Self-reported Contraceptive Use Research Articles

A comparison of self-reported oral contraceptive use and automated pharmacy data in perimenopausal and early postmenopausal women

PurposeOral contraceptive (OC) use can occur throughout a woman's reproductive life span with the potential for long-term impacts on health. To assess potential measurement error in prior OC use, this study compared level of agreement between self-reported prior OC use and pharmacy dispensing data in perimenopausal and/or early postmenopausal women. MethodsThe study's 1399 women (ages, 45–59 years) were participants in a population-based case-control study of the association between OC use and fracture risk. Episodes of lifetime self-reported OC use (in months) were collected, by telephone interview, for January 1, 2008 through November 25, 2012. Pharmacy fills, back to 1980, were collected from automated data. Agreement was measured using the prevalence-adjusted and bias-adjusted kappa index. ResultsThe number of women with OC pharmacy fills was 11% to 45% higher than those who reported OC use during each time period. Between-measures agreement was better for more recent use. Prevalence-adjusted and bias-adjusted kappa index values ranged from 0.88 (95% confidence interval, 0.85–0.90) within 5 years from the reference date to 0.65 (95% confidence interval, 0.59–0.71) within 15 to 20 years. ConclusionsFor studies designed to assess the long-term effects of OC use, the current results are reassuring in noting moderate agreement between self-reported OC use and pharmacy data for up to 15 to 20 years before the interview.

Menstrual Phase as Predictor of Outcome After Mild Traumatic Brain Injury in Women

To determine whether menstrual cycle phase in women at the time of mild traumatic brain injury (mTBI) predicts 1-month outcomes. Six emergency departments; 5 in Upstate New York, and 1 in Pennsylvania. One hundred forty-four female participants (age, 16-60) who presented to participating emergency departments within 4 hours of mTBI. Nested cohort study with neurologic and quality-of-life outcome assessment, 1 month after enrollment. Female subjects aged 16 to 60 enrolled in the parent cohort study, with 1-month neurological determination data available, were classified into menstrual cycle groups by serum progesterone concentration and self-reported contraceptive use. Rivermead Post Concussion Questionnaire and EuroQoL/EQ5D. Women injured during the luteal phase of their menstrual cycle, when progesterone concentration is high, had significantly lower EuroQoL General Health Ratings and Index Scores than women injured during the follicular phase of their cycle or women taking oral contraceptives. Multivariate analysis confirmed a significant independent effect of menstrual cycle phase on EuroQoL Index Score and the Rivermead Post Concussion Questionnaire Somatic Subscore. Menstrual cycle phase and progesterone concentration at the time of mTBI affect 1-month quality-of-life and neurologic outcomes. This association has important implications for treatment and prognosis after mTBI.

PS2-29: Comparison of Self-reported Oral Contraceptive Use and Automated Prescription Fills

Background/Aims Self-reported use of oral contraceptives (OCs) may be subject to recall bias. Previous reports comparing self-report OC use and computerized pharmacy data have focused on current use or longer-term use in younger women and have found (adjusted) kappa statistics of 79-85%. The objective of the current analysis was to evaluate the reliability of self-reported OC use obtained from a sample of peri- and early post-menopausal women. Methods Participants were 45-59 year-old women eligible for an ongoing population-based case-control study assessing the association between OC use and incident fractures around the menopausal transition. Cases were all women enrolled in Group Health with an ICD9 osteoporotic fracture code in 2008-2009; age-matched non-fracture controls were randomly selected. Eligible cases and controls (n=535) who reported at interview that they always/usually filled prescriptions at GH pharmacies and agreed to record review were included. Respondents who reported ever using OCs before the reference date (fracture date for cases; randomly assigned dates based on distribution of case dates for controls) were asked for each episode of use their age and length of use. A life events- calendar tool was available to interviewers. Computerized pharmacy information was obtained on OC fills back to 1977. OC use was based on GH pharmacy and First Data Bank OC class key ingredients [e.g. ethinyl estradiol levonorgestrel] and name. OC use was evaluated using >1 fill or >2 fills within a 1-year period. Ever use use since ages 35 38 and 40 and 5 years before reference date were examined. Women were required to be enrolled for the designated time period except for the ever-use category. We calculated kappa (K) the chance-corrected measure of agreement and the prevalence-adjusted bias-adjusted kappa (PABAK). Results The agreement between self-reported OC use and OC fills was highest for more recent use (PABAK=92% for OC use within 5 years of reference date and 55% for use at ages >38). Conclusion In women around the menopausal transition agreement between self-reported OC use and computerized OC prescription fills was moderate for use after age 38 and excellent for OC use within 5 years of the reference date.

