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Predictors of contraceptive selection at visit

Haleh Sangi-Haghpeykar, PhD1, Samuel F. Posner, PhD2, and Alfred N. Poindexter, MD1. (1) OB/GYN, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, (713)798-8057, halehs@bcm.tmc.edu, (2) Division of Reproductive Health, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS K-34, Atlanta, GA 30341

Little data is available on how woman's experience and perception of risk for unwanted pregnancy or disease, as well as relationship characteristics may influence her choice of commonly used hormonal contraceptives. Methods: 600 new users of Depo Medroxy-progesterone (DMPA) (N=400) or oral contraceptives (Ocs) (N=200) were surveyed at the clinic when they started the method. Results: Women who selected DMPA were more likely to be older, Hispanic and married than OC recipients. Partner support for use of both contraceptives were high (87%), and did not vary by method (85% DMPA vs. 90% OC, p=.08). Seventeen percent of women believed that DMPA or OCs are effective in prevention of HIV/STDs (9% whites, 27% Hispanics, 12% blacks; p<.0001). Within Hispanics, these incorrect perceptions were more prevalent among DMPA than OC recipients (30% vs. 17%; p=.05). After controlling for potential confounders, women who selected DMPA over OC were less likely to have used condoms in the past (OR=.67; p=.04) or have plans to use them in the future, (OR=.66; p=.04), and were more likely to have had a history of STD (OR=1.73; p=.03), a history of abortion (OR=2.2; p=.005), and to place great importance on the user-independent attribute of acontraceptive (OR=3.3; p<.01). Presence of a concurrent partner was unrelated to method selection. The majority were very satisfied with their method at 3 months (74% DMPA, 78% OC). Conclusion: Distinct behavioral and attitudinal differences exist between new users of DMPA and OC. The former may be the preferred method by women with a history of unwanted pregnancies. DMPA users may be at greater risk for disease than OC users.

Learning Objectives:

Keywords: Contraception, Decision-Making

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Factors Related to Use of Family Planning and Reproductive Health Services: Poster Session

The 132nd Annual Meeting (November 6-10, 2004) of APHA