Contraception matters: indicators of poor usage of contraception in sexually active women attending family planning clinics in Victoria, Australia

The sexual and reproductive health knowledge of women in Australia: A scoping review

ISSUE ADDRESSED

Sexual and reproductive health (SRH) knowledge influences health literacy and promotes positive health behaviours. This scoping review explores the SRH knowledge of women in Australia and reports on knowledge assessment, ways of learning, enablers and barriers, and interventions to improve knowledge.

METHODS

Seven databases were searched for eligible articles published in English between 2012 and 2022.

RESULTS

Eighty-five sources were included for analysis. Data were mapped by knowledge topic and population group and charted against four review objectives. Assessment of knowledge was the primary focus in 59% of sources. Two sources used a validated knowledge assessment tool. Knowledge was assessed using self-assessment, a measurement of correctness, or both. Women learnt about SRH through a range of sources, including healthcare providers, peers, family, internet, and school. Enablers and barriers spanned information content, delivery, timing, accessibility, interactions with those providing information, cultural and gendered norms, pre-migration experiences, and functional health literacy. Nine sources reported on interventions to facilitate SRH knowledge.

CONCLUSIONS

This review identified topics, population groups, and gaps in assessment of SRH knowledge of women in Australia. Overall, the measurement of women's SRH knowledge is largely conducted using unvalidated tools focusing on specific topics. SO WHAT?: It is recommended a validated tool be developed to comprehensively assess the SRH knowledge of women in Australia allowing for intersectional population analysis and exploration of knowledge conceptualisation. This would enable assessment of interventions aiming to improve SRH knowledge thereby facilitating improved health literacy and outcomes.

Knowledge, attitudes and practices of contraceptive methods among students in public and private high schools in Cameroon

The use of contraceptive methods is still a controversial subject in the societies of developing countries. This study aims to assess the knowledge, attitudes, and practices of contraceptive methods among students, aged 15 to 25 years, in public and private schools in the district of Bonaberi, Douala, Cameroon. This research was modeled on the pattern of descriptive study. The population in this study was composed of students (N = 1649) from the five public and private high schools of Bonaberi, Cameroon. The sample size of this study was 379 students. These data were collected in person by the researcher between 1 and 30, June 2022. The data collection tools are the student information form, the Knowledge and Practices of Contraceptive Methods Questionnaire, and the Contraceptive Attitude Scale (CAS). The data of this study were analyzed using descriptive statistics tests, Kruskal-Wallis Test, Pearson Chi-Square, Kolmogorov-Smirnoff, Student's T-Test, Mann-Whitney Test, and the One-way ANOVA. It was found that almost half (45.91 percent) of students were 19-22 years old, 59.1 percent of them were male, and almost half (49.3 percent) of them were sexually active. Currently, the male condom is the most commonly used and known method of contraception among students. It was determined that students take an average of 3.406 points from the total score of CAS. This result indicated a positive attitude toward contraceptive methods. There were no statistically significant differences in contraceptive attitudes according to gender, religion, or sexual activity. There was a statistically significant difference in contraceptive attitudes according to marital status and age. It is recommended to provide family planning counseling services in these schools in order to increase the use of effective methods and provide students with a reliable source of information on contraceptive methods.

Contraceptive Attitudes and Use among Tertiary Students in Greece

Objective:A sizable fraction of young people with active sex lives do not utilize contraceptives and engage in high-risk sexual activity. School-based programs can prevent sexual activity, encourage birth control and reduce high-risk behavior. A survey was conducted to assess the key sources of knowledge on sexual education and document attitudes and methods of contraception used by Greek students, providing valuable information for expanding contraceptive services. Material and methods:A descriptive cross-sectional study was conducted by using an online questionnaire which was distributed to 206 digital student groups on social media platforms from May 20 to June 5, 2021. Results:The majority of participants obtained information about contraception from the Internet and used male condoms to avoid unwanted pregnancy and protect against sexually transmitted diseases (STDs). The present study found that younger ages (18-20 and 21-25) preferred to use the male condom technique in an ephemeral relationship [x² (12) =26.041, Fisher's exact test p= 0.0380.05]. Conclusions:Exploring students' attitudes toward contraceptive usage can provide valuable insights for developing effective strategies to promote safe and responsible sexual behavior among this population.

