Contraception最新文献

{"title":"The association of social deprivation index and contraception care in a statewide contraceptive access initiative","authors":"Caitlin Bernard ,&nbsp;Brownsyne Tucker Edmonds ,&nbsp;Kelly Kean ,&nbsp;Rebecca Evans ,&nbsp;Surya S. Bhamidipalli ,&nbsp;Yan Tong ,&nbsp;Steven A. Brown ,&nbsp;Maria Fernandez ,&nbsp;Kathleen Wendholt ,&nbsp;Jeffrey F. Peipert ,&nbsp;Tracey A. Wilkinson","doi":"10.1016/j.contraception.2025.110833","DOIUrl":"10.1016/j.contraception.2025.110833","url":null,"abstract":"<div><h3>Objectives</h3><div>To examine the association of social deprivation index (SDI) and contraception care in a statewide contraceptive access initiative (PATH4YOU) in Indiana.</div></div><div><h3>Study design</h3><div>A cross-sectional analysis was performed to examine associations of participant’s chosen appointment type and contraceptive method with age and SDI.</div></div><div><h3>Results</h3><div>Of the 1201 participants, 45.2% chose a short-acting contraception, 76.9% received in-person care. Those within the highest SDI quartile (greatest social deprivation) chose in-person care (93.1% vs. 63.4%) and long-acting contraception (62.8% vs. 35.6%) when compared to participants within the lowest quartile (<em>p</em> &lt; 0.01). This was confirmed by multivariable analysis, which showed that as SDI quartiles increased, OR for in-person care and long-acting contraception increased.</div></div><div><h3>Conclusions</h3><div>Participant chosen type of appointment and contraceptive method were associated with levels of social deprivation.</div></div><div><h3>Implications</h3><div>Analysis of appointment type and contraceptive method within a statewide contraceptive initiative in Indiana (PATH4YOU) was done and showed differences based on social deprivation quartiles. Those living in geographic areas of greatest social deprivation chose in-person care (vs. telehealth) and long-acting contraception.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"145 ","pages":"Article 110833"},"PeriodicalIF":2.8,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Where do female contraceptive users get their methods, and does this differ by insurance coverage? A state-level examination","authors":"Hannah Olson,&nbsp;Megan L. Kavanaugh","doi":"10.1016/j.contraception.2025.110834","DOIUrl":"10.1016/j.contraception.2025.110834","url":null,"abstract":"<div><h3>Objective</h3><div>Describe where female contraceptive users obtained their method, by insurance and state.</div></div><div><h3>Study design</h3><div>Using 2022 Behavioral Risk Factor Surveillance System data from female contraceptive users in 26 states, we describe source of contraception by state and type of insurance coverage.</div></div><div><h3>Results</h3><div>Most female contraceptive users utilized private providers, but those with public or no insurance often used community health centers and family planning clinics, which commonly receive public funding.</div></div><div><h3>Conclusion</h3><div>People who are publicly insured or uninsured often rely on publicly supported providers.</div></div><div><h3>Implications</h3><div>Supporting a variety of providers may facilitate people accessing care, regardless of income.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"145 ","pages":"Article 110834"},"PeriodicalIF":2.8,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Web traffic and Google Trends data show increased interest in novel male contraception following the Supreme Court’s Dobbs v. Jackson ruling","authors":"Claudia Brewer ,&nbsp;Brian T. Nguyen","doi":"10.1016/j.contraception.2025.110835","DOIUrl":"10.1016/j.contraception.2025.110835","url":null,"abstract":"<div><h3>Objectives</h3><div>Explore online public interest in male contraception in the United States after the Supreme Court’s <em>Dobbs v</em>. <em>Jackson</em> ruling.</div></div><div><h3>Study design</h3><div>We used Google Trends to examine relative search volumes for “male birth control” and observed the number of daily visits to two male contraception research websites during the weeks before and after the ruling.</div></div><div><h3>Results</h3><div>The mean relative search volume for “male birth control” more than doubled during the period after the ruling was publicized (<em>p</em> = 0.002). Daily visits to both male contraception websites peaked immediately following the ruling.</div></div><div><h3>Conclusions</h3><div>The overturning of federal abortion protections preceded a spike in United States public interest in male contraception.