The authors are with Division of Clinical Research, Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St. Louis, MO.
Am J Public Health. 2013 Oct;103(10):1857-64. doi: 10.2105/AJPH.2013.301371. Epub 2013 Aug 15.
We evaluated the impact of exposure to emotional, physical, or sexual abuse on contraceptive method selection and discontinuation.
We performed a secondary analysis of 7170 women enrolled in the Contraceptive CHOICE Project in St. Louis, Missouri, a prospective cohort study in which 9256 women were provided their preferred method of contraception at no cost from 2007 to 2011. We defined contraceptive discontinuation as device removal or nonuse for at least 4 weeks within the first 12 months after initiation.
One third of women experienced some abuse in their lifetimes. Women with an abuse history were as likely as those without to select a long-acting reversible contraceptive method and more likely to choose a contraceptive injection, the patch, or the ring. When we compared women who were abused to those who were not, rates of discontinuation at 12 months were higher among women who selected long-acting reversible contraception (17% vs 14%; P = .04) and significantly higher among women who selected non-long-acting methods (56% vs 47%; P < .001). Type of abuse did not alter the association between abuse and contraceptive continuation.
Previous experiences of abuse are associated with both contraceptive method selection and continuation.
我们评估了情感、身体或性虐待的暴露对避孕方法选择和停用的影响。
我们对密苏里州圣路易斯市避孕选择项目中的 7170 名女性进行了二次分析，这是一项前瞻性队列研究，在 2007 年至 2011 年期间，9256 名女性免费获得了她们首选的避孕方法。我们将避孕措施的停用定义为在开始后 12 个月内至少有 4 周未使用或移除避孕装置。
三分之一的女性在其一生中经历过某种形式的虐待。有虐待史的女性与没有虐待史的女性选择长效可逆避孕方法的可能性相同，而更有可能选择避孕注射、贴片或环。当我们将被虐待的女性与未被虐待的女性进行比较时，选择长效可逆避孕措施的女性在 12 个月时的停药率更高（17%比 14%；P=0.04），而选择非长效避孕方法的女性停药率显著更高（56%比 47%；P<0.001）。虐待类型并没有改变虐待与避孕持续使用之间的关系。
以前的虐待经历与避孕方法的选择和使用都有关联。
