Contraception: X最新文献

{"title":"Evaluation of the LMUP in Ethiopia: Requirements, challenges and best practice","authors":"Geraldine Barrett, Ana Luiza Vilela Borges, Justine N. Bukenya, Ararso Baru Olani, Jennifer A. Hall","doi":"10.1016/j.conx.2023.100097","DOIUrl":"10.1016/j.conx.2023.100097","url":null,"abstract":"","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"5 ","pages":"Article 100097"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cf/72/main.PMC10474351.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10524072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential discontinuation by covert use status in Kenya","authors":"Dana Sarnak ,&nbsp;Shannon N. Wood ,&nbsp;Phil Anglewicz ,&nbsp;Elizabeth Gummerson ,&nbsp;Peter Gichangi ,&nbsp;Mary Thiongo ,&nbsp;Caroline Moreau","doi":"10.1016/j.conx.2023.100102","DOIUrl":"10.1016/j.conx.2023.100102","url":null,"abstract":"<div><h3>Objectives</h3><p>Qualitative research suggests that covert users may be more likely to discontinue contraception due to the logistics of discretion and fear of disclosure. This study sought to quantify whether covert users are more likely to discontinue contraception than overt users.</p></div><div><h3>Study design</h3><p>We used a national longitudinal survey from Kenya conducted from November 2019/February 2020 to November 2020/April 2021 to test whether the time to discontinuation between covert and overt users still in need of contraception differed using survival analyses over a period of 5 years since method initiation.</p></div><div><h3>Results</h3><p>Multivariate Cox regression results showed there was an interaction with time and covert use on the risk of discontinuation; for every additional month of use, there was an increased risk of discontinuation of covert users compared to overt users (3% increased hazard, <em>p</em> = 0.02). At 1 and 2 years, there were no differences in the hazard of discontinuation (adjusted hazard ratio [aHR]_1 year 0.95, 95% CI 0.54–1.65 and aHR_2 years 1.37, 95% CI 0.85–2.21), yet at 3, 4, and 5 years, the hazard of discontinuation was higher for covert compared to overt users (aHR_3 years 1.99, 95% 1.11–3.56; aHR_4 years 2.89, 95% CI 2.0–6.40; aHR_5 years 4.18, 95% CI 1.45–12.0).</p></div><div><h3>Conclusions</h3><p>These results suggest efforts are needed to support covert users in managing their contraceptive use and for improving contraceptive counseling surrounding covert use. Our findings shed light on the increasing challenge covert users face after approximately the first 2 years of use; covert users require additional follow-up in both research and care provision.</p></div><div><h3>Implications</h3><p>Covert users are at a higher risk of discontinuation of contraception while still trying to avoid pregnancy, particularly after the first 2 years of use. Family planning providers and programs must protect access to and maintain the privacy of reproductive services to this population, focusing on follow-up care provision and counseling.</p></div>","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"5 ","pages":"Article 100102"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10625140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71479001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concern that contraception affects future fertility: How common is this concern among young people and does it stop them from using contraception?","authors":"Annalisa Watson ,&nbsp;Jennifer Yarger ,&nbsp;Erica Sedlander ,&nbsp;Josephine Urbina ,&nbsp;Kristine Hopkins ,&nbsp;Maria I. Rodriguez ,&nbsp;Liza Fuentes ,&nbsp;Cynthia C. Harper","doi":"10.1016/j.conx.2023.100103","DOIUrl":"https://doi.org/10.1016/j.conx.2023.100103","url":null,"abstract":"<div><h3>Objectives</h3><p>This study examines the concern that contraception affects future fertility among community college students and its association with contraceptive use.</p></div><div><h3>Study design</h3><p>We used baseline data from a randomized controlled trial with 2060 community college students assigned female at birth. We used mixed-effects multivariate logistic regression adjusted for clustered data to assess sociodemographic factors associated with concerns about contraception affecting future fertility and to test the association between this concern and contraceptive use.