Stopping and switching contraceptive methods: findings from Contessa, a prospective longitudinal study of women of reproductive age in England

Wellings, Kaye; Brima, Nataliya; Sadler, Katharine; Copas, Andrew; McDaid, Lisa; Mercer, Catherine H; McManus, Sally; Stephenson, Judith; Glasier, Anna

doi:10.1016/j.contraception.2014.09.008

Cited by 39 publications

(39 citation statements)

References 21 publications

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“…TRIO was designed with placebo products to permit examination of preferences among delivery forms, first and foremost, without consideration of side effects and adverse events that might result from use of active products. Side effects do constitute an important contributor to contraceptive and PrEP discontinuation [25, 26] and would likely contribute to uptake and adherence of a future MPT. Discussions of product dosing and drug exposure were infrequently mentioned by participants, likely owing to our use of placebo products.…”

Section: Discussionmentioning

confidence: 99%

Young Women’s Ratings of Three Placebo Multipurpose Prevention Technologies for HIV and Pregnancy Prevention in a Randomized, Cross-Over Study in Kenya and South Africa

Minnis

Roberts²,

Agot

et al. 2018

AIDS Behav

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End-user input is critical to inform development of multipurpose prevention technology (MPT) products that prevent HIV and pregnancy. The TRIO Study, conducted in Kenya and South Africa, enrolled 277 HIV-negative women aged 18–30 in a randomized cross-over study to use each placebo MPT (daily oral tablets, monthly injections, and monthly vaginal ring) for one month. At the end of each month, participants rated how much they liked using the product on a 5-point Likert scale (5 = liked very much). We compared mean ratings using paired t-tests and examined sociodemographic-, attribute-, and behavior-related characteristics associated with ratings using multivariable linear regression and data from in-depth interviews. After use, mean ratings were significantly higher for injections [4.3 (SD = 1.0)] compared with tablets [3.0 (SD = 1.3)] and rings [3.3 (SD = 1.4)] (p < 0.001); mean ratings for rings were significantly higher than for tablets (p = 0.013). Mean ratings of a hypothetical active MPT increased for all products after the one-month period of use, with the greatest increase for rings, the least familiar product. In multivariable analysis, acceptability of key product attributes (e.g., product look) were associated with a significant increase of ≥ 1 point in the mean rating across all three products (p ≤ 0.001). Perceived ability to use the product without partner knowledge was associated with a higher mean rating for rings (b = 0.50; p = 0.006). The acceptability of product attributes contributed significantly to the rating of all products, highlighting the value of choice in pregnancy and HIV prevention to accommodate diverse users.

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Section: Discussionmentioning

confidence: 99%

Young Women’s Ratings of Three Placebo Multipurpose Prevention Technologies for HIV and Pregnancy Prevention in a Randomized, Cross-Over Study in Kenya and South Africa

Minnis

Roberts²,

Agot

et al. 2018

AIDS Behav

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“…For example, many unintended pregnancies can be attributed to incorrect use, inconsistent use or nonuse of available contraceptives, or to interruptions in contraceptive coverage during periods of discontinuation or method switching . Whether an individual uses contraceptives is related to a constellation of individual and social factors, such as desire to avoid pregnancy, demographic characteristics (e.g., education, race, age), frequency of sexual intercourse, relationship status and interactions with health care providers . In addition, product‐specific factors, such as overall satisfaction with a method, as well as users’ evaluations and perceptions of specific product characteristics, influence patterns of contraceptive use.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, product‐specific factors, such as overall satisfaction with a method, as well as users’ evaluations and perceptions of specific product characteristics, influence patterns of contraceptive use. To develop and offer effective prevention technologies, we must have an in‐depth understanding of these person‐ and product‐related factors . Users must be able and willing to use an accessible method that suits their lifestyle and relationships.…”

Section: Discussionmentioning

confidence: 99%

A Qualitative Systematic Review of Women's Experiences Using Contraceptive Vaginal Rings: Implications for New Technologies

