Freilich Karen, Holton Sara, Rowe Heather, Kirkman Maggie, Jordan Lynne, McNamee Kathleen, Bayly Christine, McBain John, Sinnott Vikki, Fisher Jane
a Jean Hailes Research Unit , Monash University , Melbourne , Australia.
b Family Planning Victoria , Melbourne , Australia.
Eur J Contracept Reprod Health Care. 2017 Jun;22(3):212-221. doi: 10.1080/13625187.2017.1304534. Epub 2017 May 11.
Unintended pregnancy and abortion may, in part, result from suboptimal use of effective contraception. This study aimed to identify sociodemographic factors associated with the use of effective and less effective methods among women and men of reproductive age living in Australia.
In a cross-sectional national survey, 1544 women and men aged 18-51 were identified as being at risk of pregnancy. Chi-square and logistic regression analyses were used to assess the sociodemographic factors related to contraceptive use.
Most respondents (n = 1307, 84.7%) reported using a method of contraception. Use of any contraceptive was associated with being born in Australia (Odds Ratio [OR] 1.89; 95% Confidence Interval [CI]1.186, 3.01; p = .008), having English as a first language (OR 1.81; 95% CI: 1.07, 3.04; p = .026), having private health insurance (OR 2.25; 95% CI 1.66, 3.04; p < .001), and not considering religion important to fertility choices (OR 0.43; 95%CI 0.31, 0.60; p < .001). A third used effective contraceptive methods (n = 534, 34.6%; permanent methods: 23.1%, and long-acting reversible contraception (LARC): 11.4%). Permanent methods were more likely to be used in rural areas (OR 0.62; 95%CI 0.46, 0.84; p = .002). Use of the least effective, short-term methods was reported by nearly half (condoms: 25.6%, withdrawal: 12.5%, and fertility-awareness-based methods: 2.8%). Those who relied on withdrawal were more likely to live in a metropolitan area (OR 2.85; 95% CI 1.95, 4.18; p < .001), and not have private health insurance (OR 0.52; 95% CI 0.38, 0.71; p < .001).
Targeted promotion of the broad range of available contraceptives may raise awareness and uptake of more effective methods and improve reproductive autonomy in certain population groups.
意外怀孕和堕胎可能部分归因于有效避孕措施使用不当。本研究旨在确定澳大利亚育龄男女中与有效和低效避孕方法使用相关的社会人口学因素。
在一项全国性横断面调查中,1544名年龄在18 - 51岁的男女被确定为有怀孕风险。采用卡方检验和逻辑回归分析来评估与避孕措施使用相关的社会人口学因素。
大多数受访者(n = 1307,84.7%)报告使用了某种避孕方法。使用任何避孕措施与出生在澳大利亚(优势比[OR] 1.89;95%置信区间[CI]1.186,3.01;p = 0.008)、以英语为第一语言(OR 1.81;95% CI:1.07,3.04;p = 0.026)、拥有私人医疗保险(OR 2.25;95% CI 1.66,3.04;p < 0.001)以及不认为宗教对生育选择很重要(OR 0.43;95%CI 0.31,0.60;p < 0.001)有关。三分之一的人使用有效避孕方法(n = 534,34.6%;永久性方法:23.1%,长效可逆避孕法(LARC):11.4%)。永久性方法在农村地区使用的可能性更高(OR 0.62;95%CI 0.46,0.84;p = 0.002)。近一半的人报告使用了效果最差的短期避孕方法(避孕套:25.6%,体外射精:12.5%,基于生育意识的方法:2.8%)。那些依赖体外射精的人更有可能居住在大都市地区(OR 2.85;95% CI 1.95,4.18;p < 0.001),且没有私人医疗保险(OR 0.52;95% CI 0.38,0.71;p < 0.001)。
有针对性地推广各种可用的避孕方法可能会提高对更有效方法的认识和采用率,并改善某些人群的生殖自主权。