Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.
Melbourne Sexual Health Centre, Melbourne, Victoria, Australia.
Cult Health Sex. 2021 Aug;23(8):1153-1164. doi: 10.1080/13691058.2020.1758344. Epub 2020 Jul 9.
Young women in Australia disproportionately experience unintended pregnancy and sexually transmissible infections (STIs). As the promotion of highly effective pregnancy prevention methods such as long-acting reversible contraception (LARC) increases, concurrent use of condoms with LARC remains optimal for pregnancy and STI prevention. There is little data exploring condom use behaviour in young Australian women using LARC. In this qualitative study we interviewed twenty women using LARC about their experiences of making decisions regarding condom use. We used inductive thematic analysis to identify factors influencing participant decision-making. We found that while LARC had an impact on condom use and sexual practices, decisions regarding condom use were influenced by multiple factors including mood, menstrual changes related to LARC, and relationship dynamics. Participants' views of 'safe sex' extended beyond pregnancy and STI protection, to include desired outcomes such as pleasure, consent and communication. Access to STI testing and treatment was key to how participants managed STI risk. Findings highlight the need for a more comprehensive approach to safer sex health promotion, and the importance of ensuring STI testing and treatment services continue to be available and accessible to all young people.
澳大利亚的年轻女性不成比例地经历意外怀孕和性传播感染（STIs）。随着长效可逆避孕（LARC）等高效避孕方法的推广增加，同时使用避孕套和 LARC 仍然是预防怀孕和 STI 的最佳选择。几乎没有数据探索使用 LARC 的澳大利亚年轻女性的避孕套使用行为。在这项定性研究中，我们采访了 20 名使用 LARC 的女性，了解她们在决定使用避孕套时的经验。我们使用归纳主题分析来确定影响参与者决策的因素。我们发现，虽然 LARC 对避孕套使用和性行为有影响，但避孕套使用的决定受到多种因素的影响，包括情绪、与 LARC 相关的月经变化以及关系动态。参与者对“安全性行为”的看法不仅限于怀孕和 STI 保护，还包括如愉悦、同意和沟通等期望结果。获得 STI 检测和治疗是参与者管理 STI 风险的关键。研究结果强调需要采取更全面的方法来促进安全性行为健康，并确保 STI 检测和治疗服务继续向所有年轻人提供和可及。
