Frederiksen Brittni N, Ahrens Katherine
Kaiser Family Foundation, San Francisco, CA.
University of Southern Maine, Muskie School of Public Service, Portland, ME.
Contracept X. 2020 Jul 11;2:100033. doi: 10.1016/j.conx.2020.100033. eCollection 2020.
To describe characteristics of U.S. contraceptive non-users to inform tailored contraceptive access initiatives.
We used National Survey of Family Growth data from 2011 to 2017 to identify characteristics of contraceptive non-users compared to other women ages 15-44 at risk for unintended pregnancy. We also examined reasons for not using contraception by when non-users expected their next birth. We calculated unadjusted and adjusted prevalence ratios using two definitions of contraceptive non-use: (1) contraceptive non-use during the interview month, and (2) a more refined definition based on contraception use during the most recent month of sexual intercourse and expectation of timing of next birth. We considered p-values < 0.05 statistically significant.
Approximately 20% ( = 2844) of 12,071 women at risk of unintended pregnancy were classified as standard contraceptive non-users. After adjusting for all other variables, non-users were more likely to be low-income, uninsured, never married, expect a birth within 2 years, and have zero or one parity. The top reasons for contraceptive non-use were not minding if they got pregnant (22.6%), worried about contraceptive side effects (21.0%), and not thinking they could get pregnant (17.6%). After applying the more refined non-user definition, we identified 5.7% ( = 721) of women as non-users; expecting a birth within 2-5 years and having a parity of one were associated with non-use after adjustment of all other factors.
Our more refined definition of non-users could be used in future studies examining the causes of unintended pregnancy and to inform programmatic interventions to reduce unintended pregnancy.
Describing contraceptive non-users and reasons for contraceptive non-use could help us better understand reasons for unintended pregnancy and inform tailored contraceptive access initiatives.
描述美国非避孕使用者的特征，为针对性的避孕服务举措提供参考。
我们使用了2011年至2017年全国家庭成长调查数据，以确定非避孕使用者相较于其他15 - 44岁有意外怀孕风险的女性的特征。我们还根据非使用者预期的下次生育时间，研究了不使用避孕措施的原因。我们使用两种非避孕使用定义计算了未调整和调整后的患病率比：（1）访谈当月未使用避孕措施；（2）基于最近一次性交时的避孕使用情况和预期下次生育时间的更精确定义。我们认为p值<0.05具有统计学意义。
在12,071名有意外怀孕风险的女性中，约20%（n = 2844）被归类为标准非避孕使用者。在对所有其他变量进行调整后，非使用者更有可能低收入、未参保、从未结婚、预计在2年内生育，且生育次数为零或一次。不使用避孕措施的首要原因是不介意是否怀孕（22.6%）、担心避孕副作用（21.0%）以及认为自己不会怀孕（17.6%）。应用更精确的非使用者定义后，我们确定5.7%（n = 721）的女性为非使用者；在调整所有其他因素后，预计在2至5年内生育且生育次数为一次与非使用相关。
我们对非使用者的更精确定义可用于未来研究意外怀孕的原因，并为减少意外怀孕的项目干预提供参考。
描述非避孕使用者及其不使用避孕措施的原因有助于我们更好地理解意外怀孕的原因，并为针对性的避孕服务举措提供参考。
