Keck School of Medicine of the University of Southern California, Los Angeles, CA, United States.
Section of Family Planning, Department of Obstetrics and Gynecology, Keck School of Medicine of the University of Southern California, Los Angeles, CA, United States; Division of Family Planning, Department of Obstetrics and Gynecology, University of California Irvine School of Medicine, Irvine, CA, United States.
Contraception. 2021 Aug;104(2):170-175. doi: 10.1016/j.contraception.2021.04.005. Epub 2021 Apr 11.
Limited research and guidance on the use of "withdrawal" or coitus interruptus for contraception lead to inconsistent or even inaccurate physician recommendations regarding its use. Consequently, patients rely on online communities to learn about this commonly used contraceptive method. To identify knowledge gaps and concerns between men and women, as well as explore how they use withdrawal, we examined withdrawal-related posts on the popular internet discussion forum, Reddit.
To explore gendered variations in withdrawal-related Reddit posts, we extracted posts from the gendered forums: "TwoXChromosomes," "Askwomen," "Askmen," and "OneY" between 2010 and 2019 that contained the search terms: "coitus interruptus," "withdrawal," "pull out," "preejaculate," or "precum." We developed an initial codebook with expected codes and augmented it with emerging findings from a random sampling of 10% of posts. We revised iteratively for interrater agreement, after which researchers coded the remaining posts independently.
Of 269 withdrawal-related queries, 19% were submitted by men; 81% referenced the contributor's own withdrawal use. Salient domains included: concerns about pregnancy risk (59%), how to effectively use withdrawal (13%), benefits/pleasure from using withdrawal (12%), impact on personal life/relationship (9%), and problems encountered, inclusive of consent (7%). Posts to female-focused forums more frequently inquired about pregnancy risk, while those on male forums more frequently inquired about withdrawal-related logistics (p < 0.001); domains were not associated with contributor gender.
Withdrawal-related queries within this Reddit sample are frequently posted by women, the majority of whom want to understand their risk of pregnancy with withdrawal. Research operationalizing withdrawal and more accurately estimating withdrawal-related pregnancy risk is warranted.
Reddit users discuss their personal experiences with withdrawal as contraception, as well as seek advice regarding its use from the online community. Pregnancy risk, logistics of use, and ongoing stigma are salient topics. Further research on pregnancy risk, operationalizing success, and approaches for discussing this behavioral method is warranted.
关于“体外排精”或中断性交作为避孕方法的使用，相关研究和指导有限，导致医生对此的建议不一致，甚至不准确。因此，患者依赖于在线社区来了解这种常用的避孕方法。为了确定男性和女性之间的知识差距和关注点，并探讨他们如何使用体外排精，我们研究了流行的互联网讨论论坛 Reddit 上与体外排精相关的帖子。
为了探索与体外排精相关的 Reddit 帖子中的性别差异，我们从以下性别论坛中提取了帖子：2010 年至 2019 年间的“TwoXChromosomes”、“Askwomen”、“Askmen”和“OneY”，其中包含搜索词：“coitus interruptus”、“withdrawal”、“pull out”、“preejaculate”或“precum”。我们制定了一个初始代码本，其中包含预期的代码，并从 10%的帖子中随机抽样得出的新发现中进行了扩充。我们反复修订以达到评分者间的一致性，之后研究人员独立对其余帖子进行了编码。
在 269 个与体外排精相关的查询中，19%是男性提交的；81%提到了贡献者自己使用体外排精的情况。突出的领域包括：对怀孕风险的担忧（59%）、如何有效地使用体外排精（13%）、使用体外排精的好处/乐趣（12%）、对个人生活/关系的影响（9%）以及遇到的问题，包括同意（7%）。女性关注论坛上的帖子更频繁地询问怀孕风险，而男性关注论坛上的帖子更频繁地询问与体外排精相关的后勤问题（p<0.001）；领域与贡献者的性别无关。
在这个 Reddit 样本中，与体外排精相关的查询经常由女性发布，其中大多数人希望了解她们在使用体外排精时怀孕的风险。有必要对体外排精进行研究并更准确地估计体外排精相关的怀孕风险。
Reddit 用户讨论他们个人使用体外排精作为避孕的经验，以及向在线社区寻求关于其使用的建议。怀孕风险、使用的后勤问题和持续的污名化是突出的话题。进一步研究怀孕风险、操作成功以及讨论这种行为方法的方法是必要的。
