Jain Aparna, Dwyer Sara Chace, Mozumdar Arupendra, Tobey Elizabeth
Aparna Jain, Sara Chace Dwyer, Elizabeth Tobey, Population Council, Washington, DC, USA.
Arupendra Mozumdar, Population Council, New Delhi, India.
Stud Fam Plann. 2021 Jun;52(2):165-178. doi: 10.1111/sifp.12150. Epub 2021 Apr 23.
Side effects are a primary reason why women stop using contraception, even though they may still want to avoid a pregnancy. The Demographic and Health Surveys (DHS), the largest source of nationally representative data on contraceptive discontinuation, only asks women who discontinued a method their reasons for discontinuation, for which side effects is an option. Yet, side effects are also experienced by continued users. Using longitudinal data collected from a cohort of contraceptive users in Odisha and Haryana, India, this study explores the effect of side effect severity and frequency on six-month discontinuation. Among women who experienced side effects of their enrollment method, 49.7 percent continued to use it by the six-month interview. Women who experienced moderate/severe side effects infrequently were 67 percent (adjusted odds ratio [AOR]: 0.33; 95 percent confidence interval [CI]: 0.16-0.64) less likely to discontinue the enrollment method compared to women who experienced moderate/severe side effects always. Women who experienced mild side effects were even less likely to discontinue (AOR: 0.15; 95 percent CI: 0.06-0.37). Study results suggest side effect severity and frequency are more important factors than simply the experience of a side effect in understanding contraceptive discontinuation. DHS and other national surveys should expand their exploration of side effects to include questions asked of current users.
副作用是女性停止使用避孕措施的主要原因，即便她们可能仍希望避免怀孕。人口与健康调查（DHS）是关于避孕措施停用情况的全国代表性数据的最大来源，该调查仅询问停用某种避孕方法的女性其停用原因，副作用是其中一个选项。然而，继续使用避孕措施的女性也会经历副作用。本研究利用从印度奥里萨邦和哈里亚纳邦的一组避孕措施使用者收集的纵向数据，探讨副作用的严重程度和发生频率对六个月内停用避孕措施的影响。在经历了其登记使用的避孕方法产生副作用的女性中，49.7%的人在六个月的访谈时仍继续使用该方法。与总是经历中度/重度副作用的女性相比，很少经历中度/重度副作用的女性停用登记使用的避孕方法的可能性低67%（调整后的优势比[AOR]：0.33；95%置信区间[CI]：0.16 - 0.64）。经历轻度副作用的女性停用的可能性甚至更低（AOR：0.15；95%CI：0.06 - 0.37）。研究结果表明，在理解避孕措施停用方面，副作用的严重程度和发生频率比仅仅是经历了副作用这一情况更为重要。人口与健康调查及其他全国性调查应扩大对副作用的探索范围，将对当前使用者的提问纳入其中。
