The Lancet Regional Health - Americas
January 2024

Estimates of use of preferred contraceptive method in the United States: a population-based study
Anu Manchikanti Gómez, University of California, Berkeley Ariana H. Bennett, University of California, Berkeley Jennet Arcara, University of California, Berkeley Lisa Stern, Coalition to Expand Contraceptive Access Jamie Bardwell, Converge Denicia Cadena Aisha Chaudhri, Illinois Caucus for Adolescent Health Laura Davis, Advocates for Youth Christine Dehlendorf, University of California, San Francisco Brittni Frederiksen, KFF Catherine Labiran Raegan McDonald-Mosley, Power to Decide Whitney S. Rice, Rollins School of Public Health Tara B. Stein, New York City Department of Health and Mental Hygiene Ena Suseth Valladares, California Latinas for Reproductive Justice Megan L. Kavanaugh, Guttmacher Institute Cassondra Marshall, University of California, Berkeley

First published on The Lancet Regional Health - Americas:

Background

In the U.S. and globally, dominant metrics of contraceptive access focus on the use of certain contraceptive methods and do not address self-defined need for contraception; therefore, these metrics fail to attend to person-centeredness, a key component of healthcare quality. This study addresses this gap by presenting new data from the U.S. on preferred contraceptive method use, a person-centered contraceptive access indicator. Additionally, we examine the association between key aspects of person-centered healthcare access and preferred contraceptive method use.

Methods

We fielded a nationally representative survey in the U.S. in English and Spanish in 2022, surveying non-sterile 15-44-year-olds assigned female sex at birth. Among current and prospective contraceptive users (unweighted n = 2119), we describe preferred method use, reasons for non-use, and differences in preferred method use by sociodemographic characteristics. We conduct logistic regression analyses examining the association between four aspects of person-centered healthcare access and preferred contraceptive method use.

Findings

A quarter (25.2%) of current and prospective users reported there was another method they would like to use, with oral contraception and vasectomy most selected. Reasons for non-use of preferred contraception included side effects (28.8%), sex-related reasons (25.1%), logistics/knowledge barriers (18.6%), safety concerns (18.3%), and cost (17.6%). In adjusted logistic regression analyses, respondents who felt they had enough information to choose appropriate contraception (Adjusted Odds Ratio [AOR] 3.31; 95% CI 2.10, 5.21), were very (AOR 9.24; 95% CI 4.29, 19.91) or somewhat confident (AOR 3.78; 95% CI 1.76, 8.12) they could obtain desired contraception, had received person-centered contraceptive counseling (AOR 1.72; 95% CI 1.33, 2.23), and had not experienced discrimination in family planning settings (AOR 1.58; 95% CI 1.13, 2.20) had increased odds of preferred contraceptive method use.

Interpretation

An estimated 8.1 million individuals in the U.S. are not using a preferred contraceptive method. Interventions should focus on holistic, person-centered contraceptive access, given the implications of information, self-efficacy, and discriminatory care for preferred method use.

Funding

Arnold Ventures.

Read the full article here.

Topic

United States

Geography

Tags

birth control