Low-income women and use of prescribed contraceptives in the context of full health insurance coverage in France, 2019

OBJECTIVE

Major socioeconomic differences in contraceptive use are observed in high-income countries. Cost is often cited as a main factor to explain these differences but other barriers may also exist. Our aim was to compare prescribed contraceptive use among low-income and non-low-income women in a national context of full health insurance coverage.

STUDY DESIGN

In the French national health insurance database, we selected all women (14.8 million) aged 15-49 years living in France in 2019. We compared the prevalence of use of each prescribed contraceptive between low-income and non-low-income women: oral contraceptives, copper intrauterine devices (IUDs), the levonorgestrel intrauterine system (LNG-IUS), and implants.

RESULTS

In the study population, 11% had a low income. Fewer low-income women used prescribed contraceptives than non-low-income women (36% vs. 46%, p < 0.001). When using a contraceptive, low-income women used a different method: at 20-24 years old, they used less oral contraceptives (60% vs. 77%, p < 0.001) and more implants (22% vs. 9%, p < 0.001), while at 40-44 years, they used less levonorgestrel intrauterine systems (18% vs. 30%, p < 0.001).

CONCLUSIONS

Even in a national context of free access to medical care for low-income women, they use less and different prescribed contraceptives than non-low-income women. These results could reflect barriers other than financial cost to the use of prescribed contraceptives by low-income women.

IMPLICATIONS

Financial barriers need to be removed in order to increase contraceptive use. However, this may not be sufficient and further research should explore barriers that low-income women may encounter in accessing and choosing their contraception.

Knowledge, attitudes, and perception patterns of contraception methods: Cross-sectional study among Saudi males

Purpose:

The aim of this study is to assess the knowledge, attitude, and perception pattern of contraception and family planning among males in Saudi Arabia.

Methods:

A cross-sectional study was conducted using a self-administered questionnaire. Study sample were Saudi males who presented to the urology clinics in one tertiary center. Beside demographic data, we evaluate the responders’ knowledge about types of contraceptive methods, usage of one or more methods, reasons for using contraceptives, knowledge of contraception complications, awareness of religious opinion on contraception, the ideal number of children, and birth interval between them. Statistical analysis was performed using the Chi-square and Fisher's exact tests. A value of P < 0.05 was considered statistically significant.

Results:

Two hundred and forty-three subjects filled the questioner. The participants’ mean age was 42.7 years (range, 19–81); 227 (93.4%) were married. The majority of the participants were aware of the concept of contraception (79%). However, only 54% of the cohort reported using at least one type of contraception. A high percentage of the participants wanted a limited number of children with longer birth intervals. Many factors are responsible for increasing awareness and practice of contraception, additionally; there is limited knowledge and practice regarding male contraception, particularly vasectomy. Withdrawal technique and oral contraceptive pills for females were the most commonly used contraceptive methods for Saudi family planning. The most common reason for using birth control methods was having a lot of children. More than two-thirds of males believed that birth control methods are not prohibited by Islamic law.

Conclusions:

Younger age, shorter duration of marriage, governmental employee, less number of children, higher education degree, and higher monthly income had higher impact on contraception awareness and utilization. Couples still prefer noninvasive methods for contraception. Despite the relatively low use of contraceptive methods, particularly the male methods, the majority of the participants know about contraception. Efforts to advocate and promote the effective use of reproductive and sexual health services among newly married couples are warranted.

A study to assess the socio-demographic factor and knowledge, attitude, and practice of family planning methods in Lohpeeta migrants tribe located in Shivpuri central India

Background

Even though India was the first country in the whole world to introduce the national family planning policy, the acceptance rate of contraceptive methods has been unsatisfactory to date. Many women in their fertility period, who were ready to control their fertility and limit the number of unwanted children, were not aware of different methods of contraceptives available and their proper use and other benefits.

Aim and Objective

1. To assess the socio-demographic status of the study participants. 2. To assess the knowledge, attitude, and practice of contraceptive methods in Lohpeeta mobile tribe located in Shivpuri, central India.

