Department of Obstetrics and Gynecology, MetroHealth Medical Center, Cleveland, Ohio.
Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania.
J Womens Health (Larchmt). 2020 Jul;29(7):989-995. doi: 10.1089/jwh.2019.8036. Epub 2020 Feb 4.
We sought to compare associations of contraceptive preferences, beliefs, self-efficacy, and knowledge with use of sterilization versus other methods of contraception. This is a secondary analysis of a telephone-based survey of a nationally representative sample of women Veterans not desiring future pregnancy. Contraceptive method used at last sex was categorized as female sterilization, long-acting reversible contraception (LARC), short-acting methods, or nonprescription methods/no method. Multinomial regression models were performed to compare the association between independent variables (contraceptive preferences, beliefs, self-efficacy, and knowledge) and use of sterilization versus other contraceptive methods. Six hundred twelve women Veterans aged 18-44 years who were sexually active with men, had no history of hysterectomy or infertility, did not desire future pregnancy, and were not using male sterilization as their method of contraception were surveyed. A total of 208 women Veterans reported using female sterilization (34.0%). While method effectiveness was rated as extremely important by the majority of participants, there was no association between perceiving method effectiveness as extremely important and method selected in adjusted multinomial models. Women Veterans were more likely to use sterilization compared to hormonal methods of contraception if they reported that lack of hormones was an extremely important contraceptive method characteristic (aRRR 3.69, 95% CI 1.94-7.03). Women Veterans who strongly agreed with the belief that birth control decisions are mainly a woman's responsibility were less likely to use sterilization compared to LARC (aRRR 0.54, 95% CI 0.29-0.98). Associations between contraceptive preferences, beliefs, self-efficacy, and knowledge and use of sterilization in a population of women Veterans not desiring future pregnancy are complex, and decisions may not solely be driven by desire to select a highly effective method.
我们旨在比较避孕偏好、信念、自我效能感和知识与使用绝育与其他避孕方法之间的关联。这是一项针对不希望未来怀孕的女性退伍军人进行的基于电话的全国代表性样本调查的二次分析。上一次性行为中使用的避孕方法分为女性绝育、长效可逆避孕（LARC）、短效方法或非处方方法/无方法。使用多项回归模型比较独立变量（避孕偏好、信念、自我效能感和知识）与使用绝育与其他避孕方法之间的关联。共调查了 612 名年龄在 18-44 岁之间、与男性发生性行为、没有子宫切除术或不孕史、不希望未来怀孕且不使用男性绝育作为避孕方法的活跃女性退伍军人。共有 208 名女性退伍军人报告使用女性绝育（34.0%）。虽然大多数参与者认为方法有效性非常重要，但在调整后的多项回归模型中，认为方法有效性非常重要与所选方法之间没有关联。如果女性退伍军人认为缺乏激素是避孕方法的一个非常重要的特征，那么与使用激素避孕方法相比，她们更有可能使用绝育（ARR 3.69，95%CI 1.94-7.03）。强烈认同避孕决策主要是女性责任的信念的女性退伍军人与 LARC 相比，使用绝育的可能性较低（ARR 0.54，95%CI 0.29-0.98）。在不希望未来怀孕的女性退伍军人群体中，避孕偏好、信念、自我效能感和知识与绝育的使用之间的关联是复杂的，并且决策可能不仅仅是由选择高度有效的方法的愿望所驱动。
