背景:获得按需的口周口服避孕药-用于在性交周围的限定窗口内预防怀孕-可以为女性提供更多的生殖代理。具有这种适应症的避孕药目前在任何市场上都没有。这篇评论旨在了解国际用户对按需口服避孕药的呼吁。
方法:系统范围审查,包括2014-2023年间发表的30篇同行评审论文。
结果:来自世界卫生组织五个地区的16个国家的30篇论文的数据表明,用户对可在治疗前后使用的按需口服避孕药具有广泛的吸引力。尤其是年轻的女性,受教育程度更高或性生活频率更低的人。不同年龄的女性,财富,就业或关系状况,以及使用现代避孕药的不同经验,也有兴趣。女性确定了使用和偏爱这些类型产品的明确理由:与女性的无计划性生活密切相关,自发或偶尔发生性行为;感知的便利性和有效性;谨慎使用药丸来协商限制其生殖能力的上下文环境。抑制使用的因素包括服务提供商的知识障碍和态度,最终用户缺乏知识和错误信息,女性对月经副作用的厌恶以及与激素含量对未来生育能力的影响有关的神话。
结论:采用随需应变的口周口服避孕药可以扩大对现代避孕需求未得到满足以及性和生殖能力受限的不同女性的避孕选择。未来研究的重点包括:扩大证据的地理范围,以包括东南亚和太平洋地区,和国际农村和城市周边环境;记录青少年和未婚青年的观点;确定供应渠道的创新机会,负担得起的按需口服避孕药;以及如何在各种国际环境中将新的口周避孕药推向市场。
可以根据需要使用口服避孕药来预防怀孕,并在性交周围的特定窗口内服用(即按需的口周口服避孕药)可以为女性提供更多的生殖能力。虽然目前在任何市场上都没有,我们从这篇国际文献综述中进行的分析显示,女性使用这类避孕产品具有广泛的吸引力.支持使用和偏好的明确理由包括:(1)与女性的性生活更紧密地保持一致,包括期望但计划外的生活,自发或偶尔发生性行为,而不是其他避孕药;(2)感知的便利性和有效性,提供超过其他现代避孕药具的好处;和(3)妇女感到能够克服社会价值观和信仰,限制他们的生殖机构。使用这类产品也存在障碍,包括服务提供商的知识差距和态度,最终用户缺乏知识和错误信息,女人不喜欢副作用,以及关于药丸中激素含量对未来生育能力影响的神话和误解。采用按需的口周口服避孕药可以扩大对现代避孕需求未得到满足以及性和生殖机构受限的不同女性的避孕选择。未来研究的重点包括:扩大证据的地理范围,以包括东南亚和太平洋地区,记录青少年和未婚青年的观点;确定供应渠道的创新机会,负担得起的获得这种类型的避孕药;以及如何在各种国际环境中将这种新的避孕药推向市场。
BACKGROUND: Access to an on-demand pericoital oral contraceptive pill - used to prevent pregnancy within a defined window around sexual intercourse - could offer women more reproductive agency. A contraceptive with this indication is not currently available in any market. This review aims to understand international user appeal for an on-demand pericoital oral contraceptive pill.
METHODS: Systematic scoping review, comprising 30 peer-reviewed papers published between 2014-2023.
RESULTS: Data from 30 papers reporting on research from 16 countries across five World Health Organisation regions suggests widespread user appeal for on-demand oral contraceptive pills that can be used peri- or post-coitally, especially among women who are younger, more educated or who have less frequent sex. Women of varying age, wealth, employment or relationship status, and with different prior experience of using modern contraceptives, were also interested. Women identified clear rationale for use and preference of these types of product: close alignment with women\'s sexual lives that comprised unplanned, spontaneous or occasional sex; perceived convenience and effectiveness; discreet use of pills to negotiate contextual circumstances that constrained their reproductive agency. Factors inhibiting use included knowledge barriers and attitudes of service providers, a lack of knowledge and misinformation among end-users, women\'s dislike of menstrual side effects and myths related to the effects of hormone content on future fertility.
CONCLUSIONS: Introduction of an on-demand pericoital oral contraceptive pill could expand contraceptive choice for diverse women experiencing unmet need for modern contraception and constrained sexual and reproductive agency. Priorities for future research include: broadening the geographical scope of evidence to include SE Asia and the Pacific, and international rural and peri-urban settings; documenting the perspectives of adolescents and unmarried young people; identifying opportunities for innovation in the supply channels to enhance appropriate, affordable access to on-demand oral contraceptives; and unpacking how to bring new pericoital contraceptives to the market in a variety of international settings.
Access to an oral contraceptive pill that is used as needed to prevent pregnancy and taken within a defined window around sexual intercourse (i.e. an on-demand pericoital oral contraceptive pill) could offer women more reproductive agency. Though not currently available in any market, our analysis from this review of international literature reveals widespread appeal among women for using this type of contraceptive product. Clear rationale supporting use and preference included: (1) closer alignment with women’s sexual lives that comprised desired but unplanned, spontaneous or occasional sex than other contraceptives; (2) perceived convenience and effectiveness, offering benefits over other modern contraceptives; and (3) women feeling able to overcome social values and beliefs that constrained their reproductive agency. There were also barriers to use of this type of product, including knowledge gaps and attitudes of service providers, a lack of knowledge and misinformation among end-users, women’s dislike of the side effects, and myths and misconceptions about the impact of the hormone content in pills on future fertility. Introduction of an on-demand pericoital oral contraceptive pill could expand contraceptive choice for diverse women experiencing unmet need for modern contraception and constrained sexual and reproductive agency. Priorities for future research include: broadening the geographical scope of evidence to include SE Asia and the Pacific, and rural and peri-urban settings; documenting the perspectives of adolescents and unmarried young people; identifying opportunities for innovation in the supply channels to enhance appropriate, affordable access to this type of contraceptive; and unpacking how to bring this new contraceptive to the market in a variety of international settings.