Methods

The present study was an observational cross-sectional survey conducted from 1^st December 2019 to 28^th February 2020 in Lohpeeta mobile tribe located in Shivpuri local; nonrandom convenience sampling method was used after applying the inclusion and exclusion criteria, so the total sample size was 209. Data were collected by a principal investigator with a predesigned, pretested, questionnaire by conducting face-to-face interview with the participants. Firstly, the data was administered in an excel sheet then it was analyzed and presented in the form of percentage, and a Chi-square test was applied to assess the level of significance.

Result

The most common age group of participants was 18-30 year (37.3%) and most were married (97.6%); we found that the knowledge and attitude toward contraceptives of participants was very poor, most 185 (88.5%) of the participants had never used any contraceptive method and only a few participants were using it occasionally, and none of the participants were using any contraceptive methods regularly.

Conclusion

The knowledge, attitude, and compliance towards contraceptives were poor in this group, we need to focus on this type of migrant population to increase their awareness and change their attitude towards contraceptives, so that they can use it without any fear.

Contraceptive discontinuation and switching in urban Istanbul region in Turkey

OBJECTIVE

To evaluate rates of contraceptive discontinuation and method switching and examine their determinants in Istanbul, Turkey, because discontinuation of modern contraception leading to unintended pregnancy is a public health concern.

METHODS

We conducted a cross-sectional household survey between March and June 2018 among 4224 married women of reproductive age (16-44 years). Information on contraceptive use and discontinuation for the 31 months preceding the survey was recorded in a monthly calendar. Using single and multiple decrement life-table methods, we calculated the overall discontinuation and the cause-specific discontinuation rates.

RESULTS

The 12-month overall discontinuation rate was 12.32%. Intrauterine devices had the lowest discontinuation rate (7.12%). The most common reasons for discontinuation were the desire to become pregnant (6.56%) and method failure (2.76%). One in three episodes of discontinuation was not followed by method switching (32.16%). Age, education, and the method type were predictive of contraceptive discontinuation.

CONCLUSION

To reduce method failure, women should be provided with information about method effectiveness, correct use of methods, and what to do if they anticipate their method failed (e.g., emergency contraception). Programs should focus on improving knowledge about discontinuation and method failure. Contraceptive counseling should also emphasize timely switching to an effective method after discontinuation.

Impact of a pay-for-performance scheme for long-acting reversible contraceptive (LARC) advice on contraceptive uptake and abortion in British primary care: An interrupted time series study

BACKGROUND

Long-acting reversible contraception (LARC) is among the most effective contraceptive methods, but uptake remains low even in high-income settings. In 2009/2010, a target-based pay-for-performance (P4P) scheme in Britain was introduced for primary care physicians (PCPs) to offer advice about LARC methods to a specified proportion of women attending for contraceptive care to improve contraceptive choice. We examined the impact and equity of this scheme on LARC uptake and abortions.

METHODS AND FINDINGS

We examined records of 3,281,667 women aged 13 to 54 years registered with a primary care clinic in Britain (England, Wales, and Scotland) using Clinical Practice Research Datalink (CPRD) from 2004/2005 to 2013/2014. We used interrupted time series (ITS) analysis to examine trends in annual LARC and non-LARC hormonal contraception (NLHC) uptake and abortion rates, stratified by age and deprivation groups, before and after the P4P was introduced in 2009/2010. Between 2004/2005 and 2013/2014, crude LARC uptake rates increased by 32.0% from 29.6 per 1,000 women to 39.0 per 1,000 women, compared with 18.0% decrease in NLHC uptake. LARC uptake among women of all ages increased immediately after the P4P with step change of 5.36 per 1,000 women (all values are per 1,000 women unless stated, 95% CI 5.26-5.45, p < 0.001). Women aged 20 to 24 years had the largest step change (8.40, 8.34-8.47, p < 0.001) and sustained trend increase (3.14, 3.08-3.19, p < 0.001) compared with other age groups. NLHC uptake fell in all women with a step change of -22.8 (-24.5 to -21.2, p < 0.001), largely due to fall in combined hormonal contraception (CHC; -15.0, -15.5 to -14.5, p < 0.001). Abortion rates in all women fell immediately after the P4P with a step change of -2.28 (-2.98 to -1.57, p = 0.002) and sustained decrease in trend of -0.88 (-1.12 to -0.63, p < 0.001). The largest falls occurred in women aged 13 to 19 years (step change -5.04, -7.56 to -2.51, p = 0.011), women aged 20 to 24 years (step change -4.52, -7.48 to -1.57, p = 0.030), and women from the most deprived group (step change -4.40, -6.89 to -1.91, p = 0.018). We estimate that by 2013/2014, the P4P scheme resulted in an additional 4.53 LARC prescriptions per 1,000 women (relative increase of 13.4%) more than would have been expected without the scheme. There was a concurrent absolute reduction of -5.31 abortions per 1,000 women, or -38.3% relative reduction. Despite universal coverage of healthcare, some women might have obtained contraception elsewhere or had abortion procedure that was not recorded on CPRD. Other policies aiming to increase LARC use or reduce unplanned pregnancies around the same time could also explain the findings.

