Contraception: X最新文献

{"title":"Dilation and evacuation versus medication abortion at 15–24 weeks of gestation in low-middle income country: A retrospective cohort study","authors":"Abraham Fessehaye Sium,&nbsp;Amani Nureddin Abdu,&nbsp;Zerihun Beyene","doi":"10.1016/j.conx.2024.100110","DOIUrl":"10.1016/j.conx.2024.100110","url":null,"abstract":"<div><h3>Objective</h3><p>To compare the effectiveness and safety of dilation and evacuation (D&amp;E) to that of medication abortion at 15–24 weeks in a low-middle income country.</p></div><div><h3>Study design</h3><p>We conducted a retrospective cohort on effectiveness and safety of D&amp;E vs medication abortion at 15–24 weeks in an Ethiopian setting over a year (January 1–December 31, 2023). We looked at success (need for additional procedure) of both abortion procedures and their complication rates. Hemorrhage, infection, uterine perforation/rupture, and cervical tear were the complications we compared between the groups (D&amp;E group vs medication abortion group). <em>P</em>-value less than 0.05 and Adjusted odds ratio (AOR) with 95% CI were used to present results significance.</p></div><div><h3>Results</h3><p>A total of 225 abortion cases (162 medication abortion cases and 63 D&amp;E cases) at gestational age of 15–24 weeks were included in the final analysis. The mean gestational age was 18 ± 2.8 weeks in the D&amp;E group compared to 21 ± 3 weeks in the medication abortion group (<em>p</em>-value<!--> <!-->&lt;<!--> <!-->0.001). The overall procedure effectiveness between the abortion procedures was similar (95.2% vs 96.9% in the D&amp;E group and medication abortion groups, <em>p</em>-value<!--> <!-->=<!--> <!-->0.542). D&amp;E (AOR<!--> <!-->=<!--> <!-->2.92 [95% CI<!--> <!-->=<!--> <!-->0.62–13.69]) was not associated with increased overall complications compared to medication abortion, after controlling for parity, gestational age, and history of prior uterine scar.</p></div><div><h3>Conclusion</h3><p>We found both abortion methods (D&amp;E and medication abortion) are effective with comparable complication rates.</p></div><div><h3>Implications</h3><p>D&amp;E and medication abortion are safe and effective methods of abortion for gestations up to 24 weeks even in a low-middle income country (LMIC) setting; as such, greater resources are needed to ensure to increase availability of D&amp;E in order for women to have a choice in their treatment options.</p></div>","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"6 ","pages":"Article 100110"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590151624000078/pdfft?md5=f4cf2c2381c0def0532e91cb2471a6ce&pid=1-s2.0-S2590151624000078-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142084003","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":"Experiences of delay-causing obstacles and mental health at the time of abortion seeking","authors":"Ortal Wasser ,&nbsp;Lauren J. Ralph ,&nbsp;Shelly Kaller ,&nbsp;M. Antonia Biggs","doi":"10.1016/j.conx.2024.100105","DOIUrl":"10.1016/j.conx.2024.100105","url":null,"abstract":"<div><h3>Objectives</h3><p>The delays and challenges people encounter when seeking abortion are well-documented, but their psychological implications are understudied. Aiming to fill this gap, we explored the associations between experiences of delay-causing obstacles to abortion care and adverse mental health symptoms among individuals seeking abortion care.</p></div><div><h3>Study design</h3><p>In 2019, we surveyed 784 people (of 1092 approached) ages 15–45 accessing abortion care in four clinics in abortion-supportive states: California, Illinois, and New Mexico. We conducted multivariable Poisson regressions to examine associations between experiencing delay-causing obstacles to abortion care and stress, anxiety, and depression at the abortion appointment. We also used Poisson regression to examine whether some individuals are more likely to experience delay-causing obstacles than others.