Henley Catherine, Jenner Eric, Richardson Barbra, Falk Gretchen, Leger Rebekah, Heffron Renee
The Policy & Research Group, New Orleans, LA, United States.
The Policy & Research Group, New Orleans, LA, United States.
Contraception. 2023 Feb;118:109897. doi: 10.1016/j.contraception.2022.09.135. Epub 2022 Oct 12.
To describe use of non-barrier contraceptives over a 9-month period, consistency in method use, and identify factors associated with method nonuse, switching, and consistency among Latina adolescents attending California sexual and reproductive health (SRH) centers.
We conducted a cohort study using data self-reported at baseline, and 3- and 9-months post-baseline. The analysis included 1162 sexually active adolescents aged 18 to 19 who self-identified as female and Latina, indicated that they were not currently pregnant or trying to become pregnant, and who attended California SRH centers between June 2016 and June 2020. We used binomial generalized multivariable linear models with a log link to assess the likelihood of nonbarrier method consistency, switching, and non-use.
At baseline, 453 of 1162 (39%) of respondents were using short-acting methods (pill, patch, ring, or injection), 113 of 1162 (9.7%) were using long-acting methods (implants or intrauterine devices [IUDs]), and 596 of 1162 (51.3%) reported using neither short- nor long-acting methods. Over a 9-month period, 22/33 (66.7%) of those using IUDs consistently used the method, which was a statistically greater frequency of consistency than individuals who selected other nonbarrier methods (270/530 [50.9%], aRR: 1.40; 95% CI: 1.11, 1.77). Implant users had rates of method consistency similar to users of other nonbarrier methods (aRR: 1.11; 95% CI: 0.89, 1.38). Factors independently associated with method consistency included being older, having never been pregnant, having greater perceived risk of pregnancy, and greater contraceptive knowledge.
Sexually active Latina adolescents attending California SRH centers who were not trying to become pregnant maintained consistent contraceptive use more frequently when using an IUD. Using a patient-centered approach, contraceptive counseling for Latina adolescents can describe the combined efficacy and contraceptive stability offered by IUDs should patients desire it.
This study addressees gaps in knowledge about U.S. Latina adolescents' contraceptive use patterns. We demonstrate that IUD users, and not implant users, appear more likely to consistently use their method than those using non-LARC methods. Patient-centered contraceptive counseling for Latina adolescents can describe the greater contraceptive stability that IUDs may offer.
描述9个月期间非屏障避孕方法的使用情况、方法使用的一致性,并确定与加利福尼亚州性与生殖健康(SRH)中心的拉丁裔青少年不使用避孕方法、更换避孕方法以及使用一致性相关的因素。
我们进行了一项队列研究,使用基线时以及基线后3个月和9个月时自我报告的数据。分析纳入了1162名年龄在18至19岁之间、自我认定为女性且为拉丁裔的性活跃青少年,他们表示目前未怀孕且未试图怀孕,并且在2016年6月至2020年6月期间前往加利福尼亚州的SRH中心就诊。我们使用具有对数链接的二项式广义多变量线性模型来评估非屏障方法使用一致性、更换方法以及不使用的可能性。
在基线时,1162名受访者中有453人(39%)使用短效方法(避孕药、避孕贴、避孕环或注射剂),1162人中有113人(9.7%)使用长效方法(植入剂或宫内节育器[IUD]),1162人中有596人(51.3%)报告既未使用短效方法也未使用长效方法。在9个月的时间里,使用IUD的人群中有22/33(66.7%)持续使用该方法,这一使用一致性频率在统计学上高于选择其他非屏障方法的人群(270/530[50.9%],调整后风险比:1.40;95%置信区间:1.11,1.77)。植入剂使用者的方法使用一致性率与其他非屏障方法使用者相似(调整后风险比:1.11;95%置信区间:0.89,1.38)。与方法使用一致性独立相关的因素包括年龄较大、从未怀孕、感知到的怀孕风险较高以及避孕知识更丰富。
在加利福尼亚州SRH中心就诊的、未试图怀孕的性活跃拉丁裔青少年在使用IUD时更频繁地保持一致的避孕措施使用。采用以患者为中心的方法,对于拉丁裔青少年的避孕咨询可以根据患者需求描述IUD所提供的综合效果和避孕稳定性。
本研究填补了关于美国拉丁裔青少年避孕使用模式知识方面的空白。我们证明,与使用非长效可逆避孕方法(LARC)的人群相比,IUD使用者而非植入剂使用者似乎更有可能持续使用其避孕方法。针对拉丁裔青少年的以患者为中心的避孕咨询可以描述IUD可能提供的更高的避孕稳定性。