Delvaux Thérèse, Jespers Vicky, Benova Lenka, van de Wijgert Janneke
Institute of Tropical Medicine, Antwerp, Belgium.
Belgian Health Care Knowledge Centre, Brussels, Belgium.
Front Glob Womens Health. 2021 Dec 14;2:799963. doi: 10.3389/fgwh.2021.799963. eCollection 2021.
Acceptability of and satisfaction with contraceptive methods are paramount for uptake and continuation. In the current context of multipurpose prevention of pregnancy and sexually transmitted diseases/HIV development, it is critical to have a better understanding of acceptability of and satisfaction with the contraceptive vaginal ring (CVR) including sexual satisfaction. The objective of this study was to review the evidence about acceptability of CVRs and general and sexual satisfaction of users. We searched PubMed, CINAHL, and Web of Science (until December 31, 2020) and selected original studies documenting actual use of hormonal CVR and explicitly addressing any of the 3 outcomes. Of a total of 1,129 records screened, 46 studies were included. Most studies ( = 43, 93%) were prospective, conducted in high-income settings ( = 35), and reported on NuvaRing use ( = 31). Overall, 27 (59%) studies included a comparison group, 38 (82%) studies used exclusively quantitative questionnaires, with qualitative only ( = 4, 9%), or mixed methods ( = 4, 9%) studies being less common. Ease of CVR insertion/removal/reinsertion was high in all the settings and improved with time of use, with qualitative studies supporting these findings. When mentioned, ring-related events were associated with discontinuation, and results on continuation of use were mixed. Among NuvaRing studies, general satisfaction (being satisfied or very satisfied) was between 80 and 90% and tended to mirror continuation. Sexual satisfaction was less commonly reported and results were mixed. Overall, limited information was provided on actual CVR experiences of women (and men) and cultural norms that may affect sexuality and CVR use. Positive aspects of acceptability of and satisfaction with CVRs were reported, but ring-related events and factors, which may affect long-term CVR use, deserve further study. More information is needed on actual experiences of women using CVRs, relationship aspects, male partner opinions, and contextual norms to better understand the acceptability of and satisfaction with CVRs.
避孕方法的可接受性和满意度对于其采用率和持续使用至关重要。在当前预防怀孕和性传播疾病/艾滋病毒发展的多用途背景下，更好地了解避孕阴道环（CVR）的可接受性和满意度，包括性满意度，至关重要。本研究的目的是回顾关于CVR可接受性以及使用者总体满意度和性满意度的证据。我们检索了PubMed、CINAHL和科学网（截至2020年12月31日），并选择了记录激素CVR实际使用情况并明确涉及这三个结果中任何一个的原始研究。在总共筛选的1129条记录中，纳入了46项研究。大多数研究（n = 43，93%）是前瞻性的，在高收入环境中进行（n = 35），并报告了NuvaRing的使用情况（n = 31）。总体而言，27项（59%）研究包括对照组，38项（82%）研究仅使用定量问卷，仅有定性研究（n = 4，9%）或混合方法研究（n = 4，9%）较少见。在所有环境中，CVR插入/取出/重新插入的难易程度都很高，并且随着使用时间的推移而改善，定性研究支持了这些发现。当被提及的时候，与环相关的事件与停用有关，关于继续使用的结果不一。在NuvaRing研究中，总体满意度（满意或非常满意）在80%至90%之间，并且往往与继续使用情况相符。性满意度的报告较少，结果不一。总体而言，关于女性（和男性）实际使用CVR的经历以及可能影响性行为和CVR使用的文化规范，所提供的信息有限。报告了CVR可接受性和满意度的积极方面，但可能影响CVR长期使用的与环相关的事件和因素值得进一步研究。需要更多关于女性使用CVR的实际经历、关系方面、男性伴侣的意见以及背景规范的信息，以更好地了解CVR的可接受性和满意度。
