Biddlecom A E, Fapohunda B M
Institute for Social Research, University of Michigan, USA.
Stud Fam Plann. 1998 Dec;29(4):360-72.
This article examines women's covert use of contraceptives, that is, their use of a method without their husbands' knowledge. Three questions are addressed: (1) How is covert use measured? (2) How prevalent is it? and (3) What are the factors underlying covert use? Existing studies are used together with survey and qualitative data collected in 1997 in an urban setting in Zambia from married women and their husbands. Women's covert use of contraceptives is estimated to account for 6 to 20 percent of all current contraceptive use, and it is more widespread when contraceptive prevalence is low. The multivariate analysis indicates that difficult spousal communication about contraception is the strongest determinant of covert use. Husbands' disapproval of contraception works through spousal communication rather than as a direct influence on covert use. Husbands' pronatalism had no significant effect. The article concludes with implications of covert use for reproductive health and family planning programs, especially women's (and men's) needs for confidential services.
本文探讨了女性对避孕药具的隐秘使用情况，即她们在丈夫不知情的情况下使用某种避孕方法。文中提出了三个问题：（1）如何衡量隐秘使用情况？（2）其普遍程度如何？以及（3）隐秘使用背后的因素有哪些？现有的研究与1997年在赞比亚一个城市地区从已婚妇女及其丈夫那里收集的调查和定性数据相结合。据估计，女性对避孕药具的隐秘使用占当前所有避孕措施使用的6%至20%，并且在避孕普及率较低时更为普遍。多变量分析表明，夫妻之间在避孕问题上沟通困难是隐秘使用的最主要决定因素。丈夫对避孕的反对是通过夫妻沟通起作用的，而不是直接影响隐秘使用情况。丈夫的生育意愿并没有显著影响。文章最后阐述了隐秘使用情况对生殖健康和计划生育项目的影响，特别是女性（和男性）对保密服务的需求。