</p></div><div><h3>Results</h3><p>Three in five participants (58%) experienced delay-causing obstacles when accessing abortion care. The most prevalent obstacles were cost-related (45%), followed by access-related (43%), and travel time-related (35%) delays. In adjusted analyses, experiencing any type of delay-causing obstacle to abortion care was significantly associated with more symptoms of stress, anxiety, and depression and higher risk of anxiety and depressive disorders. Participants were more likely to experience delay-causing obstacles if they traveled from another state or over 100 miles to reach the clinic, sought abortion beyond 13 weeks gestation, lacked money for unexpected expenses, and found it difficult to pay for the abortion.</p></div><div><h3>Conclusion</h3><p>Abortion is a time-sensitive healthcare, but most individuals are forced to delay care due to various obstacles that may have a negative impact on their psychological well-being.</p></div><div><h3>Implications</h3><p>Obstacles causing delays in accessing abortion care may contribute to elevated symptoms of stress, anxiety, and depression and higher risk of anxiety and depressive disorders for abortion patients. As restrictive policies increase, delays are likely to worsen, potentially leading to psychological harm for people seeking abortion.</p></div>","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"6 ","pages":"Article 100105"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590151624000029/pdfft?md5=9afc1159cd88ea22b96691c7ff671cb7&pid=1-s2.0-S2590151624000029-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140088463","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 new vision for male contraception research and development","authors":"Regine Sitruk-Ware,&nbsp;Jim Sailer,&nbsp;David Serfaty,&nbsp;Richard Anderson","doi":"10.1016/j.conx.2024.100108","DOIUrl":"10.1016/j.conx.2024.100108","url":null,"abstract":"","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"6 ","pages":"Article 100108"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945935","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":"Evaluation of the London Measure of Unplanned Pregnancy (LMUP) among a nationally representative sample of pregnant and postpartum women Ethiopia","authors":"Celia Karp ,&nbsp;Caroline Moreau ,&nbsp;Solomon Shiferaw ,&nbsp;Assefa Seme ,&nbsp;Mahari Yihdego ,&nbsp;Linnea A. Zimmerman","doi":"10.1016/j.conx.2023.100094","DOIUrl":"10.1016/j.conx.2023.100094","url":null,"abstract":"<div><h3>Objectives</h3><p>Rigorous measurement of pregnancy preferences is needed to address reproductive health needs. The London Measure of Unplanned Pregnancy (LMUP), developed in the UK, has been adapted for low-income countries. Psychometric properties of LMUP items remain uncertain in contexts with limited access to and use of health services.</p></div><div><h3>Study design</h3><p>This cross-sectional study examines the six-item LMUP’s psychometric properties among a nationally representative sample of 2855 pregnant and postpartum women in Ethiopia. Principal components analysis (PCA) and confirmatory factor analysis (CFA) estimated psychometric properties. Hypothesis testing examined associations between the LMUP and other measurement approaches of pregnancy preferences using descriptive statistics and linear regression.</p></div><div><h3>Results</h3><p>The six-item LMUP had acceptable reliability (α = 0.77); two behavioral items (contraception, preconception care) were poorly correlated with the total scale. A four-item measure demonstrated higher reliability (α = 0.90). Construct validity via PCA and CFA indicated the four-item LMUP’s unidimensionality and good model fit; all hypotheses related to the four-item LMUP and other measurement approaches were met.</p></div><div><h3>Conclusions</h3><p>Measurement of women’s pregnancy planning in Ethiopia may be improved through use of a four-item version of the LMUP scale. This measurement approach can inform family planning services to better align with women’s reproductive goals.</p></div><div><h3>Implications</h3><p>Improved pregnancy preference measures are needed to understand reproductive health needs. A four-item version of the LMUP is highly reliable in Ethiopia, offering a robust and concise metric for assessing women’s orientations toward a current or recent pregnancy and tailoring care to support them in achieving their reproductive goals.