Prol Barbara, Klein Sarah, Rennie Christopher, Andelija Sanela
Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA.
Department of Obstetrics and Gynecology, HCA Florida Brandon Hospital, Brandon, USA.
Cureus. 2024 Jan 28;16(1):e53121. doi: 10.7759/cureus.53121. eCollection 2024 Jan.
Contraception is an important tool for helping to prevent both unintended pregnancies and sexually transmitted infections (STIs). Medical costs related to STIs are high and impose a large burden on both patients and the healthcare system. In addition, unintended pregnancies account for a large portion of pregnancies in the United States (US) and are associated with adverse maternal and infant health outcomes. Both STIs and unintended pregnancies are continuous public health concerns, and this study aims to identify patterns in contraceptive method use in relation to specific social determinants of health.
Utilizing the Centers for Disease Control and Prevention (CDC)'s 2017-2019 National Survey of Family Growth report on current contraceptive status, we isolated data from 3,572 respondents who reported using one of the following contraceptive methods: oral contraceptive pills (OCPs), male condoms, partner's vasectomy, female sterilization, withdrawal, medroxyprogesterone acetate injections (Depo-Provera), hormonal implant, or an intrauterine device (IUD). We analyzed these contraceptive methods among age, race, education, marital status, and insurance status. Data were analyzed in RStudio 2022.02.0 (RStudio Team, RStudio: Integrated Development for R. RStudio, PBC, Boston, MA) through a test of equal proportions for a significance of < 0.05. A concurrent Yates' continuity correction was performed in order to limit erroneous significant findings based on small sample sizes where applicable. The study conception and data analysis were performed independently with oversight from our preceptor at HCA Florida Brandon Hospital, Brandon, Florida.
There were statistically significant differences for all our selected methods of contraception across different age groups. There were statistically significant differences for OCPs, male condoms, partner's vasectomy, female sterilization, Depo-Provera, hormonal implant, and IUD across different race groups and different insurance statuses. There were statistically significant differences for OCPs, male condoms, partner's vasectomy, female sterilization, withdrawal, hormonal implant, and IUD across different education levels and different marital statuses.
This analysis highlights gaps that are present in female reproductive autonomy through the statistical differences in contraceptive methods across various demographics and warrants continued focus on the role that social determinants of health play in the prevention of unintended pregnancies and STIs. In order to promote fairness and equality in healthcare, it is essential to increase education on these topics both within and beyond medical settings. This effort aims to provide patients with equitable access to healthcare and attempt to address health disparities that are prevalent in multiple different sectors.
避孕是预防意外怀孕和性传播感染（STIs）的重要手段。与性传播感染相关的医疗成本高昂，给患者和医疗系统都带来了沉重负担。此外，意外怀孕在美国的怀孕总数中占很大比例，并与母婴健康不良后果相关。性传播感染和意外怀孕一直是公共卫生关注的问题，本研究旨在确定与特定健康社会决定因素相关的避孕方法使用模式。
利用疾病控制与预防中心（CDC）2017 - 2019年全国家庭成长调查中关于当前避孕状况的报告，我们从3572名报告使用以下避孕方法之一的受访者中提取数据：口服避孕药（OCPs）、男用避孕套、伴侣输精管切除术、女性绝育术、体外射精、醋酸甲羟孕酮注射剂（Depo - Provera）、激素植入物或宫内节育器（IUD）。我们分析了这些避孕方法在年龄、种族、教育程度、婚姻状况和保险状况方面的情况。数据在RStudio 2022.02.0（RStudio团队，RStudio：R集成开发环境。RStudio，PBC，马萨诸塞州波士顿）中通过比例相等检验进行分析（显著性水平<0.05）。在适用的情况下，进行了Yates连续性校正，以限制基于小样本量的错误显著结果。本研究的构思和数据分析在佛罗里达州布兰登市HCA佛罗里达布兰登医院的指导教师监督下独立进行。
我们所选的所有避孕方法在不同年龄组之间存在统计学显著差异。口服避孕药、男用避孕套、伴侣输精管切除术、女性绝育术、Depo - Provera、激素植入物和宫内节育器在不同种族组和不同保险状况之间存在统计学显著差异。口服避孕药、男用避孕套、伴侣输精管切除术、女性绝育术、体外射精、激素植入物和宫内节育器在不同教育水平和不同婚姻状况之间存在统计学显著差异。
通过不同人口统计学特征在避孕方法上的统计差异，该分析突出了女性生殖自主权方面存在的差距，并且有必要持续关注健康社会决定因素在预防意外怀孕和性传播感染中所起的作用。为了促进医疗保健中的公平和平等，在医疗环境内外增加对这些主题的教育至关重要。这项工作旨在为患者提供公平的医疗保健机会，并试图解决多个不同部门普遍存在的健康差距问题。
