Josephine Jacobs is a doctoral candidate, Institute of Health Policy, Management, and Evaluation, University of Toronto.
Perspect Sex Reprod Health. 2013 Sep;45(3):139-47. doi: 10.1363/4513913. Epub 2013 Aug 6.
In the United States, unintended pregnancies disproportionately affect minority populations. Persistent disparities in contraceptive use between black and Hispanic women and white women have been identified, but it is unclear whether racial and ethnic differences in use of the most effective methods have changed.
Data on 4,727 women from the 1995 National Survey of Family Growth and 5,775 women from the 2006-2010 cycle were used to examine the association between race and ethnicity and women's choice of reversible contraceptives according to level of method effectiveness. Stepwise multinomial logistic regressions were used to identify changes in this association between cycles. Analyses controlled for demographic, socioeconomic, family, religious, behavioral and geographic characteristics.
The proportion of women using the most effective reversible contraceptive methods increased from 46% in 1995 to 53% in 2006-2010. In 1995, black and Hispanic women's use of the most effective reversible contraceptives did not differ from that of white women. By 2006-2010, however, black women were substantially less likely than white women to use highly effective reversible contraceptive methods rather than no method (relative risk ratio, 0.6). An analysis that combined the two data sets and included a term for the interaction between survey year and race and ethnicity found that relative to white women, black women were less likely in 2006-2010 than in 1995 to use more effective methods rather than no method (0.6).
Further research is needed to identify factors that may be causing racial and ethnic disparities in contraceptive decisions to widen.
在美国，意外怀孕的情况不成比例地影响着少数族裔。人们已经发现，黑人女性和西班牙裔女性与白人女性在避孕措施的使用上存在持续的差异，但尚不清楚在最有效的避孕方法的使用方面，种族和民族差异是否已经发生了变化。
本研究使用了 1995 年全国家庭增长调查中的 4727 名女性和 2006-2010 年周期中的 5775 名女性的数据，根据方法有效性的不同水平，来检验种族和民族与女性选择可逆避孕方法之间的关系。采用逐步多项逻辑回归来确定两个周期之间这种关系的变化。分析中控制了人口统计学、社会经济、家庭、宗教、行为和地理特征。
使用最有效可逆避孕方法的女性比例从 1995 年的 46%增加到 2006-2010 年的 53%。1995 年，黑人女性和西班牙裔女性使用最有效的可逆避孕方法与白人女性没有区别。然而，到 2006-2010 年，黑人女性使用高度有效的可逆避孕方法而不是不采用任何避孕方法的可能性明显低于白人女性（相对风险比，0.6）。对两个数据集进行的分析并纳入了调查年份与种族和民族之间的交互项的分析发现，与白人女性相比，黑人女性在 2006-2010 年使用更有效的方法而不是不采用任何方法的可能性（0.6）低于 1995 年。
需要进一步研究，以确定可能导致避孕决策方面的种族和民族差异扩大的因素。