CONCLUSIONS

In this study, we found that LARC uptake increased and abortions fell in the period after the P4P scheme in British primary care, with additional impact for young women aged 20-24 years and those from deprived backgrounds.

Utilization of Family Planning Methods and Associated Factors Among Reproductive-Age Women with Disability in Arba Minch Town, Southern Ethiopia

Introduction

Globally in 2019, there were 1.9 billion reproductive-age women. Around 922 million of them were using either modern or traditional methods of family planning. Women with disabilities comprise 10% of worldwide women and three-quarters of them reside in low- and middle-income countries.

Objective

The purpose of this study was designed to assess the magnitude and associated factors for family planning methods use among reproductive-age women with disabilities in Arba Minch town, southern Ethiopia.

Patients and Methods

A community-based cross-sectional study was conducted among 418 reproductive-age women with disabilities. Data were collected with eight women who had completed grade 12 and two of them were proficient in sign language. The data were entered into Epi-info™ version-7 software and exported into SPSS version 20 for analysis. A statistically significant variable in the final model was declared by adjusted odds ratio (AOR), 95% confidence interval (CI) and p-value <0.05.

Results

The magnitude of family planning utilization among reproductive-age women with disabilities was 33.7%. Factors significantly associated with family planning use were being employed (AOR: 2.2, CI: 1.77–4.15), having positive attitudes (AOR: 2.3, 95% CI: 1.21–3.87) and marital status (AOR: 3.9, 95% CI: 2.31–6.63).

Conclusion

The magnitude of family planning use among reproductive women with disabilities was low. Attitude, marital status, and being employed were significantly associated factors with family planning use. Therefore, the governmental and non-governmental organizations should work to change their attitude and creating job opportunities.

A study of knowledge, attitude, and practice of contraception among nursing staff in All India Institute of Medical Sciences, Jodhpur, Rajasthan

Objective:

Despite the increase in contraceptive usage over the years, there still exists a gap in the knowledge, attitude, and practices regarding contraception. The study has been designed to assess the knowledge, attitude, practice, and preferences on contraceptive methods among the nursing staff, to determine the association between knowledge and attitude on contraceptive methods with the variables.

Materials and Methods:

A cross-sectional descriptive study of 173 nursing staff using a structured questionnaire on knowledge, attitude scale, and practice and preference were done at AIIMS, Jodhpur during June 2018 to August 2019.

Results:

It was observed that 82.6% were of 21–30 years of age, 86.7% were Hindus, 67% were from the nuclear family, 41% were married between 19 and 25 years, 86.7% were nulliparous, 75.7% had access to various contraceptives through health workers, 79.8% got information through media. 73.4% were willing to use postpartum contraception. In our study, a major reason for 80.9% to use family planning was to prevent unintended pregnancies. Majority 71% had the favorable attitude and 14.4% had an unfavorable attitude toward contraceptive methods. In this study, 64.1% preferred male condom as Rank 1, intrauterine device 57.8% as Rank 2, and Lactational Amenorrhea Method 58.3% as Rank 3 for postpartum contraception. There was an association between the practice of family planning and marital status, age, and family size.

Conclusions:

The study showed that the majority of the females nursing staff had moderate knowledge and favorable attitude toward contraception use.

Knowledge, Attitude, and Practice of Contraception Methods Among Female Undergraduates in Dodoma, Tanzania

Introduction

Contraception is regarded as an important preventive measure of unintended pregnancies and sexually transmitted diseases, including human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS), among youths. This study aimed to assess the knowledge, attitude, and practice of contraception among female undergraduates in Dodoma, Tanzania.

