Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
Contraception. 2021 Jun;103(6):431-438. doi: 10.1016/j.contraception.2021.02.002. Epub 2021 Feb 12.
Advancing reproductive autonomy requires targeted strategies and interventions that address barriers to contraceptive use. The primary objective of this study is to investigate whether perceptions of low pregnancy likelihood are associated with lower likelihood of using contraception among presumably fecund, sexually active women.
We used population-based survey data of reproductive age women at risk of pregnancy collected in 2018 from Côte d'Ivoire (N = 1447), Nigeria (N = 4110), and Rajasthan, India (N = 1994). To assess one's perceived biological likelihood of pregnancy, we used 2 measures: likelihood following a single act of sex without contraception and likelihood following 1 year of regular sex without contraception. Response options included: definitely yes, maybe yes, maybe no, definitely no, and do not know. We conducted multivariable logistic regression to assess the relationship between each perception measure with odds of contraceptive use separately by country.
Perceived chance of definitely or maybe becoming pregnant after one act of sex without contraception ranged from 54.0% to 55.0% in Nigeria and Rajasthan to 80.0% in Côte d'Ivoire, while it was higher for regular sex without contraception (76.0%-85.1%). Multivariable results indicate that perceptions of pregnancy likelihood were associated with contraceptive use among presumably fecund women, with a stronger relationship observed in relation to cumulative likelihood (odds ratio 0.1-0.6) than likelihood after one act (odds ratio 0.4-0.8) and a dose-response pattern by strength of perceived chance.
Results indicate that women's use of contraception in low-resource settings is associated with their perceived likelihood of becoming pregnant after unprotected sex.
Findings suggest that understanding women's perceived likelihood of pregnancy may aid in the development of interventions to help women achieve their reproductive goals.
推进生殖自主权需要有针对性的策略和干预措施，以解决避孕使用的障碍。本研究的主要目的是调查对于低妊娠可能性的认知是否与有生育能力、有性行为的女性使用避孕措施的可能性降低有关。
我们使用了 2018 年在科特迪瓦（N=1447）、尼日利亚（N=4110）和印度拉贾斯坦邦（N=1994）从有妊娠风险的育龄妇女中收集的基于人群的调查数据。为了评估一个人对怀孕的生物学可能性的认知，我们使用了 2 个指标：没有避孕措施一次性行为后的怀孕可能性和没有避孕措施规律性行为 1 年后的怀孕可能性。回答选项包括：肯定会、可能会、可能不会、肯定不会和不知道。我们进行了多变量逻辑回归分析，以按国家分别评估每种认知指标与避孕措施使用的几率之间的关系。
在尼日利亚和拉贾斯坦邦，没有避孕措施一次性行为后肯定或可能怀孕的几率为 54.0%至 55.0%，而在科特迪瓦这一比例为 80.0%，而没有避孕措施规律性行为后的几率更高（76.0%-85.1%）。多变量结果表明，对于怀孕可能性的认知与有生育能力的女性使用避孕措施有关，与单次行为后的几率（比值比 0.4-0.8）相比，与累积几率（比值比 0.1-0.6）的关系更强，并且按照感知几率的强弱呈现出剂量反应模式。
结果表明，在资源匮乏的环境中，女性使用避孕措施与她们在无保护性行为后怀孕的可能性有关。
研究结果表明，了解女性对怀孕的可能性的认知可能有助于制定干预措施，帮助女性实现她们的生殖目标。
