Frost Jennifer J, Darroch Jacqueline E
Guttmacher Institute, New York, USA.
Perspect Sex Reprod Health. 2008 Jun;40(2):94-104. doi: 10.1363/4009408.
Pregnancies among contraceptive users account for nearly half of all unintended pregnancies and are almost entirely due to inconsistent or incorrect contraceptive use. Understanding what factors contribute to inconsistent contraceptive behavior can help efforts to reduce unintended pregnancy.
In 2004, a nationally representative sample of women aged 18-44 using reversible contraceptive methods were surveyed to examine factors associated with contraceptive choice and with inconsistent use of the pill and condoms. Bivariate and multivariate analyses were used to examine the data.
Contraceptive choice was associated with a range of socioeconomic and partnership characteristics, and with pregnancy-, method- and provider-related experiences and attitudes; inconsistent pill or condom use was associated mainly with partnership, experiential and attitudinal factors. For example, not having a college education was negatively associated with pill use (odds ratio, 0.6) and positively associated with use of long-acting methods (1.8-1.9). Women for whom avoiding pregnancy was only a little or not important had reduced odds of using the pill (0.4) and elevated odds of using other methods, such as withdrawal or periodic abstinence (4.4), and of using condoms inconsistently (2.6). Use of a method chosen mostly out of dislike of other methods was positively associated with condom use (4.0) and negatively associated with use of the pill or long-acting methods (0.4 for each). Women who were not completely satisfied with their method were more likely than others to use their method inconsistently (1.6 for pill users and 1.9 for condom users).
Greater efforts are needed to provide women and their partners with a range of method options, to facilitate selection of methods that best suit their needs and circumstances, and to identify and assist users who are dissatisfied or are having difficulties using contraceptives effectively.
使用避孕药具的女性怀孕占所有意外怀孕的近一半，几乎完全是由于避孕药具使用不规律或不正确。了解哪些因素导致避孕药具使用不规律有助于减少意外怀孕。
2004年，对全国18 - 44岁使用可逆避孕方法的女性进行了具有代表性的抽样调查，以研究与避孕方法选择以及避孕药和避孕套使用不规律相关的因素。采用双变量和多变量分析来检验数据。
避孕方法的选择与一系列社会经济和伴侣特征以及与怀孕、方法和提供者相关的经历及态度有关；避孕药或避孕套使用不规律主要与伴侣关系、经历和态度因素有关。例如，未接受大学教育与避孕药使用呈负相关（优势比为0.6），与长效方法使用呈正相关（1.8 - 1.9）。认为避免怀孕不太重要或不重要的女性使用避孕药的几率降低（0.4），使用其他方法（如体外射精或定期禁欲）的几率升高（4.4），以及不规律使用避孕套的几率升高（2.6）。因不喜欢其他方法而大多选择某种方法的使用与避孕套使用呈正相关（4.0），与避孕药或长效方法使用呈负相关（每种方法均为0.4）。对其使用方法不完全满意的女性比其他人更有可能不规律使用该方法（避孕药使用者为1.6，避孕套使用者为1.9）。
需要做出更大努力，为女性及其伴侣提供多种方法选择，以方便选择最适合其需求和情况的方法，并识别和帮助那些对避孕药具不满意或在有效使用避孕药具方面有困难的使用者。
