Murray Catriona, Roke Christine
New Zealand Family Planning, PO Box 11515, Wellington 6142, New Zealand.
J Prim Health Care. 2018 Oct;10(3):201-206. doi: 10.1071/HC18024.
INTRODUCTION The Mirena®, a levonorgestrel-releasing intrauterine system (LNG-IUS), is an effective form of contraception that lasts for 5 years. In New Zealand, it is not subsidised for contraception and the device costs NZ$340 at Family Planning clinics. AIM To determine if there is a difference in the socioeconomic status and ethnicity of women who chose an LNG-IUS for contraception compared with women opting for a subsidised long-acting contraceptive (copper intrauterine device (IUD) or Jadelle® implant) or who qualified for a Special Authority Mirena® (funded by Pharmac, as treatment for heavy menstrual bleeding). METHODS All the Mirena®, Jaydess®, IUD and Jadelle® insertions that occurred at Family Planning clinics in 2015 in the Wellington region were identified. The deprivation quintile of current address and ethnicity were determined. RESULTS In the study period, 1410 devices were inserted. Of the self-funded LNG-IUSs inserted, 5% were for women with quintile 5 addresses (areas with the most deprived New Zealand Deprivation (NZDep) scores) and 28% for quintile 1 areas (least deprived NZDep scores). Of the Special Authority Mirenas® inserted, 24% were for women residing in quintile 5 areas and 19%, quintile 1 areas. Self-funded LNG-IUS were chosen by 2.5% of Māori women choosing contraception at study Family Planning clinics and no Pacific Peoples, whereas 21% of New Zealand European women chose LNG-IUS. Special Authority Mirenas® were chosen by 9.5% Māori and 9.6% Pacific Peoples compared to 4% New Zealand Europeans. DISCUSSION Māori, Pacific Peoples and women residing in quintile 5 areas chose self-funded LNG-IUSs less often than Special Authority Mirenas®. This was not the case for the other groups, who showed higher use of self-funded LNG-IUSs than Special Authority Mirenas®.
引言 曼月乐（Mirena®），一种释放左炔诺孕酮的宫内节育系统（LNG - IUS），是一种有效的避孕方式，有效期为5年。在新西兰，它在避孕方面没有补贴，在计划生育诊所该装置售价为340新西兰元。目的 确定选择LNG - IUS进行避孕的女性与选择有补贴的长效避孕方法（铜宫内节育器（IUD）或杰德环（Jadelle®）植入剂）的女性或符合特殊授权使用曼月乐（由新西兰药物基金Pharmac资助，用于治疗月经过多）的女性在社会经济地位和种族方面是否存在差异。方法 确定2015年惠灵顿地区计划生育诊所发生的所有曼月乐、杰德环、宫内节育器和杰德环植入情况。确定当前住址的贫困五分位数和种族。结果 在研究期间，共植入了1410个装置。在自费植入的LNG - IUS中，5%是为居住在五分位数5地区（新西兰贫困得分最高的地区）的女性植入的，28%是为五分位数1地区（贫困得分最低的地区）的女性植入 的。在植入的特殊授权曼月乐中，24%是为居住在五分位数5地区的女性植入的，19%是为五分位数1地区的女性植入的。在研究的计划生育诊所选择避孕的毛利女性中，2.5%选择了自费LNG - IUS，没有太平洋岛民选择，而21%的新西兰欧洲女性选择了LNG - IUS。特殊授权曼月乐的选择率在毛利女性中为9.5%，在太平洋岛民中为9.6%，而在新西兰欧洲女性中为4%。讨论 毛利人、太平洋岛民以及居住在五分位数5地区的女性选择自费LNG - IUS的频率低于特殊授权曼月乐。其他群体则不然，他们使用自费LNG - IUS的比例高于特殊授权曼月乐。