</p></div><div><h3>Results</h3><p>Most participants (69%) worried about contraception affecting their future fertility. Multivariable results indicated that first-generation college students (adjusted odds ratio [aOR], 1.24; 95% confidence interval [CI], 1.01–1.55) and non-English speakers at home (aOR, 1.30; 95% CI, 1.04–1.64) were more concerned. Racial and ethnic differences were significant, with Black non-Hispanic (aOR, 2.83; 95% CI, 1.70–4.70), Asian/Pacific Islander non-Hispanic (aOR, 2.12; 95% CI, 1.43–3.14), and Hispanic (aOR, 1.54; 95% CI, 1.17–2.02) participants more likely to be concerned than White non-Hispanic counterparts. Participants who received contraceptive services in the past year had lower odds of this concern (aOR, 0.72; 95% CI 0.59–0.88). Furthermore, participants with this concern had lower odds of using contraception (aOR, 0.67; 95% CI, 0.49–0.91), especially hormonal contraception (aOR, 0.77; 95% CI, 0.61–0.97).</p></div><div><h3>Conclusions</h3><p>Most students feared contraception’s impact on fertility, and this fear was associated with not using contraception. Disparities in this concern may be tied to discrimination, reproductive coercion, and limited reproductive health care access. Addressing concerns about contraception affecting future fertility is crucial to person-centered contraceptive counseling.</p></div><div><h3>Implications</h3><p>This study examines the concern that contraception affects future fertility among sexually active female community college students and its impact on contraceptive use. Most participants expressed concerns about contraception affecting future fertility. Addressing future fertility concerns in patient-centered contraceptive counseling is crucial for reaching young people.</p></div>","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"5 ","pages":"Article 100103"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590151623000151/pdfft?md5=9b639ec669fbc370ff1a611e5221937a&pid=1-s2.0-S2590151623000151-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138557550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Missed opportunity for self-injectable contraception awareness and adoption: Insights from client exit interviews in Uganda and Nigeria","authors":"Susan Ontiri ,&nbsp;Claire Rothschild ,&nbsp;Doreen Nakimuli ,&nbsp;Oluwatosin Adeoye","doi":"10.1016/j.conx.2023.100098","DOIUrl":"10.1016/j.conx.2023.100098","url":null,"abstract":"<div><h3>Objectives</h3><p>To assess the extent to which self-injection contraceptive information and services are provided to women in Uganda and Nigeria.</p></div><div><h3>Study design</h3><p>We conducted a descriptive information cascade analysis using data from a cross-sectional exit interviews with 492 family planning clients in Uganda and 720 in Nigeria.</p></div><div><h3>Results</h3><p>More than a third of respondents in Uganda (31.2%) and Nigeria (40.5%) reported not receiving any information about the self-injection contraceptive during service provision. Only 45.6% clients who adopted self-injected DMPA-SC in Uganda and 1.7% in Nigeria were issued with additional doses to take home.</p></div><div><h3>Conclusion</h3><p>The findings suggest that there are missed opportunities to provide women with information and services on DMPA-SC self-injection.</p></div><div><h3>Implication</h3><p>A contraceptive counseling and services cascade can be a useful tool for identifying gaps in the quality and person-centeredness of family planning services, and ultimately improving the experience of clients.</p></div>","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"5 ","pages":"Article 100098"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/51/b0/main.PMC10495597.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10252695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“Adoption is just not for me”: How abortion patients in Michigan and New Mexico factor adoption into their pregnancy outcome decisions","authors":"Liza Fuentes,&nbsp;Megan L. Kavanaugh,&nbsp;Lori F. Frohwirth,&nbsp;Jenna Jerman,&nbsp;Nakeisha Blades","doi":"10.1016/j.conx.2023.100090","DOIUrl":"10.1016/j.conx.2023.100090","url":null,"abstract":"<div><h3>Objectives</h3><p>In public discourses in the United States, adoption is often suggested as a less objectionable, equal substitute for abortion, despite this pregnancy outcome occurring much less frequently than the outcomes of abortion and parenting. This qualitative study explores whether and how abortion patients weighed adoption as part of their pregnancy decisions and, for those who did, identifies factors that contributed to their ultimate decision against adoption.