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Contraception: Condoms Are King, Plan B Takes Hold

Ƶ MedicalToday
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In the realm of contraception, the condom reigns supreme, but one in 10 have used emergency contraception such as Plan B, according to two reports on the contraceptive methods used by women of reproductive age in the U.S.

That's one of the findings of a new report on the contraceptive methods used by women of reproductive age in the U.S., issued by the CDC's National Center for Health Statistics.

Action Points

  • Note that this report based upon survey data demonstrates that condom use has risen steadily over the past 2 decades in the U.S.
  • Of women surveyed, over 99% reported ever having used contraception.

A separate data brief – with overlapping authors – reported that 11% of sexually active women interviewed in the latest National Survey of Family Growth had used emergency contraception.

One of the "most striking changes" over time has been the increase in the proportion of women who report their male partners used a condom – from 52% in 1982, to 82% in 1995, and to 93.4% in the latest figures.

One possible explanation for the trend, the authors concluded, is "heightened awareness and concern for preventing sexually transmitted infections, including HIV."

Overall, the proportion of sexually active women ages 15 through 44 who reported ever using any form of contraception has steadily increased – from 94.8% in 1982 to 99.1% in the latest figures.

The report is based primarily on interviews with 12,279 women who took part in the latest round of the National Survey of Family Growth from 2006 through 2010.

The researchers used earlier rounds of the survey -- in 1982, 1995, and 2002 -- to illustrate trends in the use of contraception.

The surveys asked about what methods women have ever used; in 2006-2010, the median number of methods ever used by women was about three, but nearly 30% reported trying five or more.

In the 2006-2010 snapshot, the researchers reported, the most common methods that women or their partners had ever used were the male condom (93%), the Pill (82%), withdrawal (60%), and the injectable contraceptive Depo-Provera (23%).

Aside from the growth in condom use, the trend analysis showed:

  • The proportion of women who had ever used the Pill is roughly stable -- 76% in 1982, but plateauing at about 82% in 1995, 2002, and 2006–2010.
  • Depo-Provera, first available in 1992, had been used by 4.5% of women in 1995 and by 23% in 2006–2010.
  • Use of the contraceptive patch rose from 0.9% in 2002 to 10% in 2006–2010.
  • The proportion of women who had ever used an intrauterine device was 18% in 1982, fell to 5.8% in 2002, and then rebounded slightly to 7.7% in 2006-2010.
  • In the 2006-2010 period, 60% of sexually experienced women had ever used withdrawal compared with about 25% in 1982, a change that may be linked to the increase in condom use, since the two methods are often used together.
  • There were no changes in the proportions of women who had ever used periodic abstinence by calendar to prevent pregnancy.
  • The use of barrier and spermicidal methods -- such as diaphragms, female condoms, and spermicidal foams or jellies – either remained low or fell.

The 2006-2010 snapshot shows little difference in contraceptive use by religious affiliation – 99.4% of those who said they had no current affiliation reported ever using contraception, compared with 98.6% of Catholics, 99.4% of Baptists and fundamentalist Protestant groups, and 99.5% of other Protestant groups.

There were also no significant differences by race and ethnicity in the proportions of women who had ever used contraception, although the researchers found some differences in preferred methods.

For instance, they reported that 91.3% of white women have used any highly effective, reversible method (such as the Pill or contraceptive patch), compared with 81% of all Hispanic women and 63% of Asian women.

Almost half of those who reported using one of the four available emergency contraceptive products (45%) said they did so because they feared their usual methods of contraception had failed.

A similar proportion (49%) said they used emergency contraception because they had had unprotected sex.

The main report found that many women stop using a contraceptive method because they are dissatisfied, either with efficacy or side effects.

For instance, the authors reported, 30% of the 45 million women who have ever used the pill, 46% of the million women who had used Depo-Provera, and 49% of the 5.6 million women who had used the contraceptive patch reported stopping because of dissatisfaction.

In comparison, 9.3% of the 50 million women whose partners had used the condom reported stopping because of dissatisfaction.

Disclosures

The analyses were supprted by the CDC's National Center for Health Statistics.

The authors are employees of the agency.

Primary Source

National Center for Health Statistics

Daniels K, et al "Contraceptive methods women have ever used: United States, 1982–2010" NCHS 2013; No 62.

Secondary Source

National Center for Health Statistics

Daniels K, et al "Use of emergency contraception among women aged 15–44: United States, 2006–2010" NCHS 2013; No 112.