Zimmerman Linnea A, Sarria Isabella, Kassa Munir, Karp Celia, Seme Assefa, Shiferaw Solomon
Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
Federal Ministry of Health, Ethiopia, Addis Ababa, Ethiopia.
PLOS Glob Public Health. 2024 Aug 15;4(8):e0002111. doi: 10.1371/journal.pgph.0002111. eCollection 2024.
Despite widespread concerns about contraceptive side effects among contraceptive users, few studies explore the specific side effects women are told about during contraceptive counseling. It is thus unclear whether women receive appropriate and sufficient information on side effects they may experience. The objective of this study is to describe which specific side effects of hormonal contraception or copper IUD users are counseled on and identify relevant user characteristics associated with receipt of counseling, using nationally representative cross-sectional data from Ethiopia. Data were collected from a nationally representative sample of women between October and December 2019. Analyses were restricted to 2,039 current users of hormonal contraception (implant, injectable, pill, or emergency contraception) or the copper IUD. Descriptive analyses identified the types and number of side effects, across all methods and by the injectable, implant, and pill. Multinomial regression identified factors associated with receipt of counseling on bleeding changes only, non-bleeding changes only, or both, relative to no counseling on side effects, adjusting for method type, source, and socio-economic characteristics. Less than 10% of users were told of at least one bleeding and non-bleeding side effect. Relative to implant users, injectable and other method users were less likely to be told about bleeding changes only (aRRR: 0.65, 95% CI: 0.46-0.93 and aRRR: 0.31, 95% CI: 0.16-0.61, respectively) and users of other methods were less likely to be told about both a bleeding and non-bleeding change (aRRR: 0.43, 95% CI: 0.19-0.93). Users who received their method from a non-public source were less likely to receive counseling on any kind of side effect and nulliparous women were less likely to be told about both kinds of side effects. There is need to improve counseling on the method specific side effects on which women are counseled, particularly in the private sector.
尽管避孕药具使用者普遍担心避孕药具的副作用，但很少有研究探讨女性在避孕药具咨询过程中被告知的具体副作用。因此，尚不清楚女性是否获得了关于她们可能经历的副作用的适当和充分信息。本研究的目的是利用埃塞俄比亚具有全国代表性的横断面数据，描述激素避孕或铜宫内节育器使用者在咨询中被告知的具体副作用，并确定与接受咨询相关的使用者特征。数据收集自2019年10月至12月全国具有代表性的女性样本。分析仅限于2039名激素避孕（植入剂、注射剂、药丸或紧急避孕）或铜宫内节育器的当前使用者。描述性分析确定了所有方法以及注射剂、植入剂和药丸的副作用类型和数量。多项回归确定了与仅接受出血变化咨询、仅接受非出血变化咨询或两者都接受咨询相关的因素，相对于未接受副作用咨询，同时调整方法类型、来源和社会经济特征。不到10%的使用者被告知至少一种出血和非出血副作用。与植入剂使用者相比，注射剂和其他方法使用者被告知仅出血变化的可能性较小（调整后相对风险比分别为：0.65，95%置信区间：0.46 - 0.93和0.31，95%置信区间：0.16 - 0.61），其他方法使用者被告知出血和非出血变化的可能性较小（调整后相对风险比：0.43，95%置信区间：0.19 - 0.93）。从非公共来源获得避孕方法的使用者接受任何一种副作用咨询的可能性较小，未生育的女性被告知两种副作用的可能性较小。有必要改进对女性进行咨询的特定方法副作用的咨询，特别是在私营部门。
