Contraception最新文献

{"title":"YOUNG PEOPLE’S ONLINE SOURCES OF CONTRACEPTIVE INFORMATION AND ASSOCIATIONS WITH CONTRACEPTIVE KNOWLEDGE AND ATTITUDES","authors":"ZH Pleasure,&nbsp;EA Pleasants,&nbsp;B Whitfield,&nbsp;C Larsen,&nbsp;D Johnson,&nbsp;RJ Steiner,&nbsp;L Lindberg","doi":"10.1016/j.contraception.2024.110643","DOIUrl":"10.1016/j.contraception.2024.110643","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to assess concordance between adolescent and young adults’ (AYA) preferred and actual sources of online contraceptive information; and examine associations between sources and contraceptive attitudes and knowledge.</div></div><div><h3>Methods</h3><div>We used data from a 2023 online national survey of AYA (15-29 years) assigned-female-at-birth (n=1,150). We examined the prevalence of preferred and actual information sources, and assessed multivariable associations between information received from websites and social networking sites (SNS) and four contraceptive knowledge and attitude measures.</div></div><div><h3>Results</h3><div>One-third of respondents preferred websites as a contraceptive information source (33%), but they were an actual source for only 15% in the past year. Conversely, SNS were a preferred source for only 10%, yet the second most common actual source (22%). Adjusting for age, sexual activity, and other information sources, receiving information from websites was positively associated with identifying the most effective contraceptive method (adjusted OR (aOR)=2.83, 95%-CI:1.82-4.40) and, marginally, with agreeing that hormonal contraception is safe (aOR=1.63, 95%-CI:0.98-2.70). Receiving information from SNS was positively associated with identifying the most effective contraceptive method (aOR=1.87, 95%-CI:1.26-2.77), but had a marginal negative association with believing that benefits outweigh side effects (aOR=0.72, 95%-CI:0.48-1.08).</div></div><div><h3>Conclusions</h3><div>Websites were a desired source with potential positive impacts on contraceptive outcomes, but AYA face challenges accessing them. SNS, while less desired than websites, are a more common source with potential positive and negative impacts on outcomes. Future research, advocacy, and clinical practice should distinguish between these online sources, monitor the impacts of SNS, and leverage websites as preferred and beneficial contraceptive information sources for AYA.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426897","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":"USING THE SOCIAL VULNERABILITY INDEX AND ABORTIONFINDER.ORG TO DETERMINE THE RELATIONSHIP BETWEEN SOCIAL VULNERABILITY AND SPATIAL ACCESS TO SECOND TRIMESTER ABORTION","authors":"E Dindinger,&nbsp;RH Cohen,&nbsp;WB Allshouse,&nbsp;J Sheeder","doi":"10.1016/j.contraception.2024.110604","DOIUrl":"10.1016/j.contraception.2024.110604","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to assess the relationship between social vulnerability and driving distances from each US county to the closest second trimester abortion clinic as of October 2023.</div></div><div><h3>Methods</h3><div>Using AbortionFinder.org, we calculated drive time from the centroid of each US county to the closest second trimester abortion facility. Data was joined to the Social Vulnerability Index (SVI) by county FIPS code. Counties were stratified into three SVI tertiles. We compared the median driving distance for states where second trimester abortions were legal vs not-legal. We used logistic regression models to determine the SVI predictors (lowest tertile vs highest tertile) of living in a county with a &gt;2-hour driving distance of a second trimester abortion facility (adjusted for state legality of second trimester abortions).</div></div><div><h3>Results</h3><div>We assessed 3,143 US counties; 67.1% of counties were within a two-hour drive of a second trimester abortion facility. The median travel time for counties in states with legal second trimester abortion was 1.6 (range:0.1–7.3) vs 4.2 (range:0.9–12.0) hours p&lt;0.001. In logistic regression, counties with the lowest socioeconomic SVI score had increased odds of a &gt;2-hour drive (adjusted OR (aOR) 1.63;95%CI:1.28–2.17) and counties with the lowest racial/ethnic SVI score had increased odds of a &gt;2-hour drive (aOR 1.56;95%CI:1.18–2.04).</div></div><div><h3>Conclusions</h3><div>Abortion bans disproportionately affect not only those living in restrictive states but also those who are more socially vulnerable. Current legislative and judicial efforts further threaten access to first trimester abortions including medication abortion nationwide. The necessity for second trimester abortions and inequity in access may increase.