PERSPECTIVES TOWARD DMPA-SC SELF-ADMINISTRATION AMONG BLACK WOMEN

Abstract

Objectives

Black women are less likely to use contraceptives and have a higher rate of unintended pregnancy. Depot-medroxyprogesterone acetate (DMPA), known colloquially as Depo or “the shot”, is a highly effective, injectable form of contraception that provides three months of pregnancy protection. Black women have the highest rate of DMPA use in the US, but the method has a high rate of discontinuation. Self-administration of subcutaneous DMPA (DMPA-SC) could reduce discontinuation rates and support improved contraceptive access. A global body of evidence has shown that users can safely and effectively administer the subcutaneous DMPA themselves. We explored Black women’s perspectives regarding self-administering this method.

Methods

We conducted nine focus group discussions with 24 Black women from Ohio, Michigan, and Indiana. We transcribed and thematically analyzed focus group discussions.

Results

None of the participants had ever heard of DMPA-SC for self-injection. Although they identified reduced barriers to obtaining contraception as a potential benefit of self-injection, the majority indicated little to no interest in self-injecting DMPA-SC because they were concerned about administration. However, they offered several implementation suggestions that could support DMPA-SC utilization, including: safely introducing users to the injection, regular check-in and follow-up support, and expansive education for users. Relatedly, participants emphasized the need for providers to proactively provide comprehensive information about contraception during clinic visits.

Conclusions

Findings buttress the critical role comprehensive contraception education plays in helping women feel confident in their contraceptive decision making. Findings also offer insights into what Black-women would consider as practical implementation strategies that can support DMPA-SC utilization.