Ipas Nepal, Kathmandu, Nepal.
Family Welfare Division, Ministry of Health and Population, Kathmandu, Nepal.
Contraception. 2021 Dec;104(6):623-627. doi: 10.1016/j.contraception.2021.07.009. Epub 2021 Jul 16.
We compared acceptability and continuation of Sayana Press, a subcutaneous formulation of depot-medroxyprogesteone acetate (DMPA) in a Uniject injection system, to intramuscular (IM) DMPA, among both current users of DMPA-IM and new users in Nepal.
We recruited women seeking injectable contraception at 14 public health facilities in Nepal selected for geographic diversity. We enrolled women who self-selected either Sayana Press or DMPA-IM and used structured interviews to obtain baseline demographics and assess satisfaction and continuation rates at 1, 3, and 6 months.
Seven hundred ninety-four women (71%) selected and received Sayana Press, while 318 women (28.6%) selected and received DMPA-IM. One hundred and seventy-eight (48%) women continuing Sayana Press injection reported that they experienced "no possible side effects" compared to 29 (22%) among DMPA-IM selectors during the previous 6 months. The continuation rate of Sayana Press at 6 months was higher than DMPA-IM (Sayana Press 46.5% vs DMPA-IM 34.4%; p < 0.001). Selection of Sayana Press method (OR. 1.74; 95% confidence interval 1.32-2.3) and approval from husband (OR. 1.59; 95% confidence interval 1.21-2.09) were associated with injection continuation.
Sayana Press is acceptable to women in Nepal with the preference for Sayana Press over DMPA-IM (higher proportion chose the method when counseled and given the option, better continuation).
The potential for self-injection with Sayana Press® may have implications for continuation and opportunity for future research and strategies to roll out this innovative technology must be explored.
我们比较了皮下注射醋酸甲羟孕酮储库（DMPA）的苏娜依®（一种 Uniject 注射系统）在尼泊尔的当前 DMPA-IM 用户和新用户中的可接受性和持续性，与肌内（IM）DMPA 进行比较。
我们在尼泊尔的 14 个公共卫生机构招募了正在寻求注射避孕的女性，这些机构的选择考虑了地理位置的多样性。我们招募了自我选择苏娜依®或 DMPA-IM 的女性，并使用结构化访谈获得基线人口统计学数据，并在 1、3 和 6 个月时评估满意度和持续率。
794 名女性（71%）选择并接受了苏娜依®，而 318 名女性（28.6%）选择并接受了 DMPA-IM。178 名（48%）继续使用苏娜依®注射的女性报告说，与前 6 个月内选择 DMPA-IM 的 29 名女性（22%）相比，她们“没有可能的副作用”。6 个月时苏娜依®的持续率高于 DMPA-IM（苏娜依®46.5% vs DMPA-IM 34.4%；p<0.001）。选择苏娜依®方法（OR. 1.74；95%置信区间 1.32-2.3）和获得丈夫的同意（OR. 1.59；95%置信区间 1.21-2.09）与注射的持续有关。
苏娜依®在尼泊尔的女性中是可以接受的，与 DMPA-IM 相比，女性更喜欢苏娜依®（当被咨询和给予选择时，更多的人选择该方法，持续率更高）。
苏娜依®的自我注射潜力可能对持续率产生影响，需要进一步研究和探索推出这一创新技术的机会。