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426176","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":"COMPARISON OF BLEEDING PATTERNS WITH REPLACEMENT VERSUS EXTENDED USE OF THE CONTRACEPTIVE IMPLANT","authors":"SK Mody,&nbsp;G Kully,&nbsp;MC Hildebrand,&nbsp;S Averbach","doi":"10.1016/j.contraception.2024.110633","DOIUrl":"10.1016/j.contraception.2024.110633","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to compare bleeding days and spotting days and satisfaction among individuals who replaced their contraceptive implant at three years versus those who extended use of the implant past three years.</div></div><div><h3>Methods</h3><div>We conducted a prospective cohort study. Participants reported number of bleeding and spotting days for 30 days prior to their implant appointment, decided to replace (replacers) or extend (extenders) use, and then reported number of bleeding and spotting days for 30 days after. Participants also recorded their satisfaction with the amount of bleeding and/or spotting. We used Wilcoxon Rank Sum tests to compare unadjusted median differences between groups and multivariable median (quantile) regression to adjust for co-variates.</div></div><div><h3>Results</h3><div>Among 52 participants, there was no significant difference between the two groups 30 days before or 30 days after replacing or extending use of the implant for spotting only days (0 vs 0, p=1.00) or any bleeding days (0 vs. 0, p=0.39). There were more spotting days 30 days prior to the appointment among those who decided to replace their implant, however the difference was not statistically significant (2 vs. 1, p=0.06). We found no statistically significant differences in median number of days reporting satisfaction with bleeding/spotting patterns from before and after 30 days (0 vs. -1, p=0.85).</div></div><div><h3>Conclusions</h3><div>Neither implant replacers nor extenders experienced significant changes in bleeding 30 days before or after replacing or extending. This data can help clinicians counsel patients regarding bleeding patterns when they are deciding to keep or replace their contraceptive implant at three years.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426189","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":"USING THE AMERICAN COMMUNITY SURVEY AND THE MYERS ABORTION DASHBOARD TO DETERMINE THE RELATIONSHIP BETWEEN SPATIAL POLARIZATION AND ACCESS TO IN-PERSON ABORTION CARE","authors":"E Dindinger,&nbsp;RH Cohen,&nbsp;WB Allshouse,&nbsp;J Sheeder","doi":"10.1016/j.contraception.2024.110603","DOIUrl":"10.1016/j.contraception.2024.110603","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to assess the relationship between spatial polarization and driving times from each US county to the closest abortion clinic before and after <em>Dobbs v Jackson Women’s Health Organization</em>.</div></div><div><h3>Methods</h3><div>We calculated county-level Index of Concentrations at the Extremes (ICE), which quantifies extremes of disadvantage and privilege and is used as a proxy for structural racism. We calculated the distance from the centroid of each US county to the closest abortion clinic before (March 2022) and after <em>Dobbs</em> (March 2023). We compared travel times before and after <em>Dobbs</em> using a medians test. We used logistic regression to determine ICE quintile predictors of the closest facility being ≥2-hours adjusted for legality of abortion and time period.</div></div><div><h3>Results</h3><div>We assessed 3,143 US counties. Median travel time increased from 1.6 (range:0.1-6.7) to 2.0 (range:0-11.6) hours post-<em>Dobbs; p</em>&lt;0.001. In logistic regression, those in the most-disadvantaged race and income ICE quintile versus those in the least-disadvantaged quintile had increased odds of living in a county ≥2 hours from an abortion facility of (adjusted OR (aOR) 2.32; 95%CI:1.94–2.79) and the odds of living ≥2 hours from a facility increased by (aOR 2.24; 95%CI:2.01-2.51) post-<em>Dobbs</em>. Similarly, those in the most-disadvantaged ethnicity and income quintiles verses those in the least-disadvantaged quintile had increased odds of living ≥2 hours from an abortion facility of 2.50;95%CI[2.09–3.01]) and the odds of living ≥2 hours from a facility increased by 2.25;95%CI[2.01-2.52] post-<em>Dobbs</em>.</div></div><div><h3>Conclusions</h3><div>Abortion bans are increasing the travel time to the closest facility which may be increasing barriers to care among communities already facing systemic poverty and structural racism.