Firman Nicola, Palmer Melissa J, Timæus Ian M, Wellings Kaye
Life Course Epidemiology and Biostatistics, Population, Policy and Practice Programme, Great Ormond Street Institute of Child Health, University College London, London, UK.
Centre for Sexual and Reproductive Health Research, London School of Hygiene and Tropical Medicine, London, UK.
BMJ Sex Reprod Health. 2018 May 25;44(3):165-74. doi: 10.1136/bmjsrh-2017-200037.
One in six pregnancies in Britain are unplanned. An understanding of influences on contraceptive method choice is essential to provision compatible with users' lifestyles. This study describes contraceptive method use by age, and relationship status and duration, among women in Britain.
Data from women participating in the third British National Survey of Sexual Attitudes and Lifestyles were used to describe contraceptive use grouped as: unreliable method or none; barrier methods; oral/injectable hormonal methods; and long-acting reversible contraception. A total of 4456 women at risk of pregnancy were used to examine associations between contraception use, age, relationship type and duration. Age-stratified odds ratios for contraceptive use by relationship type and duration were estimated using binary logistic regression.
Some 26.0% of 16-49-year-olds used hormonal contraception as their usual method. Use of hormonal and barrier methods was highest in the youngest age group and decreased with age; the reverse was true for use of unreliable methods or none. Barrier method use was higher in short-term relationships among younger participants; this was not seen among older respondents. Duration was more strongly associated with usual contraceptive method than relationship type; this pattern was more marked among younger participants.
Asking about relationship status and duration may help providers support women's contraceptive use by considering their priorities and preferences at different life stages. Interactions between relationship characteristics, age and contraception are complex, and bear closer scrutiny both in research and in policy and practice.
在英国，六分之一的怀孕是意外怀孕。了解影响避孕方法选择的因素对于提供符合用户生活方式的避孕措施至关重要。本研究描述了英国女性按年龄、恋爱关系状态和时长划分的避孕方法使用情况。
来自参与第三次英国全国性态度与生活方式调查的女性的数据，用于描述避孕方法的使用情况，分为：不可靠方法或未采取避孕措施；屏障法；口服/注射激素法；以及长效可逆避孕法。共有4456名有怀孕风险的女性被用于研究避孕措施使用、年龄、恋爱关系类型和时长之间的关联。使用二元逻辑回归估计按恋爱关系类型和时长划分的不同年龄组避孕措施使用的优势比。
在16 - 49岁的女性中，约26.0%的人将激素避孕作为常用方法。激素法和屏障法在最年轻年龄组的使用率最高，并随年龄增长而下降；不可靠方法或未采取避孕措施的使用情况则相反。在较年轻参与者的短期恋爱关系中，屏障法的使用率更高；在年龄较大的受访者中未观察到这种情况。时长比恋爱关系类型与常用避孕方法的关联更强；这种模式在较年轻参与者中更为明显。
询问恋爱关系状态和时长可能有助于医疗服务提供者通过考虑女性在不同生活阶段的优先事项和偏好来支持她们使用避孕措施。恋爱关系特征、年龄和避孕之间的相互作用很复杂，在研究以及政策和实践中都需要更仔细的审视。
