Anglewicz Philip, Larson Elizabeth, Akilimali Pierre, Guiella Georges, Kayembe Patrick, Kibira Simon P S, Makumbi Fredrick, Radloff Scott
Johns Hopkins Bloomberg School of Public Health, Department of Population, Family and Reproductive Health.
School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo.
Contracept X. 2021 Jan 20;3:100055. doi: 10.1016/j.conx.2021.100055. eCollection 2021.
To what extent is DMPA-SC reaching new users versus encouraging method switching among existing users? Though increasingly-popular, little is known about characteristics of women using DMPA-SC in SSA. We compared characteristics of women using DMPA-SC with those of other modern methods, and identified the extent to which women using DMPA-SC switched from another method or are first-time users of contraception.
We used data collected by the Performance Monitoring for Action (PMA) Project between 2016 and 2019 from three countries, Burkina Faso, Democratic Republic of Congo, and Uganda. We tabulated characteristics of DMPA-SC, DMPA-IM, implant, and male condom users, and used multivariate analysis to compare characteristics of women using DMPA-SC those of the other three methods. We also examined previous contraceptive method use (if any) among women currently using DMPA-SC.
We found that never-married women were more likely to use male condoms instead of DMPA-SC. Women with two or more children (compared to no children or one child) were more likely to use implants instead of DMPA-SC in both Uganda and DRC. DMPA-SC was the first method used by the majority of current users in Burkina Faso and Uganda. DMPA-SC users who previously used another method generally switched from less effective methods.
Although the characteristics of women using DMPA-SC varied across countries, DMPA-SC appears to be reaching new populations of women instead of inspiring existing modern users to switch to DMPA-SC, and appears to be appealing to first time users of contraception.
It appears that DMPA-SC appeals to new contraceptive users in sub-Saharan Africa, which implies that DMPA-SC may have the potential to increase modern contraceptive prevalence in sub-Saharan African countries.
与鼓励现有使用者更换避孕方法相比，皮下埋植剂（DMPA-SC）在拓展新使用者方面的成效如何？尽管皮下埋植剂越来越受欢迎，但在撒哈拉以南非洲地区（SSA）使用该方法的女性特征却鲜为人知。我们比较了使用皮下埋植剂的女性与使用其他现代避孕方法的女性的特征，并确定了使用皮下埋植剂的女性从其他方法转换而来或首次使用避孕方法的比例。
我们使用了“行动绩效监测”（PMA）项目在2016年至2019年期间从布基纳法索、刚果民主共和国和乌干达三个国家收集的数据。我们将皮下埋植剂、肌肉注射用醋酸甲羟孕酮（DMPA-IM）、宫内节育器和男用避孕套使用者的特征制成表格，并使用多变量分析来比较使用皮下埋植剂的女性与其他三种方法使用者的特征。我们还调查了目前使用皮下埋植剂的女性之前的避孕方法使用情况（如有）。
我们发现，未婚女性更有可能使用男用避孕套而非皮下埋植剂。在乌干达和刚果民主共和国，有两个或更多孩子的女性（与没有孩子或只有一个孩子的女性相比）更有可能使用宫内节育器而非皮下埋植剂。在布基纳法索和乌干达，大多数当前使用者首次使用的方法是皮下埋植剂。之前使用过其他方法的皮下埋植剂使用者通常是从不太有效的方法转换而来。
尽管不同国家使用皮下埋植剂的女性特征有所不同，但皮下埋植剂似乎在拓展新的女性群体，而非促使现有的现代避孕方法使用者转而使用皮下埋植剂，并且似乎对首次使用避孕方法的人有吸引力。
皮下埋植剂似乎对撒哈拉以南非洲地区新的避孕使用者有吸引力，这意味着皮下埋植剂可能有潜力提高撒哈拉以南非洲国家的现代避孕普及率。