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"145 ","pages":"Article 110835"},"PeriodicalIF":2.8,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consensus recommendations for measuring the impact of contraception on the menstrual cycle in contraceptive clinical trials","authors":"Amelia C.L. Mackenzie ,&nbsp;Stephanie Chung ,&nbsp;Emily Hoppes ,&nbsp;Nora Miller ,&nbsp;Anne E. Burke ,&nbsp;Sharon L. Achilles ,&nbsp;C. Leigh Allen ,&nbsp;Luis Bahamondes ,&nbsp;Diana L. Blithe ,&nbsp;Vivian Brache ,&nbsp;Rebecca L. Callahan ,&nbsp;Alice F. Cartwright ,&nbsp;Kathryn B.H. Clancy ,&nbsp;Enrico Colli ,&nbsp;Amanda Cordova-Gomez ,&nbsp;Elizabeth C. Costenbader ,&nbsp;Mitchell D. Creinin ,&nbsp;Hilary O.D. Critchley ,&nbsp;Gustavo F. Doncel ,&nbsp;Laneta J. Dorflinger ,&nbsp;Olivia Vandeputte","doi":"10.1016/j.contraception.2025.110829","DOIUrl":"10.1016/j.contraception.2025.110829","url":null,"abstract":"<div><h3>Objective</h3><div>We sought to develop consensus recommendations for measurement and analysis of data on contraceptive-induced menstrual changes (CIMCs) in contraceptive clinical trials. We built upon previous standardization efforts over the last 50 years and prioritized input from a variety of global experts and current regulatory authority guidance on patient-reported outcomes.</div></div><div><h3>Study design</h3><div>We completed a formal consensus-building process with an interdisciplinary group of 57 experts from 30 organizations and 14 countries in five global regions who work across academia, nonprofit research organizations, the pharmaceutical industry, and funding agencies. Smaller topical working groups drafted and revised recommendations.</div></div><div><h3>Results</h3><div>We developed 44 consensus recommendations, including research approaches to establish the evidence for future improvement in the measurement and analysis of CIMC data and guidance for investigators to implement presently. Priority recommendations call for simplification of terminology to make measurement accessible and patient-centered, accounting for intrinsic and extrinsic factors that may impact outcomes during study design and recruitment, standardized data collection of primary CIMC and acceptability outcomes, and harmonized approaches for analysis of these data, including addressing missing data.</div></div><div><h3>Conclusion</h3><div>By virtually convening a large group of global experts working across disciplines and sectors via a formal methodology, we developed consensus recommendations that will improve the current and future measurement and analysis of CIMC data in contraceptive clinical trials. Using these standardized approaches will permit valid and reliable contraceptive product labeling on CIMC outcomes that matter to users and greater comparability across trials that can inform clinical guidance and contraceptive counseling.</div></div><div><h3>Implications</h3><div>Consensus recommendations on measuring bleeding changes and related outcomes in contraceptive clinical trials can improve reporting of standardized, patient-centered outcomes in future product labeling. These improvements can enable healthcare providers to offer more relevant guidance on contraceptives and users to make more informed decisions about their choice of method.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"146 ","pages":"Article 110829"},"PeriodicalIF":2.8,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of institutional and state policies in management of pregnancies of unknown location: A 2024 online survey of Ryan Programs in the United States","authors":"Madeline V. Smith ,&nbsp;Jema Turk ,&nbsp;Rebecca Mercier ,&nbsp;Jody Steinauer ,&nbsp;Agatha Berger ,&nbsp;Kavita Vinekar","doi":"10.1016/j.contraception.2025.110832","DOIUrl":"10.1016/j.contraception.2025.110832","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to assess the perceived impact of state and institutional policies on managing pregnancies of unknown location (PULs) at US Ryan residency programs.</div></div><div><h3>Study design</h3><div>We conducted a cross-sectional electronic survey of US Ryan residency programs (<em>n</em> = 113) from March to April 2024. We compared the perceived influence of institutional and state policies on PUL management among Ryan Programs in restrictive vs nonrestrictive abortion climates. Provision of diagnostic uterine aspiration in the workup of PUL was a secondary outcome. We compared proportion of responses between restrictive and nonrestrictive climates with Fisher exact tests.</div></div><div><h3>Results</h3><div>We obtained responses from 75 Ryan Programs in 32 states (66.4% response rate). 