Bastow Brittney, Sheeder Jeanelle, Guiahi Maryam, Teal Stephanie
University of Colorado, Department of Obstetrics and Gynecology, 12631 E. 17th Ave., Mailstop B198-2, Aurora, CO 80045, USA.
University of Colorado, Department of Obstetrics and Gynecology, 12631 E. 17th Ave., Mailstop B198-2, Aurora, CO 80045, USA.
Contraception. 2018 Jan;97(1):70-75. doi: 10.1016/j.contraception.2017.10.002. Epub 2017 Oct 12.
The objective was to determine if young women initiating long-acting reversible contraceptives (LARCs) who report new sexual partner(s) would be less likely to report use of a condom than women using short-acting reversible contraceptive (SARC) methods.
We enrolled a prospective cohort of 13-24-year-old women attending an adolescent-specific contraception clinic. Participants completed questionnaires at the contraceptive initiation visit and 6 months later. At follow-up, we asked if they had sexual intercourse with a new partner, if they had used condoms, if their condom use patterns had changed and why. We analyzed factors associated with condom use.
We enrolled 1048 women; 771 (73.6%) initiated LARC and 384 (36.6%) initiated SARC. At 6 months, 508 participants (48.5%) completed the follow-up survey: 380 LARC initiators and 128 SARC initiators. Approximately 23% of LARC initiators and 27% of SARC initiators reported a new partner. SARC initiators who had a new partner were more likely to report condom use at least one time than LARC initiators reporting a new partner [82.4% vs. 59.6%; odds ratio (OR): 3.17, 95% confidence interval (CI): 1.19-8.43]. Such condom use was 42% higher among LARC initiators who reported a new sexual partner than those without and 38% higher for SARC initiators. In multivariable logistic regression, new sexual partner [adjusted OR (aOR) 3.29, 95% CI 2.10-5.16], SARC initiation (aOR 2.08, 95% CI 1.35-3.22) and age <20 (aOR 1.68, 95% CI 1.14-2.49) were independent predictors of condom use.
While young women are less likely to report condom use in the 6 months after initiating a LARC than after initiating a short-acting method, both groups increase their condom use similarly if they report a new sexual partner.
The differential in condom use between LARC initiators and SARC initiators is likely related to their perceived need for pregnancy prevention, as both groups increase their condom use similarly if they had new sexual partners.
确定开始使用长效可逆避孕方法（LARC）且报告有新性伴侣的年轻女性与使用短效可逆避孕方法（SARC）的女性相比，报告使用避孕套的可能性是否更低。
我们招募了一个前瞻性队列，研究对象为年龄在13 - 24岁、前往青少年专用避孕诊所就诊的女性。参与者在开始避孕就诊时和6个月后完成问卷。在随访时，我们询问她们是否与新伴侣发生过性行为、是否使用过避孕套、避孕套使用模式是否改变以及原因。我们分析了与避孕套使用相关的因素。
我们招募了1048名女性；771名（73.6%）开始使用LARC，384名（36.6%）开始使用SARC。6个月时，508名参与者（48.5%）完成了随访调查：380名LARC使用者和128名SARC使用者。大约23%的LARC使用者和27%的SARC使用者报告有新伴侣。有新伴侣的SARC使用者比报告有新伴侣的LARC使用者更有可能报告至少使用过一次避孕套[82.4%对59.6%；优势比（OR）：3.17，95%置信区间（CI）：1.19 - 8.43]。报告有新性伴侣的LARC使用者中，此类避孕套使用率比没有新伴侣的LARC使用者高42%，SARC使用者高38%。在多变量逻辑回归中，新性伴侣[调整后OR（aOR）3.29，95% CI 2.10 - 5.16]、开始使用SARC（aOR 2.08，95% CI 1.35 - 3.22）和年龄<20岁（aOR 1.68，95% CI 1.14 - 2.49）是避孕套使用的独立预测因素。
虽然年轻女性开始使用LARC后的6个月内比开始使用短效方法后报告使用避孕套的可能性更低，但如果两组都报告有新性伴侣，她们的避孕套使用率增加情况相似。
LARC使用者和SARC使用者在避孕套使用上的差异可能与她们对预防怀孕的感知需求有关，因为如果两组都有新性伴侣，她们的避孕套使用率增加情况相似。