</p></div>","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"5 ","pages":"Article 100094"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10176025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9829713","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":"Clinical outcomes of intrauterine device insertions by newly trained providers: The ECHO trial experience","authors":"Irina Yacobson ,&nbsp;Valentine Wanga ,&nbsp;Khatija Ahmed ,&nbsp;Tsungai Chipato ,&nbsp;Peter Gichangi ,&nbsp;James Kiarie ,&nbsp;Cheryl Louw ,&nbsp;Susan Morrison ,&nbsp;Margaret Moss ,&nbsp;Nelly R. Mugo ,&nbsp;Thesla Palanee-Phillips ,&nbsp;Melanie Pleaner ,&nbsp;Caitlin W. Scoville ,&nbsp;Katherine K. Thomas ,&nbsp;Kavita Nanda ,&nbsp;for the Evidence for Contraceptive Options and HIV Outcomes (ECHO) Trial Consortium","doi":"10.1016/j.conx.2023.100092","DOIUrl":"10.1016/j.conx.2023.100092","url":null,"abstract":"<div><h3>Objectives</h3><p>To assess the rates of failed insertion, expulsion, and perforation when intrauterine device (IUD) insertions were done by newly trained clinicians, and to examine factors that may affect these outcomes.</p></div><div><h3>Study design</h3><p>We evaluated skill-based outcomes following IUD insertion at 12 African sites in a secondary analysis of the Evidence for Contraceptive Options and HIV Outcomes (ECHO) randomized trial. Before trial initiation, we provided competency-based IUD training to clinicians and offered ongoing clinical support. We used Cox proportional hazards regression to examine factors associated with expulsion.</p></div><div><h3>Results</h3><p>Among 2582 IUD acceptors who underwent first attempted IUD insertion, 141 experienced insertion failure (5.46%) and seven had uterine perforation (0.27%). Perforation was more common among breastfeeding women within three months postpartum (0.65%) compared with non-breastfeeding women (0.22%). We recorded 493 expulsions (15.5 per 100 person-years, 95% confidence interval [CI] 14.1─16.9): 383 partial and 110 complete. The risk of IUD expulsion was lower among women older than 24 years (aHR 0.63, 95% CI 0.50─0.78) and may be higher among nulliparous women. (aHR 1.65, 95% CI 0.97─2.82). Breastfeeding (aHR 0.94, 95% CI 0.72─1.22) had no significant effect on expulsion. IUD expulsion rate was highest during the first three months of the trial.</p></div><div><h3>Conclusions</h3><p>IUD insertion failure and uterine perforation rates in our study were comparable to those reported in the literature. These results suggest that training, ongoing support, and opportunities to apply new skills were effective in ensuring good clinical outcomes for women receiving IUD insertion by newly trained providers.</p></div><div><h3>Implications</h3><p>Data from this study support recommendations to program managers, policymakers, and clinicians that IUDs can be inserted safely in resource-constrained settings when providers receive appropriate training and support.</p></div>","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"5 ","pages":"Article 100092"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10176026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10139740","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":"“If I use family planning, I may have trouble getting pregnant next time I want to”: A multicountry survey-based exploration of perceived contraceptive-induced fertility impairment and its relationship to contraceptive behaviors","authors":"Suzanne O. Bell ,&nbsp;Celia Karp ,&nbsp;Caroline Moreau ,&nbsp;PMA Principal Investigators Group ,&nbsp;Alison Gemmill","doi":"10.1016/j.conx.2023.100093","DOIUrl":"10.1016/j.conx.2023.100093","url":null,"abstract":"<div><h3>Objectives</h3><p>We aim to assess women’s perceptions regarding contraceptive effects on fertility across a diversity of settings in sub-Saharan Africa and how they vary by women’s characteristics. We also aim to examine how such beliefs relate to women’s contraceptive practices and intentions.</p></div><div><h3>Study design</h3><p>This study uses cross-sectional survey data among women aged 15 to 49 in nine sub-Saharan African geographies from the Performance Monitoring for Action project. Our main measure of interest assessed women’s perceptions of contraceptive-induced fertility impairment. We examined factors related to this belief and explored the association between perceptions of contraceptive-induced fertility impairment and use of medicalized contraception (intrauterine device, implant, injectable, pills, emergency contraception) and intention to use contraception (among nonusers).