Predictors of contraceptive switching and discontinuation within the first 6 months of use among Highly Effective Reversible Contraceptive Initiative Salt Lake study participants

Abstract

BACKGROUND: Nearly half of women will switch or discontinue using their selected contraceptive method in the first year. Research on early switching or discontinuation provides important clinical and public health insights, although few studies have assessed associated factors, particularly among longitudinal cohorts. OBJECTIVE: The current study explores attributes associated with early contraceptive method switching or discontinuation (<6 months of initiation) among participants enrolled in the intervention cohorts of the Highly Effective Reversible Contraceptive Initiative Salt Lake Contraceptive Initiative (Utah, United States). MATERIALS AND METHODS: Highly Effective Reversible Contraceptive Initiative Salt Lake participants have access to no-cost contraception for 3 years. This includes both the initial selection and the ability to switch or to discontinue methods without cost. Methods available included the following: nonhormonal behavioral methods (male/female condoms, withdrawal, diaphragms, cervical caps, and fertility awareness); short-acting methods (pill, patch, ring, and injectable); and long-acting methods (intrauterine devices and contraceptive implants). Participants completed surveys at baseline and at 1, 3, and 6 months. We collected data on participant demographics, contraceptive continuation, switching, and discontinuation, as well as factors associated with these changes, including established measures of pregnancy intention and ambivalence and reasons for switching or discontinuing. We conducted descriptive statistics, univariable, and multivariable Poisson regression analyses to assess predictors of both discontinuation and switching. We also conducted χ 2 analyses to compare reported reasons for stopping between switchers and discontinuers. RESULTS: At 6 months, 2,583 women (70.0%) reported continuation of their baseline method, 367 (10%) reported at least 1 period of discontinuation, 459 (12.4%) reported switching to a

Discontinuation of Different Contraceptive Methods in Thai Women During a One-year Period: A Cohort Study

“…Adjusted hazard ratio of COCs and DMPA were signi cant in multivariable Cox proportional hazard model. These results were consistent with previous clinical studies [13,14]which showed signi cant lower contraceptive discontinuation among women who used LARC compared to the other methods. However, the rates of contraceptive discontinuation during the one-year period for all four types of contraceptives in this study were quite low.…”

Provision of family planning vouchers and early initiation of postpartum contraceptive use among women living with HIV in southwestern Uganda: A randomized controlled trial

“…However, just like our study, the probability of continuation of an initiated contraceptive method was higher for the voucher cohort versus the nonvoucher cohort at 6 months. Although the inclusion/provision of information about family planning benefits and possible side effects on the voucher could have been helpful in continuously reminding women about expectations from the different contraceptive methods chosen [41], qualitative data analysis of interviews conducted with a subset of participants to understand how the voucher (information-on-voucher, counseling, time-bound, waiting time, methods administration) facilitated decision-making, initiation, and/or continuous use of contraception among these child-bearing WLWH is underway. Twelve-month postpartum data collection is still ongoing.…”

Beyond safety and efficacy: sexuality-related priorities and their associations with contraceptive method selection

“…Contraceptives improve both public health and individual lives [ 1 , 2 ], but many people use contraceptives inconsistently or not at all due to method dissatisfaction [ 3 ], and many stop using their methods after only several months [ [4] , [5] , [6] , [7] ]. While not inherently negative, discontinuation can be indicative of less-than-ideal method selection due to availability, cost or other barriers.…”