2020-2023财政年度美国现役妇女高效避孕药具使用差异

IF 3 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Amandari Kanagaratnam, Sarah Selica Miura, Helen M Barnhart, Christian Coles, Tracey Pérez Koehlmoos
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引用次数: 0

摘要

背景:尽管在军事卫生系统(MHS)中普遍覆盖了所有高效避孕(HEC)方法,但与普通美国人群相比,现役妇女(ADSW)的意外怀孕率较高,HEC使用率较低。在2016年至2019年期间,少数种族和低社会经济地位(SES)的ADSW使用HEC的几率较低。本研究进一步调查了与ADSW中HEC使用相关的因素,以评估其生殖健康需求。方法:我们使用MHS数据库中2020-2023财年的数据对18-45岁的所有ADSW进行了横断面研究。统计分析包括描述性统计和逻辑回归模型,调整和未调整,通过方法和社会特征(包括种族和军衔作为SES的代理)确定HEC总体使用的几率。结果:在确定的339,011例ADSW中,164,756例(48.6%)在研究期间至少使用了一种HEC方法。黑人(优势比[OR] = 0.89;95%可信区间[CI] = 0.88-0.91)和亚洲/太平洋岛民(OR = 0.88;95% CI = 0.78-0.82) ADSW显示总体HEC使用的几率低于白色ADSW。初级ADSW士兵的HEC使用率低于几乎所有其他军种。结论:自2019年以来,使用HEC方法的ADSW比例有所下降,而普通人群中HEC的使用有所增加。种族和社会经济差异仍然存在,因此需要进一步研究这些差异的原因,以便设计有效的缓解战略,确保所有非裔美国人获得避孕护理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Disparities in Highly Effective Contraceptive Use Among U.S. Active Duty Service Women, Fiscal Years 2020-2023.

Background: Despite universal coverage of all highly effective contraceptive (HEC) methods in the Military Health System (MHS), active duty service women (ADSW) have higher rates of unintended pregnancy and lower rates of HEC use than the general U.S. population. Between 2016 and 2019, racial minority and lower socioeconomic status (SES) ADSW demonstrated lower odds of HEC use. This study further investigated factors associated with HEC use among ADSW to assess their reproductive health needs. Methods: We conducted a cross-sectional study using fiscal year 2020-2023 data from the MHS Data Repository for all ADSW aged 18-45 years. Statistical analyses included descriptive statistics and logistic regression models, adjusted and unadjusted, determining the odds of HEC use overall, by method, and by social characteristics, including race and military rank as a proxy for SES. Results: Of the 339,011 ADSW identified, 164,756 (48.6%) used at least one HEC method during the study period. Black (odds ratio [OR] = 0.89; 95% confidence interval [CI] = 0.88-0.91) and Asian/Pacific Islander (OR = 0.88; 95% CI = 0.78-0.82) ADSW demonstrated lower odds of overall HEC use than White ADSW. Junior Enlisted ADSW demonstrated lower odds of overall HEC use than nearly all other ranks. Conclusions: The proportion of ADSW using HEC methods has decreased since 2019, while HEC use in the general population has increased. Racial and socioeconomic disparities remain, highlighting the need for future research to investigate reasons for these disparities in order to design effective mitigation strategies to ensure access to contraceptive care for all ADSW.

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来源期刊
Journal of women's health
Journal of women's health 医学-妇产科学
CiteScore
6.60
自引率
5.70%
发文量
197
审稿时长
2 months
期刊介绍: Journal of Women''s Health is the primary source of information for meeting the challenges of providing optimal health care for women throughout their lifespan. The Journal delivers cutting-edge advancements in diagnostic procedures, therapeutic protocols for the management of diseases, and innovative research in gender-based biology that impacts patient care and treatment. Journal of Women’s Health coverage includes: -Internal Medicine Endocrinology- Cardiology- Oncology- Obstetrics/Gynecology- Urogynecology- Psychiatry- Neurology- Nutrition- Sex-Based Biology- Complementary Medicine- Sports Medicine- Surgery- Medical Education- Public Policy.
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