Trends in contraceptive method use in Britain: evidence from two national probability surveys
ESC Congress Library. French R. 05/11/18; 208258; ESC88 Disclosure(s): I have received an honorarium to contribute to a meeting with the company Natural Cycles.
Dr. Rebecca French
Dr. Rebecca French
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Objectives: To describe trends in contraceptive method use in Britain and investigate demographic and sexual behaviour characteristics of users by method effectiveness through analysis of the National Survey of Sexual Attitudes and Lifestyles (Natsal). Design and Methods: Cross-sectional probability sample surveys of women and men, resident in Britain, interviewed between 1999-2001 (Natsal-2) and 2010 -2012 (Natsal-3). Respondents were asked to report their usual current contraceptive method. Current method use in both the surveys was examined in women aged 16-44 years who ever had had vaginal sex (5875/6399 women in Natsal-2 and 5237/5842 in Natsal-3) and comparative analysis of sociodemographic and behavioural characteristics was confined to those who reported vaginal sex in the last year and who were not currently pregnant (5173 in Natsal-2 and 4588 in Natsal-3). Contraceptive methods were categorized as: most effective (male/female sterilisation, intrauterine device, intrauterine system, implant) effective (pill, patch, injection) and least effective (condom, Femidon, cap, spermicides, rhythm method, withdrawal) or no method used. Analysis accounted for the weighting, clustering, and stratification of survey data. Prevalence of use of these methods was estimated, and associated factors and trends examined. Results: Most commonly used methods were the pill (used by just under a third of women) and the condom (by just under a quarter) and there were no significant changes in their overall use between both the Natsal-2 and 3 surveys. No significant difference was observed in the proportion of women using the most effective methods between surveys (21.5% and 21.1%, respectively) - though overall prevalence masks differences in methods used, use of implants increasing from 0.3% in Natsal-2 to 5.4% in Natsal-3 (OR 19.5, 95% CI 10.9-36.4), the IUS from 0.7% to 2.6%, respectively (OR 3.8, 95% CI 2.6-5.7). Use of both male and female sterilisation declined over this period, 8.9% to 4.9% (OR 0.5, 95% CI 0.4-0.7) and 7.4% to 3.2% (OR 0.4, 95% CI 0.3-0.5), respectively.  However, a ten-fold increase was observed in under 25 years old reporting current use of a most effective method from Natsal-2 to 3, OR 9.29 (95% CI 5.15-16.77). Conclusions: Increased use of long-acting reversible contraceptives offset the decline in male and female sterilisation, but was not sufficient to increase use of most effective methods overall amongst women. However, the increased odds in most effective method use amongst younger women is promising and is an indication that knowledge and attitudes amongst both users and professionals may be shifting.
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