Methodology

A cross-sectional study was conducted among 347 female undergraduates of St John’s University, Dodoma. Descriptive statistics were used for data analysis. Statistical analysis was done using Epi-Info version 7.2.2.6 (Centers for Disease Control and Prevention, Atlanta, Georgia. A p-value of less than 0.05 was considered statistically significant.

Results

The mean (±SD) age of participants was 27.4 (± 5.7). The majority (96%) of the participants were aware of contraception. Awareness of contraception was significantly associated with the age (p<0.0001), marital status (p<0.00001), and religion of the participating students (p=0.02). Slightly less than half (47.4%) of the students reported having ever used at least one type of contraception while feeling embarrassed to buy or ask for contraception (64.6%) and differing religious beliefs (32.3%) were among the reasons reported by students for not using contraception.

Conclusion

Despite the relatively low utilization of contraception, the majority of the participants had knowledge of contraception. This calls for efforts to advocate the effective utilization of reproductive and sexual health services among youths.

Features of successful sexual health promotion programs for young people: findings from a review of systematic reviews

ISSUE ADDRESSED

Young people have a high burden of sexual and reproductive health (SRH) problems, and it is important to reach this group through health promotion initiatives. We conducted a systematic review of reviews to identify successful elements of health promotion programs for improving SRH of young people.

METHODS

We identified and collated systematic reviews published in 2005-2015 which focused on young people (10-24 years), reported on SRH outcomes (pregnancy, sexually transmissible infections, condoms/contraceptive use, risky sexual behaviour, sexual healthcare access or intimate partner violence), and included primary studies predominantly conducted in high-income countries. This report focuses on features of successful SRH programs identified in the interpretation and discussion of included systematic reviews.

RESULTS

We identified 66 systematic reviews, of which 37 reported on program features which were anecdotally or statistically associated with improved program effectiveness and success. Common features of effective interventions were: longer term or repeated implementation; multi-setting and multi-component; parental involvement; culturally/gender/age appropriate; and inclusion of skills-building. SO WHAT?: There is marked consistency of features improving SRH program effectiveness for young people despite the wide variation in interventions reviewed. There is a need to better implement this knowledge in future programs, and our findings provide useful guidance for optimising the design of SRH interventions for young people.

Factors associated with nonadherence to instructions for using the Nestorone®/ethinyl estradiol contraceptive vaginal ring

OBJECTIVES

We sought to identify factors associated with nonadherence to instructions for using a novel contraceptive providing 1 year of protection.

STUDY DESIGN

Data from a multicountry Phase 3 trial of the Nestorone® (segesterone acetate)/ethinyl estradiol (NES/EE) contraceptive vaginal ring (CVR) were analyzed. Participants were instructed to use the CVR over 13 cycles and follow a 21/7 regimen. Their reports of CVR removals >2 h outside scheduled removal periods served as a proxy for nonadherence. We used multivariate logistic regression to determine factors associated with such use.

RESULTS

Of 905 participants, 120 (13%) reported CVR removals >2 h. Removals for washing [odds ratio (OR) 3.96, 95% confidence interval (CI) 2.50-6.27] or sexual intercourse (OR 3.19, 95% CI 2.03-4.99), and finding CVR insertion difficult (OR 2.80, 95% CI 1.36-5.80) were factors associated with removals >2 h. Lower educational attainment also predicted ring removal >2 h (OR 3.23, 95% CI 1.55-6.75). Women residing in Europe or Australia were less likely to remove the ring for >2 h compared with women in the United States (OR 0.44, 95% CI 0.24-0.83 and OR 0.13, 95% CI 0.02-0.98, respectively). Participants who reported removals >2 h were more likely to discontinue CVR use (OR 1.93, 95% CI 1.24-2.95), report dissatisfaction (OR 2.20, 95% CI 1.32-3.69) and become pregnant during the study (OR 4.07, 95% CI 1.58-10.50).

CONCLUSIONS

Removing the CVR for washing and removing it before intercourse are factors associated with nonadherence to ring use. These are important topics for counseling women who are considering or using vaginal rings, including the NES/EE CVR.