</p></div><div><h3>Study design</h3><p>We interviewed 29 abortion patients from 6 facilities in Michigan and New Mexico in 2015. We conducted a thematic analysis using both deductive and inductive approaches to describe participants’ perspectives, preferences, and experiences regarding the consideration of adoption for their pregnancy.</p></div><div><h3>Results</h3><p>Participants’ reasons why adoption was not an appropriate option for their pregnancy were grounded in their ideas of the roles and responsibilities of parenting and fell into three themes. First, participants described continuing the pregnancy and giving birth as inseparable from the decision to parent. Second, choosing adoption would represent an irresponsible abnegation of parental duty. Third, adoption could put their child’s safety and well-being at risk.</p></div><div><h3>Conclusions</h3><p>Adoption was not an equally acceptable substitute for abortion among abortion patients. For them, adoption was a decision that represented taking on, and then abdicating, the role of parent. This made adoption a particularly unsuitable choice for their pregnancy.</p></div><div><h3>Implications</h3><p>Rhetoric suggesting that adoption is an equal alternative to abortion does not reflect the experiences, preferences, or values of how abortion patients assess what options are appropriate for their pregnancy.</p></div>","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"5 ","pages":"Article 100090"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/93/66/main.PMC10008919.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9129345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A randomized crossover study to evaluate local tolerability following subcutaneous administration of a new depot medroxyprogesterone acetate contraceptive formulation","authors":"Vera Halpern ,&nbsp;Angie Wheeless ,&nbsp;Vivian Brache ,&nbsp;Anja Lendvay ,&nbsp;Leila Cochón ,&nbsp;Douglas Taylor ,&nbsp;Laneta J. Dorflinger","doi":"10.1016/j.conx.2023.100100","DOIUrl":"10.1016/j.conx.2023.100100","url":null,"abstract":"<div><h3>Objectives</h3><p>This study aimed to evaluate and compare local tolerability of investigational drug TV-46046 and reference drug Depo-subQ Provera 104, both containing medroxyprogesterone acetate (MPA) as an active ingredient.</p></div><div><h3>Study design</h3><p>We conducted a randomized, crossover, single-center study. Twenty-seven healthy women aged 25 to 47 years at low risk of pregnancy received a subcutaneous injection of each of the four study drugs (120 mg/0.3 mL of TV-46046, 60 mg/0.3 mL of diluted TV-46046, 0.3 mL of TV-46046 placebo, and 104 mg/0.65 mL of Depo-subQ 104) in different quadrants of the abdomen. We assessed local tolerability by occurrence of injection site reactions (ISRs), as well as injection site pain and overall safety for at least 9 months postinjections.</p></div><div><h3>Results</h3><p>Of a total of 108 study injections, three injections were partial due to needle blockage. We observed a total of 30 ISRs following 105 full-dose injections, including hypopigmentation (<em>n</em> = 24), bruising (<em>n</em> = 4), and atrophy/dimple (<em>n</em> = 2). Eleven cases of hypopigmentation occurred following 25 full-dose injections of undiluted TV-46046 (44.0%), six following 27 full-dose injections of diluted TV-46046 (22.2%), and seven following 26 full-dose injections of Depo-subQ 104 (26.9%). Hypopigmentations occurred on average 8 months postinjection. Injection pain was minimal and dissipated quickly after all four injections.</p></div><div><h3>Conclusions</h3><p>Subcutaneous administration of MPA in a suspension formulation is associated with the delayed onset of hypopigmentation at the site of injection. Although not statistically significant, the rate of ISRs was over 60% higher for undiluted TV-46046 compared to Depo-subQ 104. This difference bears careful monitoring in future studies of TV-46046.