进行了全国代表性抽样调查。受访者提供了过去12个月的避孕使用信息。采用多元逻辑回归来确定与不同避孕使用模式相关的因素。
对避免怀孕的矛盾心理与未使用避孕措施以及在仍有意外怀孕风险的情况下出现避孕措施使用中断密切相关（优势比分别为2.4和2.0）。这些危险避孕行为中任何一种的其他重要预测因素包括：受教育程度低于大学水平、黑人、年龄在35 - 44岁之间、性交频率低、目前没有恋爱关系、对自己使用的避孕方法不满意以及认为无法获得避孕服务提供者来解答与方法相关的问题（优势比为1.7 - 3.8）。
通过定期评估避孕方法使用困难、改善避孕方法选择和怀孕风险咨询，以及识别和帮助因不利条件、恋爱关系特征或对预防怀孕的矛盾心理而更易出现避孕方法使用不一致风险的女性，医疗服务提供者可以更好地帮助女性避免意外怀孕。除了医疗服务提供者的努力外，更广泛的社会承诺对于增加避孕知识以及为所有有意外怀孕风险的女性扩大获得避孕护理的机会至关重要。
