Abstract：
OBJECTIVE: Male permanent contraception (PC), that is, vasectomy, is an effective way of preventing pregnancy. In the United States, male PC use has historically been concentrated among higher-educated/higher-income males of White race. In the last decade, use of long-acting reversible contraception (LARC) has increased dramatically. We sought to understand how sociodemographic patterns of male PC have changed in the context of rising LARC use.
METHODS: We examined the nationally representative male public use files of the National Survey for Family Growth (NSFG) across five survey waves. Our outcome was primary contraceptive use at last sexual encounter within 12 months. Using four-way multinomial logistic regressions (male PC, female PC, LARC, lower-efficacy methods), we compared sociodemographic factors predictive of male PC use versus reported partner LARC use between 2006-2010 (early) and 2017-2019 (recent) waves.
RESULTS: We included 15 964 participants. From 2006 to 2019, there were absolute declines in male PC from 8.0% to 6.8%, while male-reported partner LARC use increased three-fold, from 3.4% to 11.0%. Among the highest economic strata, use of LARC converged with male PC. In adjusted analyses, high income significantly associated with male PC use in the early wave (OR 4.6 (1.4, 14.8)), but no longer in the recent wave (OR 0.9 (0.2, 4.2)). Marital status remained a significant but declining predictor of male PC across survey waves, and instead, by 2019, number of children newly emerged as the strongest predictor of male PC use.
CONCLUSIONS: Sociodemographic variables associated with vasectomy use are evolving, especially among high-income earners.
METHODS: We examined the nationally representative male public use files of the National Survey for Family Growth (NSFG) across five survey waves. Our outcome was primary contraceptive use at last sexual encounter within 12 months. Using four-way multinomial logistic regressions (male PC, female PC, LARC, lower-efficacy methods), we compared sociodemographic factors predictive of male PC use versus reported partner LARC use between 2006-2010 (early) and 2017-2019 (recent) waves.
RESULTS: We included 15 964 participants. From 2006 to 2019, there were absolute declines in male PC from 8.0% to 6.8%, while male-reported partner LARC use increased three-fold, from 3.4% to 11.0%. Among the highest economic strata, use of LARC converged with male PC. In adjusted analyses, high income significantly associated with male PC use in the early wave (OR 4.6 (1.4, 14.8)), but no longer in the recent wave (OR 0.9 (0.2, 4.2)). Marital status remained a significant but declining predictor of male PC across survey waves, and instead, by 2019, number of children newly emerged as the strongest predictor of male PC use.
CONCLUSIONS: Sociodemographic variables associated with vasectomy use are evolving, especially among high-income earners.
摘要：
目标：男性永久避孕（PC），也就是说,输精管切除术,是预防怀孕的有效方法。在美国,从历史上看，男性PC的使用一直集中在受过高等教育/收入较高的白人男性中。在过去的十年里，长效可逆避孕（LARC）的使用急剧增加。我们试图了解在LARC使用增加的背景下，男性PC的社会人口统计模式如何变化。
方法：我们在五个调查波中检查了全国家庭增长调查（NSFG）的全国代表性男性公共使用文件。我们的结果是在12个月内最后一次性接触时主要使用避孕药具。使用四向多项逻辑回归(男性PC，女性PC,LARC,疗效较低的方法)，我们比较了2006-2010年(早期)和2017-2019年(最近)期间男性使用PC的社会人口统计学因素和报告的伴侣使用LARC的预测因素.
结果：我们包括15964名参与者。从2006年到2019年，男性PC从8.0%下降到6.8%，虽然男性报告的伴侣使用LARC增加了三倍，从3.4%到11.0%。在最高经济阶层中，使用LARC与男性PC融合。在调整后的分析中，高收入与早期男性PC使用显着相关（OR4.6（1.4，14.8）），但不再在最近的浪潮中(OR0.9(0.2，4.2))。在调查浪潮中，婚姻状况仍然是男性PC的重要但正在下降的预测指标，相反，到2019年，新儿童人数成为男性PC使用的最强预测指标。
结论：与输精管切除术相关的社会人口统计学变量正在演变，尤其是高收入者。
方法：我们在五个调查波中检查了全国家庭增长调查（NSFG）的全国代表性男性公共使用文件。我们的结果是在12个月内最后一次性接触时主要使用避孕药具。使用四向多项逻辑回归(男性PC，女性PC,LARC,疗效较低的方法)，我们比较了2006-2010年(早期)和2017-2019年(最近)期间男性使用PC的社会人口统计学因素和报告的伴侣使用LARC的预测因素.
结果：我们包括15964名参与者。从2006年到2019年，男性PC从8.0%下降到6.8%，虽然男性报告的伴侣使用LARC增加了三倍，从3.4%到11.0%。在最高经济阶层中，使用LARC与男性PC融合。在调整后的分析中，高收入与早期男性PC使用显着相关（OR4.6（1.4，14.8）），但不再在最近的浪潮中(OR0.9(0.2，4.2))。在调查浪潮中，婚姻状况仍然是男性PC的重要但正在下降的预测指标，相反，到2019年，新儿童人数成为男性PC使用的最强预测指标。
结论：与输精管切除术相关的社会人口统计学变量正在演变，尤其是高收入者。
