Public Health Unit, Department of Clinical Sciences, School of Medicine, The Copperbelt University, Ndola, Zambia.
Department of Population Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia.
Eur J Contracept Reprod Health Care. 2021 Jun;26(3):255-260. doi: 10.1080/13625187.2021.1874335. Epub 2021 Feb 8.
Developing countries have seen an increase in the use of hormonal contraception due to its high efficacy in preventing pregnancy. Our study assessed risk compensation among single women of reproductive age using hormonal contraception.
The study used data from a nationally representative, cross-sectional sample of the 2018 Zambia Demographic and Health Survey (DHS). Study participants ( = 2151) were single, sexually active women aged 15-49 years, of whom 595 were using hormonal contraception.
Hormonal contraception was used by 26% of participants, 81% of whom reported they had not used a condom every time they had sexual intercourse ( < .001). Sexually transmitted infections (STIs) were reported in 4% of hormonal contraceptive users, compared with 2% of non-hormonal contraceptive users ( = .036). The odds of condom use at each occurrence of sexual intercourse were lower for: hormonal contraceptive users (adjusted odds ratio [OR] 0.62; 95% confidence interval [CI] 0.48, 0.80); women aged 15-19 years (adjusted OR 0.62; 95% CI 0.36, 1.08) and 20-24 years (adjusted OR 0.56; 95% CI 0.33, 0.95); women with no education (adjusted OR 0.33; 95% CI 0.16, 0.69) and primary education (adjusted OR 0.62; 95% CI 0.42, 0.94); women in the low wealth quintile (adjusted OR 0.46; 95% CI 0.36, 0.61); and women who had one or more children (adjusted OR 0.59; 95% CI 0.45, 0.77).
Lack of knowledge about hormonal contraception predisposes women to sexual risk behaviour. As hormonal contraception is very effective in preventing unwanted pregnancy, and condoms are effective in reducing the risk of STI transmission, the use of both (dual protection) should be encouraged.
由于激素避孕在预防妊娠方面的高效性，发展中国家使用激素避孕的比例有所增加。本研究评估了使用激素避孕的育龄单身女性的风险补偿行为。
本研究使用了 2018 年赞比亚全国代表性的横断面样本，即人口与健康调查（DHS）的数据。研究参与者（ = 2151）为 15-49 岁的、有过性行为的、单身女性，其中 595 名正在使用激素避孕。
26%的参与者使用了激素避孕，其中 81%的人报告说每次性行为都没有使用避孕套（ < .001）。报告称有 4%的激素避孕使用者患有性传播感染（STIs），而非激素避孕使用者为 2%（ = .036）。在每次性行为中使用避孕套的可能性较低的情况包括：激素避孕使用者（调整后的优势比[OR]为 0.62；95%置信区间[CI]为 0.48，0.80）；15-19 岁（调整后的 OR 为 0.62；95% CI 为 0.36，1.08）和 20-24 岁（调整后的 OR 为 0.56；95% CI 为 0.33，0.95）；未受过教育（调整后的 OR 为 0.33；95% CI 为 0.16，0.69）和接受过小学教育（调整后的 OR 为 0.62；95% CI 为 0.42，0.94）；在低财富五分位数的女性（调整后的 OR 为 0.46；95% CI 为 0.36，0.61）；以及有一个或多个孩子的女性（调整后的 OR 为 0.59；95% CI 为 0.45，0.77）。
缺乏对激素避孕的了解会使女性更容易发生性行为风险。由于激素避孕在预防意外怀孕方面非常有效，而避孕套在降低性传播感染风险方面也很有效，因此应该鼓励同时使用这两种方法（双重保护）。