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426356","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":"“I CONTROL MY BODY”: REPRODUCTIVE JUSTICE AMONG BLACK WOMEN ENGAGED IN THE CRIMINAL LEGAL SYSTEM IN NEW YORK CITY","authors":"A Dasgupta,&nbsp;J Meyer,&nbsp;D Goddard-Eckrich,&nbsp;N El-Bassel,&nbsp;L Gilbert","doi":"10.1016/j.contraception.2024.110615","DOIUrl":"10.1016/j.contraception.2024.110615","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aims to understand how rights to reproductive justice (RJ) are infringed upon or supported among Black women engaged in the criminal legal system in New York City.</div></div><div><h3>Methods</h3><div>Between October 2018 and January 2019, we conducted 43 semi-structured interviews with Black women in community supervision programs with histories of drug use who reported risks for HIV or being HIV-positive in New York City. Thematic analyses of the data were conducted using the RJ framework, with findings categorized based on each key RJ principle.</div></div><div><h3>Results</h3><div>Key themes related to the right to have a child included (1) forced abortion, (2) unexplained fertility not being followed up by doctors (and subsequent medical mistrust of providers), and (3) misinformation related to abortion and fertility. Themes related to the right to not have a child included (1) use of birth control, (2) primarily positive experiences with abortion access, (3) and having bodily autonomy. Themes related to the right to raise a child in a safe and healthy environment included (1) housing instability, (2) engagement with child protective services, and (3) the role of criminal legal systems in isolating mothers.</div></div><div><h3>Conclusions</h3><div>Findings highlight both major infringements to women’s RJ rights, as well as women describing facilitators to maintaining their RJ rights among this sample of Black women. Results also highlight the importance of access of equitable sexual and reproductive health services for women engaged in the criminal legal system, who may have competing priorities and needs to maintain their sexual and reproductive health.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426437","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":"OHIO ABORTION SEEKERS CHALLENGED BY TWO-VISIT REQUIREMENT ARE LIKELY TO REPORT MORE CHALLENGES OVERALL","authors":"A Kirkendall,&nbsp;M Bornstein,&nbsp;K Rivlin,&nbsp;A Norris Turner,&nbsp;M Davoodifar,&nbsp;T Odum,&nbsp;D Bessett","doi":"10.1016/j.contraception.2024.110607","DOIUrl":"10.1016/j.contraception.2024.110607","url":null,"abstract":"<div><h3>Objectives</h3><div>Ohio, like many restrictive states, requires abortion patients to present in-person for two appointments 24-hours apart. This study seeks to understand which, if any, patient-reported challenges are associated with the two-visit requirement.</div></div><div><h3>Methods</h3><div>1,361 participants seeking abortion care in Ohio completed an online survey between April 2020 and July 2021. Survey questions addressed challenges experienced, delayed expenses, and actions taken to cover costs. Responses of those who indicated making multiple trips for their abortion care was a challenge were compared to those who did not experience this challenge.</div></div><div><h3>Results</h3><div>29.4% of participants were challenged by the multiple trips requirement. Participants reporting this challenge were demographically similar by race, sexuality, and gender to those not reporting this challenge. Participants challenged by multiple visits reported twice as many challenges overall than those who were not challenged by multiple trips (mean=4.0 vs. 2.1, p&lt;0.01). Participants challenged by multiple trips took more actions to cover costs (mean=1.1 vs. 0.8 for those not challenged by multiple visits, p&lt;0.01). Overall, 28.5% of participants delayed expenses to cover costs, including 37.8% of those challenged by multiple visits and 24.7% of those not challenged by multiple visits (p&lt;0.01). The number of delayed expenses was greater for those challenged by multiple visits (mean=0.7 vs. 0.4, p&lt;0.01).</div></div><div><h3>Conclusions</h3><div>Many Ohioans seeking abortion identified the two-visit requirement as a challenge. The two-visit requirement occurs in conjunction with, and likely exacerbates, other challenges, especially financial stressors. Patients should be allowed to work with their care providers to determine the right number of visits for them.