29 (38.7%) were from states with restrictive abortion policies. Eight programs (10.7%) changed PUL management after the <em>Dobbs</em> decision. Compared to programs in nonrestrictive states, programs in restrictive states were more likely to report that state policy inhibits their ability to care for patients with PUL (34.5% vs 2.17%, <em>p</em> &lt; 0.001), rarely or never offer diagnostic uterine aspiration (34.5% vs 8.7%, <em>p</em> = 0.01), and identify institutional leadership as a barrier to offering diagnostic uterine aspirations (20.7% vs 2.2 %, <em>p</em> = 0.01). The most common institutional barriers to providing diagnostic uterine aspiration were staffing and faculty comfort/willingness, which did not differ by state abortion climate.</div></div><div><h3>Conclusions</h3><div>State abortion policy and institutional policy may impact the options available to patients with PULs.</div></div><div><h3>Implications</h3><div>Programs in all legislative climates should address institutional barriers to providing diagnostic uterine aspiration. Legislative advocacy in restrictive states is needed to ensure access to expedient PUL management.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"145 ","pages":"Article 110832"},"PeriodicalIF":2.8,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a transdermal gel for reversible male contraception","authors":"Regine Sitruk-Ware ,&nbsp;Diana L. Blithe ,&nbsp;Stephanie T. Page ,&nbsp;Christina Wang","doi":"10.1016/j.contraception.2025.110830","DOIUrl":"10.1016/j.contraception.2025.110830","url":null,"abstract":"<div><div>While there are several easy-to-use reversible female contraceptives, little is available for men. Introduction of novel, cost-effective male contraceptives could have important downstream global health and economic benefits. Currently, nearly half of all pregnancies globally are unintended, with many resulting in unsafe abortions, a significant burden for women and families in many countries.</div><div>Available reversible options for male contraception include male condoms or withdrawal, both with high typical use failure rates, and vasectomy, which is not easily reversible. Advanced methods of male hormonal contraception include combinations of progestin and androgen, generally testosterone itself. Administration of these steroids results in the suppression of gonadotropins leading to the suppression of sperm production with full reversibility within a few months. Importantly, the exogenous androgen replaces the suppressed endogenous testosterone, minimizing side effects for the user. Using the skin to deliver steroids in the systemic circulation is a well-accepted concept both for the treatment of hypogonadism and contraception. A transdermal gel delivering Nestorone (segesterone acetate) and testosterone is under development and is leading the way in advancing novel, self-delivered methods of male hormonal contraception.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"145 ","pages":"Article 110830"},"PeriodicalIF":2.8,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of willingness to use hormonal contraception with knowledge: A national survey","authors":"Kathleen M. Beardsworth ,&nbsp;Bharti Garg ,&nbsp;Blair G. Darney ,&nbsp;Leo Han","doi":"10.1016/j.contraception.2025.110816","DOIUrl":"10.1016/j.contraception.2025.110816","url":null,"abstract":"<div><h3>Objective</h3><div>To determine if willingness to use and concern with using hormonal contraception (HC) is associated with knowledge about HC.</div></div><div><h3>Study design</h3><div>We conducted an online cross-sectional survey of self-identified women, US residents 18 and older using Amazon Mechanical Turk and <span><span>ResearchMatch.org</span><svg><path></path></svg></span>. Primary outcome was HC knowledge level, with participants categorized into binary knowledge level variable based on accuracy of responses to seven statements about HC (e.g. HC causes infertility, HC decreases acne). We assessed participant willingness and concern with using HC, including the primary type of concern with HC (physical, emotional, complications, other). We used bivariate tests and a multivariable logistic regression model to test the association of willingness and concern about HC to knowledge level.