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Contraception and sexual acceptability: Measuring a key patient-centered aspect of contraceptive satisfaction and continuation

Jenny Higgins, PhD, MPH, University of Wisconsin, 2015

Project abstract

Persistently high rates of unintended pregnancy in the US suggest a need for new patient-centered approaches to contraceptive acceptability and promotion. A critically understudied aspect of contraceptives are their sexual acceptability, or how methods influence women’s sexual experiences, which can in turn influence family planning clients’ preferences and practices. Moreover, despite professional enthusiasm about long-acting reversible contraceptives (LARC), IUDs and implants are among the methods we know the least about regarding women’s sexual experiences. The field lacks measures of sexual acceptability that 1) capture multiple aspects of the sexual experience, 2) are suited to young, healthy, contraceptive-seeking populations, and 3) are assessed longitudinally.

This proposal addresses these gaps by documenting sexual acceptability among 500 women initiating one of five contraceptive methods (copper IUDs, levonogestrel IUDs, contraceptive implants, combined oral contraceptives, and a condom-only comparison group). Building on a successful pilot version of this protocol (SFP RF7-21), analyses will 1) assess sexual acceptability for each method over four time periods, 2) document associations between sexual acceptability, method satisfaction, and continuation rates at 6 and 12 months, and 3) develop a new, multi-faceted scale of contraceptive sexual acceptability that will become the standard measure for future assessments.

The project addresses two of SFP’s top research priorities: characterizing women’s contraceptive preferences and acceptability, and developing measures to gauge patient-centered outcomes. Findings will help assess and address the sexual aspects of all contraceptive methods in future studies and clinical programs-thereby enhancing client satisfaction, improving contraceptive use, and reducing unintended pregnancy.

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