Promoting contraceptive use among female rural-to-urban migrants in Qingdao, China: A comparative impact study of worksite-based interventions

ABSTRACTBackground We conducted a comparative study in worksites to assess the impact of sexual health promoting interventions on contraceptive use among female rural-to-urban migrants.Study design In Qingdao ten manufacturing worksites were randomly allocated to a standard package of interventions (SPI) and an intensive package of interventions (IPI). The interventions ran from July 2008 to January 2009. Cross-sectional surveys at baseline and end line assessed the sexual behaviour of young female migrants. To evaluate the impact of the interventions we assessed pre- and post-time trends.Results From the SPI group 721 (baseline) and 615 (end line) respondents were considered. Out of the IPI group we included 684 and 603 migrants. Among childless migrants, self-reported contraceptive use increased significantly after SPI and IPI (adjusted odds ratio [aOR] = 3.23; 95% confidence interval [CI] = 1.52−6.84; p < 0.01 and aOR = 5.81; 95% CI = 2.63−12.80; p < 0.001, respectively). Childless migrants older than 22 years reported a greater use after IPI than after SPI.Conclusion Implementing current Chinese sexual health promotion programmes at worksites is likely to have a positive impact on migrant women working in the manufacturing industry of Qingdao. More comprehensive interventions seem to have an added value if they are well targeted to specific groups.

Injectable and Oral Contraceptive Use and Cancers of the Breast, Cervix, Ovary, and Endometrium in Black South African Women: Case–Control Study

Oral contraceptives are known to influence the risk of cancers of the female reproductive system. Evidence regarding the relationship between injectable contraceptives and these cancers is limited, especially in black South Africans, among whom injectable contraceptives are used more commonly than oral contraceptives. We analysed data from a South African hospital-based case-control study of black females aged 18-79 y, comparing self-reported contraceptive use in patients with breast (n = 1,664), cervical (n = 2,182), ovarian (n = 182), and endometrial (n = 182) cancer, with self-reported contraceptive use in 1,492 control patients diagnosed with cancers with no known relationship to hormonal contraceptive use. We adjusted for potential confounding factors, including age, calendar year of diagnosis, education, smoking, alcohol, parity/age at first birth, and number of sexual partners. Among controls, 26% had used injectable and 20% had used oral contraceptives. For current and more recent users versus never users of oral or injectable contraceptives, the odds ratios (ORs) for breast cancer were significantly increased in users of oral and/or injectable contraceptives (OR 1.66, 95% CI 1.28-2.16, p<0.001) and separately among those exclusively using oral (1.57, 1.03-2.40, p = 0.04) and exclusively using injectable (OR 1.83, 1.31-2.55, p<0.001) contraceptives; corresponding ORs for cervical cancer were 1.38 (1.08-1.77, p = 0.01), 1.01 (0.66-1.56, p = 0.96), and 1.58 (1.16-2.15, p = 0.004). There was no significant increase in breast or cervical cancer risk among women ceasing hormonal contraceptive use ≥10 y previously (p = 0.3 and p = 0.9, respectively). For durations of use ≥5 y versus never use, the ORs of ovarian cancer were 0.60 (0.36-0.99, p = 0.04) for oral and/or injectable contraceptive use and 0.07 (0.01-0.49, p = 0.008) for injectable use exclusively; corresponding ORs for endometrial cancer were 0.44 (0.22-0.86, p = 0.02) and 0.36 (0.11-1.26, p = 0.1). In this study, use of oral and of injectable hormonal contraceptives was associated with a transiently increased risk of breast and cervical cancer and, for long durations of use, with a reduced risk of ovarian and endometrial cancer. The observed effects of injectable and of oral contraceptives on cancer risk in this study did not appear to differ substantially.

Impact of learning HIV status on contraceptive use in the MIRA trial

Background and methodologyWe examined the effect of becoming HIV-positive on contraceptive practices in a Phase III randomised controlled trial of the diaphragm for HIV prevention. We coded self-reported contraceptive use...

Reaching Adolescent Males Through School-Based Health Centers

In this issue of the Journal of Adolescent Health, Ethier et al provide yet more evidence of the effectiveness of school-based health centers (SBHCs) as a critical access point for preventive services to adolescents—a population long considered difficult to reach [1–5]. By comparing self-reported reproductive health care, contraceptive use, and screening of sexually transmitted infections among adolescents who had access to an SBHC against those without access, researchers found that SBHC access was associated with greater use of reproductive care and contraception among sexually experienced adolescent females [6].