IMPLICATIONS

Findings from this study may be useful in guiding counseling for current and prospective vaginal ring users. Anticipatory guidance should focus on how the ring feels in the vagina and during sex. Asking about ring removals may help identify women who are at increased risk for having an unplanned pregnancy.

Percepciones de las Mujeres Mexicanas Sobre el Uso de Métodos Anticonceptivos

Introducción:

Más del 50% de los embarazos a nivel mundial son no planeados. El 99% de los embarazos no planeados se presentan en países en desarrollo, el 38% de estos en América Latina y el Caribe.

Métodos:

Se realizó un estudio cualitativo, a través un análisis de contenido congruente con la descripción cualitativa. Se realizaron entrevistas semiestructuradas a mujeres de 18 a 24 años de edad.

Resultados:

La angustia por un cambio de vida, el tener planes para el futuro y una relación formal mayor a un año son los principales motivos para usar un método anticonceptivo de forma correcta y consistente. Las barreras reportadas para el uso de métodos anticonceptivos fueron los efectos secundarios, las creencias de los padres acerca de la sexualidad y la reproducción y el estigma hacia las mujeres que usan métodos anticonceptivos.

Conclusiones:

Las principales barreras en las mujeres son las de tipo cultural. Los hallazgos muestran que la influencia de la red social es más importante que las creencias individuales. Por lo que se debe de incluir al personal de salud y la comunidad en las intervenciones de salud.

Sociodemographic characteristics associated with the use of effective and less effective contraceptive methods: findings from the Understanding Fertility Management in Contemporary Australia survey

OBJECTIVE

Unintended pregnancy and abortion may, in part, result from suboptimal use of effective contraception. This study aimed to identify sociodemographic factors associated with the use of effective and less effective methods among women and men of reproductive age living in Australia.

METHODS

In a cross-sectional national survey, 1544 women and men aged 18-51 were identified as being at risk of pregnancy. Chi-square and logistic regression analyses were used to assess the sociodemographic factors related to contraceptive use.

RESULTS

Most respondents (n = 1307, 84.7%) reported using a method of contraception. Use of any contraceptive was associated with being born in Australia (Odds Ratio [OR] 1.89; 95% Confidence Interval [CI]1.186, 3.01; p = .008), having English as a first language (OR 1.81; 95% CI: 1.07, 3.04; p = .026), having private health insurance (OR 2.25; 95% CI 1.66, 3.04; p < .001), and not considering religion important to fertility choices (OR 0.43; 95%CI 0.31, 0.60; p < .001). A third used effective contraceptive methods (n = 534, 34.6%; permanent methods: 23.1%, and long-acting reversible contraception (LARC): 11.4%). Permanent methods were more likely to be used in rural areas (OR 0.62; 95%CI 0.46, 0.84; p = .002). Use of the least effective, short-term methods was reported by nearly half (condoms: 25.6%, withdrawal: 12.5%, and fertility-awareness-based methods: 2.8%). Those who relied on withdrawal were more likely to live in a metropolitan area (OR 2.85; 95% CI 1.95, 4.18; p < .001), and not have private health insurance (OR 0.52; 95% CI 0.38, 0.71; p < .001).

CONCLUSIONS

Targeted promotion of the broad range of available contraceptives may raise awareness and uptake of more effective methods and improve reproductive autonomy in certain population groups.

The relationship between area deprivation and prescription of long-acting reversible contraception in women of reproductive age in Lothian, Scotland, UK

Background

Reducing unplanned pregnancy in Scotland is a key government objective. Long-acting reversible contraception (LARC) is a cost-effective way to reduce unintended pregnancy. Abortion and teenage pregnancy rates are highest in the most deprived areas. One possible explanation could be contraceptive prescribing inequality. This study examined the relationship between area deprivation measured by the Scottish Index of Multiple Deprivation and LARC prescription.

Methods

Using Scottish electronic prescribing data from primary care and sexual and reproductive health clinics, this study analysed female Lothian residents with a valid postcode aged 16–49 years who received a contraceptive prescription from 1 April 2012 to 31 March 2014. Prescription of LARC (intrauterine, implant or injectable contraceptive) compared with non-LARC (oral pill, patch, ring or diaphragm) was examined. Logistic regression was performed adjusting for age group and prescription location.

