目的:本研究旨在确定使用长效可逆避孕(LARC)和非LARC激素方法的青少年和年轻女性使用安全套是否存在差异,并评估是否开始使用LARC与较低安全套相关。
方法:本研究使用了一项针对13-25岁性活跃女性的大型纵向研究数据。问卷调查评估避孕,使用避孕套,性史,基线访视和每六个月的合作伙伴特征。对数二项回归分析检查了激素避孕方法和避孕套使用之间的关联,以及年龄和性伴侣数量的调节作用。探索性分析比较了基于伴侣特征的避孕套使用。
结果:在1,512名参与者中,1,116例报告在任何研究访问期间使用LARC或非LARC激素方法。激素非LARC使用者(37.5%)在基线时使用避孕套显着高于LARC使用者(23.5%)(p<0.01)。LARC与非LARC使用者的安全套使用受年龄限制,因为LARC与13-18岁参与者的安全套使用率较低有关。但不是19-25岁的人。性伴侣的数量不是重要的调节因素。LARC用户比非LARC用户更有可能停止使用避孕套;然而,这没有统计学意义.在基于伴侣特征的性传播感染(STI)风险增加的参与者中,与非LARC用户相比,LARC用户的避孕套使用率较低。
结论:开始使用LARC和激素非LARC方法后,避孕套停药是常见的。然而,基线时,LARC使用者的避孕套使用率较低,在年轻的青少年中,以及合作伙伴是否有性传播感染的风险因素。
结论:在开始高效避孕后停用避孕套会增加性传播感染(STI)的风险。使用LARC的年轻女性可能比非LARC使用者面临更大的风险,尽管他们的伴侣有性传播感染的危险因素,但安全套使用率较低。使用避孕套进行性传播感染保护的咨询对青少年至关重要。
This study aimed to determine whether condom use varied between adolescents and young women using long-acting reversible contraception (LARC) vs non-LARC hormonal methods and assess if the initiation of LARC was associated with lower condom use.
This study used data from a large longitudinal study of sexually active females aged 13-25 years. Questionnaires assessed contraception, condom use, sexual history, and partner characteristics at the baseline visit and every 6 months. Log-binomial regression analyses examined associations between hormonal contraceptive methods and condom use, and the moderating effects of age and number of sexual partners. Exploratory analyses compared condom use based on partner characteristics.
Of 1512 participants, 1116 reported LARC or non-LARC hormonal method use during any study visit. Among baseline and new LARC users, 75.7% and 84.7% reported intrauterine device (IUD) use, respectively. Condom use at baseline among hormonal non-LARC users (37.5%) was significantly higher (p < 0.01) than LARC users (23.5%). Condom use among LARC vs non-LARC users was moderated by age in that LARC was associated with lower condom use among participants aged 13-18 years, but not those aged 19-25 years. Number of sexual partners was not a significant moderator. Among participants with increased sexually transmitted infection (STI) risk based on partner characteristics, LARC users had lower condom use compared to non-LARC users.
Condom discontinuation was common following initiation of LARC and hormonal non-LARC methods. However, condom use was lower in LARC users at baseline, among younger adolescents, and if partners had risk factors for STIs.
Condom discontinuation following initiation of highly effective contraception increases the risk of STI. Young women using LARC may be at greater risk than non-LARC users given lower condom use despite having partners with risk factors for STIs. Condom use counseling for STI protection is critical for adolescents.