Effect of counseling to improve compliance in Mexican women receiving depot-medroxyprogesterone acetate

Safety and tolerability of depot medroxyprogesterone acetate among HIV-infected women on antiretroviral therapy: ACTG A5093

“…Only 22.5% of the women in this study chose to receive a second DMPA injection, lower than the continuation rates reported in the general population, which vary from 57-70% at three months and from 23-51% at one year [8,[14][15][16][17]. Change in bleeding pattern was the most common reason for discontinuation in all studies, and continuation rates were improved with more intensive counseling at initiation regarding the potential changes in bleeding patterns and other side effects [14,15].…”

“…Change in bleeding pattern was the most common reason for discontinuation in all studies, and continuation rates were improved with more intensive counseling at initiation regarding the potential changes in bleeding patterns and other side effects [14,15]. The low continuation rate in this study may in part be due to the requirement that participants use a second method of contraception in addition to the DMPA at study entry because of the uncertain efficacy of DMPA with concomitant use of ARVsls.…”

Evidence-based guidance on selected practice recommendations for contraceptive use: identification of research gaps

“…In a separate prospective observational study in Bolivia, researchers found that women using DMPA who received counseling about amenorrhea as a possible side effect and women who were told to return to the clinic for side effects had longer continuation of use than women who had not been given this counseling [35]. Similar findings were noted in a randomized trial of DMPA users in Mexico; women who received information about DMPA's mechanism of action and possible bleeding abnormalities at initiation and at each follow-up visit and who were encouraged to return to the clinic for concerns about the method had higher continuation rates at 1 year than users who received routine counseling [36].…”

Anticoncepción en adolescentes mexicanos de escuelas del nivel medio superior: uso y necesidades insatisfechas

“…Su uso en este grupo poblacional es seguro y efectivo, ya que requiere poca manutención. 6 Existe evidencia nacional e internacional de que los métodos ARAP son aceptables para adolescentes; 7,8 sin embargo, al igual que en otros países, su uso se ve afectado por barreras al acceso y por el desabasto en las unidades de salud, 9 así como por una baja adherencia al tratamiento. La falta de conocimientos y de actitudes adecuadas constituyen también barreras importantes para su uso.…”

“…10,11 Algunos estudios evidencian que la promoción de conocimientos y actitudes adecuados para el uso de estos métodos, mediante campañas de información y de consejería previa al inicio del tratamiento y en cada consulta posterior, aumenta la elección de métodos ARAP 12 y disminuye de manera significativa el porcentaje de pacientes que interrumpen su uso. 8,13 La demanda insatisfecha de anticonceptivos se define como la cantidad de mujeres sexualmente activas que desean limitar o espaciar sus embarazos y no están usando ningún método anticonceptivo, en relación con el número total de mujeres sexualmente activas.…”