Elsevier

Contraception

Volume 95, Issue 4, April 2017, Pages 419-423
Contraception

Original research article
Similarities and differences in contraceptive use reported by women and men in the National Survey of Family Growth

https://doi.org/10.1016/j.contraception.2016.10.008Get rights and content

Abstract

Objective

To compare use of contraceptive methods at last heterosexual intercourse among 15–44 year-old women and men at risk of unintended pregnancy in the United States.

Study Design

We employed data from the National Survey of Family Growth 2006–2013. We considered women and men to be at risk of unintended pregnancy if they had intercourse in the last month, regardless of contraceptive use, and if they or their partner had the ability to get pregnant and was not trying to become pregnant. We categorized multiple method use according to the most effective method reported. To explore the contributions of age and relationship status to differences in reporting between women and men, we conducted sensitivity analyses, limiting age to 25–44 years and union status to married and cohabiting.

Results

Distributions of methods used at last intercourse differed for women and men. A positive difference reflects higher reporting among women, while a negative difference reflects higher reporting among men. Percentage-point differences were largest for reported use of no method (−7.6) and female sterilization (+7.4), each p<.001. These differences persisted even when the sample was restricted by age and relationship status.

Conclusion

Estimates of men's contraceptive use may be subject to underreporting of their partners' method use, particularly when their female partner is sterilized. Neither older age nor married and cohabiting relationship status accounted for the observed differences. Further research is needed to explore the factors underlying reporting differences between women and men with respect to female sterilization and use of no method.

Implications (50)

Characterizing the determinants of contraceptive use among men and the relationship of men's pregnancy intentions, feelings and desires to contraceptive use are important future research goals. To ensure valid results, researchers must be aware of the potential for underreporting of method use among men, particularly with respect to female sterilization.

Introduction

The National Center for Health Statistics (NCHS) regularly issues reports of the contraceptive methods currently used by women in the United States [1]. These reports are based on self-reporting from the National Survey of Family Growth (NSFG), a nationally representative sample of women and men in the US. NCHS investigators classify the following groups of women at risk for unintended pregnancy: (a) all women who are using contraception in the month of interview; (b) women who are not using any method and who have had heterosexual intercourse in the past 3 months; and (c) women for whom none of the following are true: (a) who are pregnant, postpartum, or trying to get pregnant; (b) who themselves or their partner is nonsurgically sterile; (c) who themselves are surgically sterile for noncontraceptive reasons [2].

Despite recent interest in men's pregnancy intentions [3], there are no equivalent reports of contraceptive use among male NSFG respondents at risk of unintended pregnancy. Indeed, the concept of “at risk of unintended pregnancy” is not defined for men by the NCHS. In a recent study, Eeckhaut and Sweeney examined patterns of sterilization use among married and cohabiting contraceptive users aged 25–44 years in the 2006–2010 NSFG [4]. While their primary objective was not to compare distributions of method use by sex, differences in the proportions of women and men reporting use of female sterilization were apparent.

Our aim is to construct at-risk criteria for men and to compare reported method use by women and men at risk for unintended pregnancy at last heterosexual intercourse. This endeavor is an important step toward more in-depth research examining not only women's but also men's contraceptive practices. We focus on last intercourse to maximize reporting accuracy and because, for men, neither method use in the past month nor contraceptive calendar data tracking contraceptive use in the 12 months prior to interview are available. Since the NSFG sample is representative of the household populations of 15–44-year-old women and men in the United States, we expect that the distributions of methods should be approximately the same for female and male respondents, provided that they are accurately reporting their and their partners' actual contraceptive use. We also investigate the potential role of assortative mating (for example, sex differences in number of recent partners and age differentials within partnerships), which could lead to divergent patterns in women's and men's reports.

Section snippets

Methods

We used data from the two latest rounds of the NSFG: 2006–2010 [5] and 2011–2013 [6]. The criteria NCHS uses to define women as at risk cannot be applied to men because the male questionnaire differs in three respects. First, men are not asked about method of contraception used in the month of interview, so we used a question common to both the male and female questionnaires, asking about method used at last intercourse. Second, men are asked only whether they and their partner are trying to

Results

We identified 10,059 women (58.9%) and 7863 men (55.7%) as being at risk for unintended pregnancy. Percentages of women and men reporting use of each method are shown in Table 1. A positive difference reflects higher reporting among women, while a negative difference reflects higher reporting among men. The distributions of methods used are similar for men and women in some respects but very different in others. The largest differences are for percentages using female sterilization (+7.4

Conclusions

Differences in reported method use between women and men at risk of unintended pregnancy are marginal for most methods but substantial for female sterilization and for no method. Reported use of female sterilization is higher among women, and reported use of no method is higher among men. Method reporting for female sterilization is likely to be more accurate among women since the woman is the partner who is actually using the method. It is also possible, however, that some respondents may have

Funding

Support for this research was provided in part by three infrastructure grants the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health (NICHD): R24HD04284 to the Population Research Center at the University of Texas at Austin (ARAA), P2C HD047879 to the Office of Population Research at Princeton University (JT), and P2C HD047873 to the Population Research at the University of Wisconsin Madison (YW and JH). The project was also

Acknowledgments

We thank Joyce Abma and Kimberly Daniels for helpful comments during manuscript preparation.

References (15)

There are more references available in the full text version of this article.

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Conflicts of Interest: None.

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