长效可逆避孕措施和 condom 的使用：对纽约市年轻女性青少年的队列研究。
Long-acting reversible contraception and condom use: A cohort study of female adolescents and young adults in New York City.
机构信息
Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
Faculty of Psychology, Beijing Normal University, Beitaipingzhuang, Haidian District, Beijing, China.
出版信息
Contraception. 2023 Sep;125:110081. doi: 10.1016/j.contraception.2023.110081. Epub 2023 May 30.
OBJECTIVES
This study aimed to determine whether condom use varied between adolescents and young women using long-acting reversible contraception (LARC) vs non-LARC hormonal methods and assess if the initiation of LARC was associated with lower condom use.
STUDY DESIGN
This study used data from a large longitudinal study of sexually active females aged 13-25 years. Questionnaires assessed contraception, condom use, sexual history, and partner characteristics at the baseline visit and every 6 months. Log-binomial regression analyses examined associations between hormonal contraceptive methods and condom use, and the moderating effects of age and number of sexual partners. Exploratory analyses compared condom use based on partner characteristics.
RESULTS
Of 1512 participants, 1116 reported LARC or non-LARC hormonal method use during any study visit. Among baseline and new LARC users, 75.7% and 84.7% reported intrauterine device (IUD) use, respectively. Condom use at baseline among hormonal non-LARC users (37.5%) was significantly higher (p < 0.01) than LARC users (23.5%). Condom use among LARC vs non-LARC users was moderated by age in that LARC was associated with lower condom use among participants aged 13-18 years, but not those aged 19-25 years. Number of sexual partners was not a significant moderator. Among participants with increased sexually transmitted infection (STI) risk based on partner characteristics, LARC users had lower condom use compared to non-LARC users.
CONCLUSIONS
Condom discontinuation was common following initiation of LARC and hormonal non-LARC methods. However, condom use was lower in LARC users at baseline, among younger adolescents, and if partners had risk factors for STIs.
IMPLICATIONS
Condom discontinuation following initiation of highly effective contraception increases the risk of STI. Young women using LARC may be at greater risk than non-LARC users given lower condom use despite having partners with risk factors for STIs. Condom use counseling for STI protection is critical for adolescents.
目的
本研究旨在确定使用长效可逆避孕措施（LARC）与非 LARC 激素方法的青少年和年轻女性之间的 condom 使用情况是否存在差异，并评估 LARC 的开始是否与 condom 使用减少相关。
研究设计
本研究使用了一项大型纵向研究的数据分析，该研究对象为年龄在 13-25 岁之间的有性行为的女性。在基线访问和每 6 个月时，调查问卷评估了避孕、 condom 使用、性史和伴侣特征。对数二项式回归分析检查了激素避孕方法与 condom 使用之间的关联，以及年龄和性伴侣数量的调节作用。探索性分析比较了基于伴侣特征的 condom 使用情况。
结果
在 1512 名参与者中，有 1116 名报告在任何研究访问期间使用了 LARC 或非 LARC 激素方法。在基线和新 LARC 用户中，分别有 75.7%和 84.7%报告使用宫内节育器（IUD）。在基线时，激素非 LARC 用户（37.5%）的 condom 使用率明显高于 LARC 用户（23.5%）（p<0.01）。在 LARC 与非 LARC 用户中， condom 使用情况受到年龄的调节，即在 13-18 岁的参与者中，LARC 与 condom 使用减少相关，但在 19-25 岁的参与者中则没有。性伴侣数量不是一个显著的调节因素。在基于伴侣特征具有增加性传播感染（STI）风险的参与者中，与非 LARC 用户相比，LARC 用户的 condom 使用率较低。
结论
LARC 和激素非 LARC 方法开始使用后， condom 停用很常见。然而，在基线时、在年轻青少年中以及伴侣具有 STI 风险因素时，LARC 用户的 condom 使用率较低。由于具有 STI 风险因素的伴侣使用 LARC 会增加 condom 使用减少的风险，因此与非 LARC 用户相比，使用 LARC 的年轻女性可能面临更大的风险。为了 STI 保护，对青少年进行 condom 使用咨询至关重要。
Zotero 插件