Beshar Isabel, So Jodi Y, Shaw Kate A, Cahill Erica P, Shaw Jonathan Glazer
Obstetrics & Gynecology, Stanford University, Stanford, California, USA
School of Medicine, Stanford University, Stanford, California, USA.
BMJ Sex Reprod Health. 2025 Jan 6;51(1):43-50. doi: 10.1136/bmjsrh-2024-202372.
Male permanent contraception (PC), that is, vasectomy, is an effective way of preventing pregnancy. In the United States, male PC use has historically been concentrated among higher-educated/higher-income males of White race. In the last decade, use of long-acting reversible contraception (LARC) has increased dramatically. We sought to understand how sociodemographic patterns of male PC have changed in the context of rising LARC use.
We examined the nationally representative male public use files of the National Survey for Family Growth (NSFG) across five survey waves. Our outcome was primary contraceptive use at last sexual encounter within 12 months. Using four-way multinomial logistic regressions (male PC, female PC, LARC, lower-efficacy methods), we compared sociodemographic factors predictive of male PC use versus reported partner LARC use between 2006-2010 (early) and 2017-2019 (recent) waves.
We included 15 964 participants. From 2006 to 2019, there were absolute declines in male PC from 8.0% to 6.8%, while male-reported partner LARC use increased three-fold, from 3.4% to 11.0%. Among the highest economic strata, use of LARC converged with male PC. In adjusted analyses, high income significantly associated with male PC use in the early wave (OR 4.6 (1.4, 14.8)), but no longer in the recent wave (OR 0.9 (0.2, 4.2)). Marital status remained a significant but declining predictor of male PC across survey waves, and instead, by 2019, number of children newly emerged as the strongest predictor of male PC use.
Sociodemographic variables associated with vasectomy use are evolving, especially among high-income earners.
男性永久性避孕（PC），即输精管切除术，是预防怀孕的一种有效方法。在美国，男性使用永久性避孕方法的情况历来集中在白人种族中受过高等教育/高收入的男性群体。在过去十年中，长效可逆避孕法（LARC）的使用急剧增加。我们试图了解在长效可逆避孕法使用增加的背景下，男性永久性避孕的社会人口统计学模式是如何变化的。
我们检查了全国家庭生育调查（NSFG）具有全国代表性的男性公共使用档案，涵盖五个调查周期。我们的结果是在过去12个月内最后一次性接触时的主要避孕方法使用情况。我们使用四项多项逻辑回归（男性永久性避孕、女性永久性避孕、长效可逆避孕法、低效能方法），比较了2006 - 2010年（早期）和2017 - 2019年（近期）调查周期中，预测男性使用永久性避孕方法与报告的伴侣使用长效可逆避孕法的社会人口统计学因素。
我们纳入了15964名参与者。从2006年到2019年，男性使用永久性避孕方法的比例从8.0%绝对下降到6.8%，而男性报告的伴侣使用长效可逆避孕法的比例增加了两倍，从3.4%增至11.0%。在最高经济阶层中，长效可逆避孕法的使用与男性永久性避孕方法的使用趋于一致。在调整分析中，高收入在早期调查周期与男性使用永久性避孕方法显著相关（比值比4.6（1.4，14.8）），但在近期调查周期不再相关（比值比0.9（0.2，4.2））。婚姻状况在各调查周期中仍然是男性使用永久性避孕方法的一个显著但逐渐下降的预测因素，到2019年，孩子数量新成为男性使用永久性避孕方法的最强预测因素。
与输精管切除术使用相关的社会人口统计学变量正在演变，尤其是在高收入者中。