Vargas

Midoun

Guillen

et al. 2019

Perspect Sexual Reproductive

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CONTEXT Vaginal rings are available for contraception and hormone replacement, and are being developed as HIV/STD or multipurpose prevention technologies. A comprehensive understanding of women's expectations of and experiences with rings is urgently needed to inform product development and to optimize ring use. METHODS Three databases (PubMed, Global Health and CINAHL) were searched for English‐language, peer‐reviewed articles published between January 1996 and November 2017 that reported qualitative data on barriers to and facilitators of use of female‐controlled contraceptive methods. Data on study methods, findings and conclusions pertaining to contraceptive rings were extracted, organized and analyzed. RESULTS Twenty‐six articles, all published since 2008, met the inclusion criteria. Seven studies focused largely or entirely on rings (and involved current, former or potential users), while the others focused on other contraceptive methods but included ring‐specific data. Familiarity with the ring was low, and women commonly had initial concerns about the method—often related to insertion and removal, cleanliness and discomfort with touching their vagina—that were typically overcome over time. Other major themes were issues related to ring use and discontinuation, the importance of ring‐related properties and characteristics, and considerations related to sexual partners and health care providers. CONCLUSIONS Qualitative data have the potential to inform ring design and promotion. Future research should further explore women's expectations and experiences with the ring, the value of involving male partners in ring evaluation, and evaluation of interventions to improve patient–provider communication concerning ring choice and use.

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“…This is relevant because implants have been shown to uniquely address individual needs for a wide range of women and have a substantial positive effect on population health and the reduction of unintended pregnancy, abortion and adverse neonatal outcomes, particularly among vulnerable populations, such as teenagers, single mothers and low-income families. [9][10][11][15][16][17][18]22,[39][40][41][42] Although current contraceptive implants have not been approved, Health Canada has approved the active ingredients now used in implants, either etonogestrel or levonorgestrel, for use in other contraceptive products.…”

Section: Discussionmentioning

confidence: 99%

“…8,20,21 Contraceptives that more closely align with individual needs are more likely to be used. 9,10,22 In particular, "set and forget" LARC intrauterine and implant methods have been exceptionally effective in reducing unintended pregnancies. 11,[15][16][17][18] The timely approval of a full range of contraceptive methods is important to assist women and their families in meeting their reproductive goals.…”

mentioning

confidence: 99%

Regulatory approval time for hormonal contraception in Canada, the United States and the United Kingdom, 2000-2015: a retrospective data analysis

et al. 2016

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Background: Access to a wide range of contraceptive methods improves prevention of unintended pregnancy by ensuring the best method fit for each individual. We compared approval times of new hormonal contraceptives by Health Canada, the US Food and Drug Administration (FDA), and the UK Medicines and Healthcare Products Regulatory Agency (MHRA). Methods:We obtained dates of applications to Health Canada, the FDA and the MHRA for contraceptive methods approved from January 2000 to January 2015. We used public data sources and direct correspondence, and excluded generic versions of previously approved drugs. The primary outcome of interest was median time to approval for novel hormonal contraceptives. Secondary outcomes included the median time to approval for all hormonal contraceptives and the number of approved hormonal contraceptives comparing countries studied, as well as the median time for approval of novel compared with nonnovel hormonal contraceptives within each country.Results: During this period 16 contraceptives were approved in Canada, 26 in the US and 14 in the UK. Applications for novel contraceptives were initiated later in Canada, and time to approval was longer in Canada than in the US (p = 0.03).

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Stopping and switching contraceptive methods: findings from Contessa, a prospective longitudinal study of women of reproductive age in England

Cited by 39 publications

References 21 publications

Young Women’s Ratings of Three Placebo Multipurpose Prevention Technologies for HIV and Pregnancy Prevention in a Randomized, Cross-Over Study in Kenya and South Africa

Young Women’s Ratings of Three Placebo Multipurpose Prevention Technologies for HIV and Pregnancy Prevention in a Randomized, Cross-Over Study in Kenya and South Africa

A Qualitative Systematic Review of Women's Experiences Using Contraceptive Vaginal Rings: Implications for New Technologies

Regulatory approval time for hormonal contraception in Canada, the United States and the United Kingdom, 2000-2015: a retrospective data analysis

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