A Belief-Behavior Gap? Exploring Religiosity and Sexual Activity Among High School Seniors

Religiosity, sexual activity, and contraception were examined via questionnaires and interviews in a diverse sample of 118 high school seniors. The majority reported religion to be important; importance and frequency ratings declined from private (e.g., prayer) to public (e.g., group activities) components of religion. Most were sexually active and used contraception. Nearly half acknowledged religious teachings on sexual activity, and one third believed premarital sex is proscribed. Religiosity items were negatively correlated with approval of sexual activity in hypothetical relationship scenarios, but religiosity was not related to self-reported sexual activity or contraceptive use. Participants emphasized relationships and physical health, not religious proscriptions, in their standards for sexual activity. Older adolescents may believe sexual activity is acceptable in committed romantic relationships.

The Influence of Changes in Fertility Related Norms on Contraceptive Use in Egypt, 1995–2005

The debate around the relative influence of ideation versus development on fertility reduction has been on-going at least since Cleland &amp; Wilson’s “iconoclastic view” of fertility transition was published in 1987. While there is fairly wide recognition that the diffusion of new behaviors through a community can play an important role in fertility transitions, there is relatively little research on the effect of changes in the normative environment—a predictable consequence of the ideational process—on a woman’s fertility decisions. For the current study, we focus on collective or group norms, which have been defined as “regularities in attitudes and behavior that characterize a social group and differentiate it from other groups.” We infer these regularities in behavior and attitudes by aggregating across individual reports to calculate the objective prevalence of these phenomena within groups. Using multilevel analysis of consecutive 1995, 2000 and 2005 Egypt Demographic and Health Surveys (EDHS), we test the effect of changes in the norms related to the desire for a large family and the use of family planning at parity 0 or 1 on self-reported contraceptive use among married women in Egypt. The analysis included 2432 married women 15–49 years for the 1995–2000 period and 5285 women for the 2000–2005 period. Norms are defined at the cluster level, which serves as our community-level unit of analysis. After controlling for individual and other community factors, including changes in literacy, we found that women residing in communities where the desire for large families increased from 1995–2000 were more than 70% less likely to use a contraceptive method. While the trend was similar, no such effect of desired family size was observed from 2000–2005. Instead, residence in a community where use of family planning after the first child increased from 2000–2005 resulted in a more than three-fold increase in contraceptive use in 2005. Results indicate that changes in norms measured at the collective level affect individual contraceptive use. Specific attitudinal and behavioral changes that influenced individual action, however, changed over time, consistent with shifts in the emphasis of the national family planning program.

Self-reported oral contraceptive use and peripheral joint laxity.

A masked, single-factor, posttest-only control group design. To explore the relationship between reported oral contraceptive use and peripheral joint laxity. Studies have found an association between increased ligamentous laxity and changes in serum levels of hormones such as estrogen, progesterone, and relaxin. Two of these hormones, estrogen and progesterone, are present in most oral contraceptives. Oral contraceptive users, therefore, provide a population for studying the effects of these hormones on the degree of ligamentous laxity. Fifty-five women between the ages of 20 and 25 years participated in this study. Thirty users of oral contraceptives were a test group and 25 nonusers of oral contraceptives were controls. The KT-1000 Arthrometer was used to measure passive anterior translation of the tibia in relation to the femur in both knees. Passive abduction and adduction of the proximal interphalangeal (PIP) joint of the second digit of the nondominant hand and distal interphalangeal (DIP) joint hyperextension of the fifth digit of the nondominant hand were measured using a goniometer. A subjective measurement of passive second PIP joint motion was also assessed and a value of minimum, moderate, or maximum laxity was assigned. Independent sample t tests were performed to compare the measurements of the oral contraceptive user and nonuser groups for each joint. A chi-square test compared the subjective PIP joint data between the 2 groups. No significant differences in laxity measurements at the knee or hand were found between the 2 groups. Average knee laxity varied between 5.7-7.9 mm of anterior displacement for both groups. Average PIP abduction and adduction varied between 6.5-6.7 degrees for both groups and DIP hyperextension was 28.6-29.9 degrees. Results of this study indicate that self-reported oral contraceptive use was not associated with peripheral joint laxity.