Results

A total of 90 150 women were included; 21.1% of prescriptions were LARC and 15.3% vLARC (intrauterine method or implant). Women residing in the most deprived quintile (Q1) and prescribed contraception received a significantly higher proportion of LARC than quintiles 2–5 (Q2–5). Odds ratios compared with Q1 were: Q2 0.86, Q3 0.77, Q4 0.59 and Q5 0.51. Women in quintile 1 were also significantly more likely to receive vLARC than quintiles 2–5.

Conclusion

Women in the most deprived quintile in Lothian who are prescribed contraception are significantly more likely to receive LARC and vLARC compared with women in less deprived quintiles.

Contraceptive Utilisation Among Mothers of Reproductive Age in Ajman, United Arab Emirates

OBJECTIVES

This study aimed to determine contraceptive utilisation among mothers aged 18-49 years old in Ajman, United Arab Emirates (UAE).

METHODS

This cross-sectional study was carried out from May to November 2013. A total of 400 participants were recruited from two primary healthcare centres and one private hospital in Ajman. An interviewer-administered validated questionnaire was used for data collection.

RESULTS

The frequency of previous and current contraceptive use was 68.0% and 61.8%, respectively. Expatriates more frequently used contraceptives in comparison to Emiratis (77.3% versus 54.3%, respectively). Contraceptive use increased significantly with age (75.5% among >35-year-olds versus 57.3% among ≤25-year-olds; P <0.050) and education level (83.3% among postgraduates versus 60.0% among those with primary education; P <0.050). In addition, contraceptive use was significantly higher among those living in a nuclear family system (P <0.050). A univariate analysis indicated significant associations between contraceptive use and age, nationality, education level, type of family system, employment sector, parity, knowledge of birth control measures and source of birth control information (P <0.050 each). However, no significant associations were found via multivariate analysis.

CONCLUSION

Healthcare practitioners can play a pivotal role in providing contraceptive advice which could lead to an improvement in contraceptive utilisation. Efforts are recommended to raise awareness regarding newer forms of contraceptives among mothers of reproductive age in the UAE.

Knowledge of contraceptive methods and services among tertiary students in far North Queensland

Despite the availability of a wide range of contraceptive options in Australia, rates of unintended pregnancy remain high. A survey of tertiary students in Far North Queensland in regard to their knowledge of contraceptive methods and services revealed significant deficiencies, suggesting that existing sex education and contraceptive advice services need improving if unplanned pregnancy rates are to be reduced in this population.

When two is better than one: differences in characteristics of women using condoms only compared to those using condoms combined with an effective contraceptive

BACKGROUND

There remain high rates of unintended pregnancy around the world. Adding an effective contraceptive to those who currently only use male condoms may reduce these rates. The aim of this study is to identify the prevalence of and factors associated with the combination use of an effective contraception with male condoms in sexually active women who are already using male condoms.

METHODS

Women attending Family Planning Victoria Clinics from April to July 2011 were approached to complete a questionnaire about contraception usage in the last 3 months and 34 associated variables. Univariate and multivariate analyses were conducted to determine women with greater odds of an effective contraception together with male condoms compared with those using male condoms only.

RESULTS

Of 1006 women surveyed, 872 women stated it was "very important" or "important" to avoid pregnancy at this stage of their life. Of these 872 women, 690 reported male condom use-274 women used male condoms and an effective contraception, while 416 used male condoms only. Of note, only 67 (16%) of the 416 solely male condom users were using this consistently. On multivariate analysis, characteristics associated with combination use (compared with condom use only) were discussion with a health professional in the last 12 months (adjusted odds ratio [AOR] 2.9; 95% confidence interval [CI] 1.9, 4.4), satisfaction with contraception (AOR 1.8; 95% CI 1.3, 2.7), having more than 1 partner in the last 3 months (AOR 1.8; 95% CI 1.2, 2.6) and past pregnancy (AOR 0.3; 95% CI 0.1, 0.5).

CONCLUSIONS

In a group of women not intending to be pregnant who were using male condoms, a significant number remained at risk for unintended pregnancy due to inconsistent use of male condoms and poor use of concurrent effective contraception.