Axinn William G, West Brady T, Schroeder Heather M, Lindberg Laura D
Institute for Social Research, University of Michigan, Ann Arbor, MI, United States.
Rutgers School of Public Health, Rutgers University, New Jersey, United States.
Contraception. 2025 Feb;142:110723. doi: 10.1016/j.contraception.2024.110723. Epub 2024 Oct 4.
The COVID-19 pandemic brought multiple simultaneous consequences, with high potential to change fertility-related behaviors. We use nationally representative sex and contraceptive use event history calendar measures to demonstrate person-specific changes in contraceptive use after the pandemic, showing differences across demographic subgroups.
We use data from the first nationally representative web survey of U.S. fertility, fielded in 2020-2022: the American Family Health Study (AFHS). Using responses from 1357 female-identifying respondents ages 18-49, we analyze 26,274 person-months of sex and contraceptive use data spanning directly before and after the beginning of the pandemic to detect change.
Individual-level hazard models of starting and stopping contraception revealed no pandemic-related changes in starting contraception, but significant reductions in the rate of stopping contraception for specific subgroups. Hispanic females reduced their rates of stopping contraceptive use during the pandemic (lowering their odds of stopping use by 71%), ultimately behaving more similarly to individuals from other racial or ethnic subgroups. Additionally, those aged 41 and older significantly reduced their rates of stopping contraceptive use (lowering their odds of stopping use by 78%) relative to other age groups.
Sudden large-scale health policy changes can produce significant changes in contraceptive use behaviors. The COVID-19 changes interacted with race, ethnicity, and age to produce different changes in contraceptive behaviors among different subgroups of the U.S.
新冠疫情带来了多重并发后果，极有可能改变与生育相关的行为。我们使用具有全国代表性的性行为和避孕使用事件史日历测量方法，来展示疫情后避孕使用方面因人而异的变化，呈现不同人口亚组之间的差异。
我们使用了2020年至2022年进行的首次具有全国代表性的美国生育情况网络调查数据：美国家庭健康研究（AFHS）。利用1357名年龄在18至49岁之间、自我认定为女性的受访者的回答，我们分析了疫情开始前后直接跨度的26274个人月的性行为和避孕使用数据，以检测变化情况。
开始和停止避孕的个体水平风险模型显示，开始避孕方面没有与疫情相关的变化，但特定亚组的停止避孕率显著下降。西班牙裔女性在疫情期间降低了她们停止避孕使用的比率（停止使用的几率降低了71%），最终其行为与其他种族或族裔亚组的个体更为相似。此外，41岁及以上的人群相对于其他年龄组显著降低了他们停止避孕使用的比率（停止使用的几率降低了78%）。
突然的大规模卫生政策变化会在避孕使用行为上产生重大变化。新冠疫情带来的变化与种族、族裔和年龄相互作用，在美国不同亚组中产生了不同的避孕行为变化。