</div></div><div><h3>Results</h3><div>Of 1041 respondents ages 18–81, 18% had no concerns and were willing to use HC, 64% had some concerns but were willing to use HC, and 18% had concerns and were not willing to use HC. Respondents who had concerns but were still willing to use HC were less likely to be concerned about complications than those who were unwilling (31.0% vs. 43.7%; <em>p</em> &lt; 0.001). The median number of correct responses to knowledge statements was three (IQR 2–5) and 94.8% of participants answered at least one statement incorrectly. After controlling for age, current form of contraception, education, rurality, census region, political, and religious beliefs, participants who were willing to use HC without concerns (aOR<!--> <!-->=<!--> <!-->4.32; 95% CI: 2.45–7.62) and those who were willing but had concerns (aOR<!--> <!-->=<!--> <!-->2.11; 95% CI: 1.35–3.30) was associated with being more knowledgeable as compared to those not willing to use HC (reference).</div></div><div><h3>Conclusion</h3><div>Women willing to use HC are more likely to be more knowledgeable about HC. More than 80% of women report concerns with HC.</div></div><div><h3>Implications</h3><div>Patients unwilling to use HC are more likely to have knowledge gaps in their understanding of HC side effects and risk of complications. For shared decision-making, providers should specifically address the facts and myths surrounding HC to ensure patients are making informed decisions about their reproductive health.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"145 ","pages":"Article 110816"},"PeriodicalIF":2.8,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in contraceptive method use, access, and experiences of care during a statewide contraceptive initiative","authors":"Taehyun Kim ,&nbsp;Julia R. Steinberg ,&nbsp;Michel Boudreaux","doi":"10.1016/j.contraception.2025.110814","DOIUrl":"10.1016/j.contraception.2025.110814","url":null,"abstract":"<div><h3>Objective</h3><div>To examine changes in contraceptive use, access, and care experiences during a statewide contraceptive access initiative, Delaware Contraceptive Access Now.</div></div><div><h3>Study design</h3><div>We used responses from the Delaware/Maryland Survey of Women at the early wave (November, 2016–March, 2017) and late wave (February, 2021–October, 2021). Our cross-sectional sample included 6467 respondents at risk of unintended pregnancy. We used logistic regression to examine changes in contraceptive outcomes, controlling for age, race/ethnicity, income, education, marital status, and employment. Using interaction terms between state and survey wave, we compared population-level changes in outcomes in Delaware to changes in Maryland, which did not implement a similar contraceptive initiative.</div></div><div><h3>Results</h3><div>The change in long-acting reversible contraceptive (LARC) use in Delaware compared to Maryland was estimated as a 2.8% point increase, but was not statistically significant (95% CI: −2.8, 8.3). Knowing where to get free LARC increased by 6.2% points (95% CI: 0.4, 12.1; <em>p</em> &lt; 0.05) in Delaware compared to Maryland. Both Delaware and Maryland indicated substantial within-state decreases in reporting their doctor asked about plans for pregnancy (Delaware: −8.9% points; Maryland: −15.1% points), but the decrease in Delaware was significantly smaller: 5.6% points (95% CI: −0.9, 12.1; <em>p</em> &lt; 0.1). Delaware also had a net decrease of 4.7% points (95% CI: −9.9, 0.5; <em>p</em> &lt; 0.1), compared to Maryland, among those very or somewhat satisfied with their current method.</div></div><div><h3>Conclusions</h3><div>We observed a mixed picture of changes in contraceptive use, access, and care experiences during the program. Our findings will be useful to Delaware program administrators and others, including the federal government, as they adopt similar reforms.</div></div><div><h3>Implications</h3><div>We found that the Delaware contraceptive access initiative substantially increased knowledge of free LARC access and led to a relative increase in respondents reporting they had been asked about their pregnancy plans, compared to Maryland, but was not associated with other outcomes.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"144 ","pages":"Article 110814"},"PeriodicalIF":2.8,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating “regulatory fog”: Challenges to rigorous abortion research after the Dobbs v. Jackson decision","authors":"Elizabeth A. Mosley ,&nbsp;Lucrecia Mena-Meléndez ,&nbsp;Heather Gould ,&nbsp;Lee Hasselbacher ,&nbsp;Melissa Madera ,&nbsp;Heidi Moseson ,&nbsp;Jane W. Seymour","doi":"10.1016/j.contraception.2025.110815","DOIUrl":"10.1016/j.contraception.2025.110815","url":null,"abstract":"<div><div>In 2022, the United States Supreme Court ruling in <em>Dobbs v. Jackson Women’s Health Organization</em> overturned <em>Roe v. Wade</em> and federal