Women's contraceptive decision-making: How well do women's preferences for certain contraceptive attributes align with the methods they use?

Background: Women’s contraceptive method choice is likely influenced by their assessment of the attributes of available methods; however, this is understudied. Assisting women in choosing methods that are consistent with attributes that are important to them may increase correct and continuous method use. Objective: To assess the importance of several contraceptive attributes when choosing a method, and examine the association between the level of importance and the contraceptive methods that women currently use. Methods: Data are from the 2009 National Survey of Reproductive and Contraceptive Knowledge, a sample of unmarried men and women ages 18-29 in the U.S. Chi-squared tests and multivariate logistic regression were used to examine the association between contraceptive attributes, sociodemographic characteristics and current contraceptive choice. Results: The greatest proportion of women (79%) reported that effectiveness in preventing pregnancy is extremely important when choosing a contraceptive method, while the lowest proportion (22%) reported that a method that doesn’t contain hormones is extremely important. Several contraceptive attribute variables were associated with sociodemographic characteristics. Women who believed it was important that a method didn’t contain hormones were less likely to use hormonal methods and women who perceived STI protection to be important were more likely to use condoms, even after accounting for their preferences regarding a method’s effectiveness. Conclusion: Women perceive a method’s level of effectiveness in pregnancy prevention to be extremely important when choosing a method, but other attributes (e.g. STI protection) do influence method choice. Understanding how women’s perceptions relate to method use can inform contraceptive counseling interventions.