</p></div><div><h3>Implications</h3><p>From a safety standpoint, investigational drug TV-46046 is appropriate for further clinical testing as a 6-month contraceptive injectable. The previously underreported hypopigmentation associated with subcutaneous administration of MPA warrants further investigation and acceptability assessment among users of existing Depo-subQ 104 as well as careful monitoring of local tolerability of TV-46046 in future clinical trials.</p></div><div><h3>Trial registration</h3><p>Registered at clinicaltrials.gov no: NCT02817464</p></div>","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"5 ","pages":"Article 100100"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10562734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41194039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of new outpatient long-acting reversible contraceptive insertions among a commercially insured, US population from 2010 to 2020","authors":"Clara E. Busse ,&nbsp;Chase D. Latour ,&nbsp;Sara Z. Dejene ,&nbsp;Andrea K. Knittel ,&nbsp;Mollie E. Wood ,&nbsp;Alan C. Kinlaw ,&nbsp;Mekhala V. Dissanayake","doi":"10.1016/j.conx.2023.100101","DOIUrl":"10.1016/j.conx.2023.100101","url":null,"abstract":"<div><h3>Objectives</h3><p>Characterize new use of long-acting reversible contraceptives (LARCs), highly effective contraceptive methods, in a broad population over time.</p></div><div><h3>Study Design</h3><p>We constructed a retrospective cohort of commercially insured individuals aged 15 to 54 years from 2010 to 2020 and estimated monthly incidence of new LARC insertions.</p></div><div><h3>Results</h3><p>The monthly standardized incidence increased from 6.0 insertions per 10,000 individuals in January 2010 to 14.1 in December 2020, with a dip in insertions after March 2020. Hormonal intrauterine devices were consistently the most inserted LARC; implants were increasingly favored over time.</p></div><div><h3>Conclusions</h3><p>LARCs are increasingly popular forms of contraception among commercially insured individuals.</p></div><div><h3>Implications</h3><p>Given the increasing popularity, ensuring access to LARCs is critical.</p></div>","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"5 ","pages":"Article 100101"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/20/3c/main.PMC10562738.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41194040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of the COVID-19 pandemic on publicly supported clinics providing contraceptive services in four US states","authors":"Jennifer Mueller,&nbsp;Alicia VandeVusse,&nbsp;Samira Sackietey,&nbsp;Ava Braccia,&nbsp;Jennifer J. Frost","doi":"10.1016/j.conx.2023.100096","DOIUrl":"10.1016/j.conx.2023.100096","url":null,"abstract":"<div><h3>Objectives</h3><p>The COVID-19 pandemic has disrupted contraceptive service provision in the United States (US). We aimed to explore the impact of COVID-19 on the publicly supported family planning network at the provider level. This study adds to the literature documenting the challenges of the pandemic as well as how telehealth provision compares across timepoints.</p></div><div><h3>Study design</h3><p>We conducted a survey among sexual and reproductive health (SRH) providers at 96 publicly supported clinics in four US states asking about two timepoints—one early in the pandemic and one later in the pandemic. We used descriptive statistics to summarize the data.</p></div><div><h3>Results</h3><p>We found that almost one-third of sites reduced contraceptive services because of the pandemic, with a few temporarily stopping contraceptive services altogether. More sites stopped provision of long-acting reversible contraception (LARC), Pap tests, and Human papillomavirus (HPV) vaccinations than other methods or services. We also found that sites expanded some practices to make them more accessible to patients, such as extending existing contraceptive prescriptions without consultations for established patients and expanding telehealth visits for contraceptive counseling. In addition, sites reported high utilization of telehealth to provide contraceptive services.</p></div><div><h3>Conclusions</h3><p>Understanding how service delivery changed due to the pandemic and how telehealth can be used to provide SRH services sheds light on how these networks can best support providers and patients in the face of unprecedented crises such as the COVID-19 pandemic.