protections for abortion. Two years later, 22 states now ban or severely restrict abortion. Sexual and reproductive health scholars aim to document the impacts of these restrictions and bans on individuals, communities, and populations. In this context, human subjects’ protections are more important than ever, as legal risks to abortion providers, seekers, and supporters have increased. However, in this commentary, we discuss how regulatory systems designed to protect human subjects, including Institutional Review Boards and the National Institutes of Health’s Certificates of Confidentiality program, present challenges that create a “regulatory fog,” which stymies abortion scholarship. Research studies have always required a balance of scientific rigor with human subjects’ protections. We argue that, in the current environment, new regulatory constraints make it impossible for some researchers to conduct rigorous abortion research and protect participant confidentiality to the extent that they could before. We offer lessons learned for working in this environment and call for clear guidance and specific protections from federal and institutional leaders to improve research quality and participant safety.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"144 ","pages":"Article 110815"},"PeriodicalIF":2.8,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the contraception-focused Preference-aligned Fertility Management Index in Uganda and Nigeria","authors":"Kelsey Holt ,&nbsp;Rouselinne Gomez ,&nbsp;Dinah Amongin ,&nbsp;Elizabeth Omoluabi ,&nbsp;Stephanie Chung ,&nbsp;Catherine Birabwa ,&nbsp;Shakede Dimowo ,&nbsp;Sneha Challa ,&nbsp;Peter Waiswa ,&nbsp;Ivan Idiodi ,&nbsp;Beth Phillips ,&nbsp;Sylvia Nanono ,&nbsp;Ayobambo Jegede ,&nbsp;Jenny Liu ,&nbsp;Ronald Wasswa ,&nbsp;Grace Nmadu ,&nbsp;Chioma Okoli ,&nbsp;Aminat Tijani ,&nbsp;Christine Galavotti","doi":"10.1016/j.contraception.2025.110813","DOIUrl":"10.1016/j.contraception.2025.110813","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to evaluate construct validity of the contraception-focused “Preference-aligned Fertility Management” (PFM) Index, a new person-centered and rights-based outcome measure, in Nigeria and Uganda.</div></div><div><h3>Study design</h3><div>We analyzed survey data from convenience samples of new users of contraception and nonusers of contraception in Uganda and users of contraception in Nigeria. PFM Index scores were calculated by combining two indicators: indicator 1 assessing alignment between desire to use contraception and actual use; indicator 2 evaluating whether users’ current methods are desired. We developed a nomological network of related constructs and conducted bivariable logistic regressions, predicting the odds of PFM associated with each variable.</div></div><div><h3>Results</h3><div>A total of 71.3% of contraception users in Nigeria, 99.2% of new users in Uganda, and 42.9% of nonusers in Uganda were practicing contraception-focused PFM. In Nigeria, high Women’s and Girls’ Empowerment in Sexual and Reproductive Health Index scores and permission to visit a health center were significantly associated with higher odds of contraception-focused PFM (odds ratio [OR] = 2.72; 95% CI = 1.01–7.31; OR = 2.64; 95% CI = 1.04–6.73, respectively). In Uganda, women’s and partner’s secondary school education were significantly associated with higher odds of contraception-focused PFM (OR = 2.58, 95% CI = 1.58–4.24; OR = 2.01; 95% CI = 1.54–2.62, respectively); as were concordance with partner’s desired number of children, recent experience of gender-based violence, and satisfaction with what (if anything) one is doing to prevent pregnancy (OR = 1.48, 95% CI = 1.30–1.69; OR = 2.33; 95% CI = 1.52–3.56; OR = 4.44, 95% CI = 2.77–7.12, respectively).</div></div><div><h3>Conclusions</h3><div>The contraception-focused PFM Index demonstrated construct validity in Nigeria and Uganda. PFM and other new measures of self-defined need contribute to the paradigm shift underway to align contraception indicators with human rights principles.</div></div><div><h3>Implications</h3><div>The contraception-focused PFM Index is a novel person-centered, rights-based measure that can be used to gauge whether individuals’ self-defined needs related to contraception are met by programs and policies. Our study finds evidence for construct validity of the index among contraceptive users in Nigeria and Uganda and nonusers in Uganda.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"144 ","pages":"Article 110813"},"PeriodicalIF":2.8,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}