Higgins Jenny A, Wang Yu
Department of Gender and Women's Studies, University of Wisconsin-Madison, 3414 Sterling Hall, 475 North Charter St, Madison WI 53706, USA.
Department of Sociology, University of Wisconsin-Madison, 4412 William Sewell Social Sciences, 1180 Observatory Drive, Madison WI 53706, USA.
Contraception. 2015 Apr;91(4):320-7. doi: 10.1016/j.contraception.2014.12.005. Epub 2014 Dec 19.
Use of withdrawal (coitus interruptus) has consequences for reproductive health, but few nationally representative studies exist. We (1) examined patterns of withdrawal among 15- to 24-year-old women and men, and (2) explored withdrawal's associations with sociodemographic, psychological, and sexual factors.
Using data from the 2006-2010 National Survey of Family Growth, we assessed reports of any and only withdrawal use at last sexual episode in the last month from 3517 sexually active 15 to 24 year-old women and men at risk of unintended pregnancy. Logistic regression documented associations with withdrawal.
Fourteen percent of young women and 17% of young men reported any use of withdrawal at last sex; 7% and 6%, respectively, reported only use of withdrawal. Though associated with few sociodemographic factors, withdrawal was significantly linked with pregnancy- and condom attitudes. In regression models, compared to those who said they would be upset if they discovered they were pregnant, young women who said they would be pleased about a pregnancy were 2.2-2.6 times as likely to have used any/only withdrawal (p<.01). For both women and men, those who felt that condoms were likely to diminish sexual pleasure were more likely to have used any/only withdrawal (odds ratio=1.8-2.6, p<.05).
At their last sexual episode, a greater proportion of young adults used withdrawal in conjunction with other methods than by itself. The psychological and sexual variables of orientation toward pregnancy and attitudes about condoms and pleasure were more strongly linked with withdrawal practices than most sociodemographic variables.
Since a substantial minority of young adults use withdrawal, providers may wish to speak directly to contraceptive clients about this method, though they should distinguish between only versus any withdrawal use. Practitioners may also be well served by assessing and responding to pregnancy orientation and pleasure attitudes in contraceptive counseling.
采用体外射精法（性交中断法）会对生殖健康产生影响，但全国性的代表性研究较少。我们（1）调查了15至24岁女性和男性的体外射精模式，（2）探讨了体外射精与社会人口学、心理和性因素之间的关联。
利用2006 - 2010年全国家庭成长调查的数据，我们评估了3517名有意外怀孕风险、年龄在15至24岁且最近一个月有过性活动的女性和男性在最近一次性交中使用体外射精的情况，包括仅使用体外射精和同时使用其他方法。逻辑回归分析记录了与体外射精相关的因素。
14%的年轻女性和17%的年轻男性报告在最近一次性交中使用过体外射精；仅使用体外射精的比例分别为7%和6%。尽管体外射精与少数社会人口学因素有关，但它与对怀孕和避孕套的态度显著相关。在回归模型中，与那些表示如果发现自己怀孕会心烦意乱的年轻女性相比，那些表示对怀孕感到高兴的年轻女性使用体外射精（包括仅使用或同时使用其他方法）的可能性是前者的2.2至2.6倍（p<0.01）。对于女性和男性来说，那些认为避孕套可能会降低性快感的人更有可能使用体外射精（包括仅使用或同时使用其他方法）（优势比 = 1.8至2.6，p<0.05）。
在最近一次性交中，更多的年轻人将体外射精与其他方法结合使用，而非单独使用。与大多数社会人口学变量相比，对怀孕的态度以及对避孕套和性快感的态度等心理和性变量与体外射精行为的关联更为紧密。
由于有相当一部分年轻人使用体外射精法，医疗服务提供者可能希望直接与避孕客户讨论这种方法，但他们应区分仅使用体外射精和同时使用其他方法的情况。在避孕咨询中，评估并回应客户对怀孕的态度和对性快感的看法，可能会对从业者有所帮助。