</p></div><div><h3>Results</h3><p>Between 20% and 40% of women across study sites agreed or strongly agreed that contraception would lead to later difficulties becoming pregnant. Women at risk of an unintended pregnancy who believed contraception could cause fertility impairment had reduced odds of using medicalized contraception in five sites; aORs ranged from 0.07 to 0.62. Likewise, contraceptive nonusers who wanted a/another child and perceived contraception could cause fertility impairment were less likely to intend to use contraception in seven sites, with aORs between 0.34 and 0.66.</p></div><div><h3>Conclusions</h3><p>Our multicountry study findings indicate women’s perception of contraceptive-induced fertility impairment is common across diverse sub-Saharan African settings, likely acting as a deterrent to using medicalized contraceptive methods.</p></div><div><h3><strong>Implications</strong></h3><p>Findings from this study can help improve reproductive health programs by addressing concerns about contraception to help women achieve their reproductive goals.</p></div>","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"5 ","pages":"Article 100093"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10127128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10101606","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":"Knowledge, attitude, and intended practice of abortion among medical students in Thailand after the amendment of the Thai abortion law","authors":"Rada Poolkumlung ,&nbsp;Ratthapong Rongkapich ,&nbsp;Natchanika Sinthuchai ,&nbsp;Somsook Santibenchakul ,&nbsp;Vorachart Meevasana ,&nbsp;Unnop Jaisamrarn","doi":"10.1016/j.conx.2023.100091","DOIUrl":"10.1016/j.conx.2023.100091","url":null,"abstract":"<div><h3>Objectives</h3><p>Following the amendment of the Thai abortion law in February 2021, the authors conducted an anonymous survey to assess knowledge, attitude, and intended practice toward abortion among fifth-year medical students at Chulalongkorn University.</p></div><div><h3>Study design</h3><p>The authors developed a self-administrated questionnaire consisting of three parts: knowledge of the recently amended Thai abortion law, attitude toward abortion, and intended practices. Pilot testing showed a high Cronbach's alpha and test-retest reliability coefficient.</p></div><div><h3>Results</h3><p>Of the 292 surveyed medical students, 70% completed the questionnaire. The mean ± standard deviation of the knowledge part was 6.9 ± 1.8, of which the maximum score was 10. Nearly half of the participants (45.6%) answered at least 80% of the knowledge statements correctly. Sixty-four percent of participants answered correctly on the gestational limit for first-trimester abortion. Around one-third of participants answered correctly on the gestational limit for second-trimester abortion. Most participants (86.8%) agreed that abortion is a woman’s right. The most acceptable conditions for abortion were pregnancy as a result of rape (93%) and serious anomalies that cause a nonviable neonate (95.6%).</p></div><div><h3>Conclusions</h3><p>Participants exhibited a lack of understanding regarding the legal gestational limit, which is a key aspect of the amendment. The findings of this study urge medical schools to emphasize the revised Thai abortion law in the Obstetrics and Gynecology curriculum.</p></div><div><h3>Implications</h3><p>Our results show that encouraging medical students to have up-to-date knowledge regarding the amendment of Thai abortion law may support their future decision to provide safe abortion services.</p></div>","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"5 ","pages":"Article 100091"},"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/21/f1/main.PMC10140783.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9386584","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":"Evaluation of the LMUP in Ethiopia: Requirements, challenges and best practice","authors":"Geraldine Barrett,&nbsp;Ana Luiza Vilela Borges,&nbsp;Justine N. Bukenya,&nbsp;Ararso Baru Olani,&nbsp;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}