Abstract
The last decade has witnessed initiatives to expand access to contraceptives in Brazil. However, the last population-based study on contraception was undertaken in 2006. A household survey in 2015 investigated contraceptive practices in women 15 to 44 years of age living in the city of São Paulo. The current study selected data on young women 15 to 19 years of age. The objectives were to identify the prevalence of contraception, the contraceptives used, sources, and differences in contraceptive practices. The young women are part of a probabilistic study sample. Differences in contraception use were compared by multiple logistic regression analysis. A total of 633 young women were interviewed, of whom 310 (48.5%) were sexually initiated. Of these, 60% reported emergency contraception use at least once in their lives. Emergency contraception use was directly proportional to age and lifetime number of partners. Prevalence of contraception was 81%. The odds of current contraception use were higher among young women residing in the health district of the city with the better social conditions, Catholics, those who reported sexual relations in the previous 30 days, and those with history of an obstetrics and gynaecology visit in the previous year, and inversely proportional to the lifetime number of sex partners. Male condoms and the pill were the most common methods (28.2% and 23%). Most of the women purchased their contraceptives in retail pharmacies (75.2%), and the Brazilian Unified National Health System (SUS) was only a significant source for injectable hormonal contraceptives. Government support for women's sexual and reproductive rights is still insufficient.
Highlights
The prevalence of contraception has increased rapidly in the last thirty years in Brazil
The current study aims to describe the prevalence of contraception and the contraceptives adopted by women 15 to 19 years of age living in the city of São Paulo
The frequent mention of the use of some contraceptive method in first intercourse had been observed in 2006 (80.3%), but reference to condom use was slightly lower in the country as a whole (67%)
Summary
The prevalence of contraception has increased rapidly in the last thirty years in Brazil. The last Brazilian National Demographic and Health Survey (2006) identified a tendency towards the expansion of the mix of contraceptives used, with greater participation by men, both an increase in male condom use and a higher vasectomy rate 3. In the last ten years, initiatives to expand access to modern (not behavioral) contraceptive methods were implemented in Brazil. These include the incorporation of injectable hormonal contraceptives by the National List of Medicines (RENAME), expansion of the distribution of contraceptives in the public healthcare system, and the inclusion of oral contraceptives and injectable hormonal contraceptives in the country’s Popular Pharmacy Program 4, for free supply in public healthcare services or in retail drugstores. Known as LARC (longacting reversible contraceptives), they have been promoted especially among adolescents in various countries, since they do not depend on daily use 7,8
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