</p></div><div><h3>Implications</h3><p>This study demonstrates that providers increased provision of telehealth for sexual and reproductive health care during the COVID-19 pandemic; policymakers in the US should support continued reimbursement of telehealth care as well as resources to expand telehealth infrastructure. In addition, this study highlights the need for more research on telehealth quality.</p></div>","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"5 ","pages":"Article 100096"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10374853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9907769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to “Evaluation of the LMUP in Ethiopia: Requirements, challenges and best practice”","authors":"Celia Karp,&nbsp;Caroline Moreau,&nbsp;Solomon Shiferaw,&nbsp;Assefa Seme,&nbsp;Mahari Yihdego,&nbsp;Linnea Zimmerman","doi":"10.1016/j.conx.2023.100099","DOIUrl":"10.1016/j.conx.2023.100099","url":null,"abstract":"","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"5 ","pages":"Article 100099"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10470396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10524074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is long‐acting reversible contraceptive method use associated with HIV testing frequency in KwaZulu‐Natal, South Africa and Lusaka, Zambia? Findings from the CUBE study","authors":"Mags Beksinska ,&nbsp;Alice F. Cartwright ,&nbsp;Jennifer Smit ,&nbsp;Margaret Kasaro ,&nbsp;Jennifer H. Tang ,&nbsp;Maria Fawzy ,&nbsp;Virginia Maphumulo ,&nbsp;Manze Chinyama ,&nbsp;Esther Chabu ,&nbsp;Rebecca Callahan","doi":"10.1016/j.conx.2023.100089","DOIUrl":"10.1016/j.conx.2023.100089","url":null,"abstract":"<div><h3>Objectives</h3><p>To assess differences in HIV testing at 6-months intervals over 24 months among intramuscular depot medroxyprogesterone acetate (DMPA-IM) injectable, levonorgestrel implant, or copper intrauterine devices (IUD) users in KwaZulu-Natal, South Africa, and Lusaka, Zambia. Testing at recommended intervals has not been previously assessed in long-acting reversible contraceptive (LARC) users (implant and IUD users) compared to those using effective but shorter-acting methods (such as DMPA-IM) in sub-Saharan Africa.</p></div><div><h3>Study design</h3><p>As part of the longitudinal contraceptive use beyond ECHO (CUBE) study, we measured HIV testing over 24 months. Participants were considered continuous users of DMPA-IM, levonorgestrel implant, or copper IUD if they used the same method across all months of their study participation, or not continuous users of their baseline CUBE method if they switched or discontinued their method. We used multivariable logistic regression models with generalized estimating equations and robust standard errors, stratified by country, to assess differences in HIV testing.</p></div><div><h3>Results</h3><p>Among the 498 participants, HIV testing rates were higher in Zambia for all methods compared to South Africa. In bivariate analyses, continuous implant or IUD users (the LARC users) were significantly less likely to report having received HIV testing at the 6-months and 24-months surveys, compared to continuous DMPA-IM users. In adjusted longitudinal models, continuous IUD users (adjusted odds ratio: 0.42, 95% CI: 0.24, 0.74), continuous implant users (adjusted odds ratio: 0.23, 95% CI: 0.12, 0.42) in South Africa had significantly lower odds of HIV testing compared to continuous DMPA-IM users. There were no significant differences in Zambia in the adjusted models.</p></div><div><h3>Conclusion</h3><p>LARC use may reduce opportunities for HIV testing and users should be counseled on regular HIV testing and the option of HIV self-testing.</p></div><div><h3>Implications</h3><p>Due to infrequent clinical contacts which may lead to lower rates of HIV testing at recommended intervals, LARC users should be provided opportunities to test for HIV at home or when seeking other health services.</p></div>","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"5 ","pages":"Article 100089"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a3/1e/main.PMC9883203.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9208339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}