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

Abstract

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.

Chinese abstract

目的：意外怀孕和人工流产, 部分原因可能是由于避孕效果不佳。本研究的目的是确定影响澳大利亚处于生殖年龄期的女性与男性使用有效和效果欠佳避孕方法的社会人口学因素。

方法：在一项全国性横断面调查中, 1544名年龄在18岁至51岁的女性和男性被确定为有妊娠风险。卡方检验和Logistic回归分析与避孕药使用相关的社会人口学因素。

结果：大多数受试者（N = 1307, 84.7%）会采取避孕措施。任何避孕措施的使用都与出生在澳大利亚相关（比值比 [OR] 1.89; 95%可信区间 [CI 1.186, 3.01; P = 0.008）, 与把英语作为第一语言相关（OR 1.81; 95% CI: 1.07, 3.04; P = 0.026）, 与拥有私人健康保险相关（OR 2.25; 95% CI, 3.04; p < .001）, 不考虑宗教对生育选择的重要性（OR 0.43; 95% CI 0.31, 0.60; P＜001）。三分之一的受试者使用有效的避孕方法（n = 534, 34.6%；永久性的方法：23.1%、长效可逆避孕（LARC）：11.4%）。永久的方法更可能被用于农村地区（OR 0.62；95% CI 0.46, 0.84; P =0. 002）。报道用最差效果的, 短期的方法近一半（避孕套：25.6%, 体外排精：12.5%、基于生育意识的方法：2.8%）。那些体外排精的人更可能生活在大都市地区（OR 2.85; 95% CI 1.95, 4.18; p < .001）并且没有私人医疗保险（OR 0.52; 95% CI 0.38, 0.71; p < .00）。

结论：有针对性地在某些人群中广泛使用现有的避孕药具, 可能会提高认知并可吸取更有效的方法来提高生育自主性。

Keywords:

• Australia
• contraception
• implant
• IUD
• long-acting reversible contraception
• condoms

Acknowledgements

The authors would like to thank Dr Karen Wynter for her assistance with data management, Dr Thach Tran for statistical advice, and Ms Hau Nguyen for project data management. The authors thank all the respondents for their generous participation.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Additional information

Funding

This research was supported by an Australian Research Council Linkage Project Grant (LP100200432) with funding and in-kind contributions from Family Planning Victoria, Melbourne IVF, The Royal Women’s Hospital, and the Victorian Department of Health. Professor Jane Fisher is supported by a Monash Professorial Fellowship and the Jean Hailes Professorial Fellowship which receives funding from the L and H Hecht Trust managed by Perpetual Trustees Pty ltd.