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426514","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":"ABORTION PATIENTS’ AWARENESS AND UNDERSTANDING OF AN EARLY PREGNANCY ABORTION BAN AND ACCESS TO IN-STATE CARE","authors":"K White,&nbsp;W Arey,&nbsp;AD Beasley,&nbsp;A Chatillon,&nbsp;C Chadwick,&nbsp;A Dane’el,&nbsp;O Leyser-Whalen,&nbsp;T Weitz","doi":"10.1016/j.contraception.2024.110612","DOIUrl":"10.1016/j.contraception.2024.110612","url":null,"abstract":"<div><h3>Objectives</h3><div>Explore We aimed to explore pregnant Texans’ awareness and understanding of a 2021 state law prohibiting abortion after detectable embryonic cardiac activity when navigating to abortion care.</div></div><div><h3>Methods</h3><div>We recruited Texans who obtained out-of-state abortion care after implementation of Senate Bill 8 (SB8) by providing flyers to abortion facilities in seven states and using online ads. Between October 2021 and February 2022, we conducted in-depth telephone interviews with English-speaking participants ≥15 years of age to explore their experiences seeking care. We used inductive and deductive codes in our thematic analysis describing participants’ understanding of how the law limited abortions.</div></div><div><h3>Results</h3><div>Most of the 65 participants discovered their pregnancy soon after a missed period, and less than half had heard of SB8 prior to pregnancy. Those who identified their pregnancy early and heard SB8 changed when an abortion could be obtained described the stress of scheduling appointments to confirm whether they could secure in-state care; a few felt rushed to make a decision. Having heard SB8 described as a six-week ban, participants were upset and frustrated to learn they were ineligible for in-state care because clinicians dated their pregnancy from weeks since last menstrual period (vs conception), there was evidence of cardiac activity before six weeks gestation, or cardiac activity appeared between ultrasound visits.</div></div><div><h3>Conclusions</h3><div>Pregnant Texans’ limited awareness of SB8 and the disjuncture between their understanding of the law and how it applied in early pregnancy increased time pressures and logistical burdens during their process seeking abortion care.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426519","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":"STUDENT EXPERIENCES WITH EMERGENCY CONTRACEPTION AND PREFERENCES FOR ON-CAMPUS VENDING MACHINES","authors":"S Knifton,&nbsp;M Quasebarth,&nbsp;V Manthena,&nbsp;L Hasselbacher","doi":"10.1016/j.contraception.2024.110648","DOIUrl":"10.1016/j.contraception.2024.110648","url":null,"abstract":"<div><h3>Objectives</h3><div>Vending machines that sell emergency contraception (EC) at discounted prices are becoming increasingly common on US college campuses. These machines facilitate convenient and timely access for college students by mitigating common barriers to obtaining EC. Limited research has investigated students’ attitudes toward this resource.</div></div><div><h3>Methods</h3><div>Currently enrolled students at a private university in Illinois were recruited via flyers and listservs to complete an electronic survey on EC accessibility between November 2023 and February 2024. Anonymous survey responses were recorded via RedCap and exported to Microsoft Excel and SPSS for analysis.</div></div><div><h3>Results</h3><div>372 students completed the survey. The majority of participants identified as cisgender women (73.1%), straight (45.8%), White (52.6%), and as undergraduate (60.1%). Results found that over one-third (38.2%) of participants had previously purchased EC. Nearly 20% of these participants found the experience difficult, mainly due to the high cost of EC. Over half (56.4%) of participants had concern about being noticed or having to interact with staff when obtaining EC at a store or at student health clinic. Most (90.4%) participants reported that they would use an on-campus EC vending machine if they needed EC. Less than half (43.6%) indicated that they would be willing to spend more than $20 for EC.</div></div><div><h3>Conclusions</h3><div>EC vending machines are a practical solution to increase EC accessibility on college campuses and support students’ reproductive and educational goals, especially in the face of increasing abortion restrictions. To best address student concerns, ensuring that EC is low-cost and machines are placed in an accessible, but confidential, location is crucial.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426893","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":"OPIATE-SPARING ANALGESIA PROTOCOL FOR PAIN AFTER OSMOTIC DILATOR PLACEMENT: A QUALITY IMPROVEMENT STUDY","authors":"PD Kendall,&nbsp;J Sheeder,&nbsp;S Wilson,&nbsp;N Fang","doi":"10.1016/j.contraception.2024.110624","DOIUrl":"10.1016/j.contraception.2024.110624","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to compare maximum overnight pain scores and patient satisfaction with routine opiate provision versus an opiate-sparing analgesia protocol after osmotic dilator placement before dilation and evacuation.</div></div><div><h3>Methods</h3><div>We conducted a quality improvement study comparing out-of-clinic analgesia protocols for patients undergoing one and two days of osmotic dilator cervical preparation prior to dilation and evacuation at 16 to 26 weeks gestation. For two 13-week periods, we assessed the outcomes of our previous analgesia protocol of universal opiate prescription to our new protocol in which we only provided an opiate prescription at patient request or provider recommendation. Pain was assessed using an 11-point numerical rating scale (NRS; scale 0-10). The primary outcome was median individual pain score change from baseline to maximum. Patient and clinical characteristics, anxiety, sleep, activity disruptions, analgesic use, and patient satisfaction were assessed by medical record review and patient surveys.</div></div><div><h3>Results</h3><div>The routine opiate provision and opiate-sparing groups included 55 and 50 patients, respectively. 52 (92.9%) in the routine opiate provision group and 7 (14%) in the opiate sparing protocol received an opiate prescription (p=&lt;0.001). For patients undergoing one and two days of osmotic dilators, the median change in pain from baseline to maximum did not differ between groups (7.0 (range:0-10) to 6.0 (0-10);p=0.06 and 8.0 (0-10) to 6.0 (5-10);p=0.45). Anxiety, satisfaction, other analgesic use, calls to providers, and complications did not differ between groups.</div></div><div><h3>Conclusions</h3><div>Clinicians can utilize an opiate-sparing protocol for analgesia after osmotic dilator placement to reduce opiate prescriptions while providing adequate analgesia and satisfaction.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426174","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":"ACCEPTABILITY OF AND PREFERENCES FOR LONG-ACTING INJECTABLE HORMONAL CONTRACEPTION: RESULTS FROM A NATIONAL ONLINE SURVEY WITH US WOMEN","authors":"A Gottert,&nbsp;T Abuya,&nbsp;E Proos,&nbsp;I Johnson,&nbsp;NH Dormer,&nbsp;U Foley,&nbsp;G Saul,&nbsp;LB Haddad,&nbsp;DR Friend","doi":"10.1016/j.contraception.2024.110635","DOIUrl":"10.1016/j.contraception.2024.110635","url":null,"abstract":"<div><h3>Objectives</h3><div>We conducted end-user research to optimize design of a sustained-release microsphere-based etonogestrel long-acting injectable (LAI) in development targeting 6- or 12-month windows of protection, steady hormone dose, and rapid return-to-fertility.</div></div><div><h3>Methods</h3><div>We implemented a national online survey including a discrete choice experiment (DCE) in June-July 2023, with cis-gender women ages 18-44 years. DCE attributes included duration of effectiveness (6/12/24-months), effect on menses, side-effects, and post-use return-to-fertility timing. Data analysis employed mixed-multinomial logit models.</div></div><div><h3>Results</h3><div>1,029 participants completed the survey (mean age 28.6 years, from 49 US states; 30.9% Black/African American; 11.6% Hispanic/Latina; 71.6% nulliparous; 49.0% not wanting a(nother) child). 35.7% currently use birth-control pills (37.4%); 35.7% male condoms; 19.8% withdrawal. In the DCE, participants strongly negatively preferred (in order-of-magnitude): may cause heavier/unpredictable periods, mild headaches/nausea, slight weight-gain, and delayed return-to-fertility (6-12-months vs. 3-months). Participants positively preferred: may cause no period, and shorter/lighter periods. Women significantly preferred 12-month to 6-month duration (p&lt;0.03). Most participants (92.4%) were interested in using the LAI if it had no/minimal side-effects/heavier bleeding and quick return-to-fertility. Two-thirds preferred a 12/24-month duration; one-third a 6-month. Preference for 6-month duration was associated with wanting a child within five years, and higher discomfort with hormones (both p&lt;0.001).</div></div><div><h3>Conclusions</h3><div>While most women report interest in an LAI, interest substantially decreases if it may cause heavier/unpredictable periods, other side-effects, or delayed return-to-fertility. Longer duration (12+ months) is preferred; a 6-month option appears important for women wanting to get pregnant relatively soon, and those concerned about hormones.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426188","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}