‘I feel like a person has a right to use a product to protect themselves…’: a qualitative study of the risk–benefit calculus on women’s contraceptive use and choice
Sofía L. Carbone A , Melissa Guillen B , Jaime J. Ramirez B , Sara E. Vargas B C , Connie Fei Lu C , Melissa L. Getz B , Yaa Frimpong C , Kelley A. Smith B , Claire Stout B , Iris Tong C D , Melanie Hill D , Robert E. Berry E , Abigail Harrison A and Kate M. Guthrie
A B C F
+ Author Affiliations
- Author Affiliations
A Brown University School of Public Health, 121 South Main Street, Providence, RI 02903, USA.
B Center for Behavioral and Preventive Medicine, Miriam Hospital, Coro West, Suite 309, 164 Summit Avenue, Providence, RI 02906, USA.
C The Warren Alpert Medical School at Brown University, 222 Richmond Street, Providence, RI 02903, USA.
D Women’s Medicine Collaborative, Lifespan, 146 West River Street, Providence, RI 02904, USA.
E Cambridge Health Alliance, 1493 Cambridge Street, Cambridge, MA 02139, USA.
F Corresponding author. Email: kate_guthrie@brown.edu
Sexual Health 17(3) 262-269 https://doi.org/10.1071/SH19197
Submitted: 7 November 2019 Accepted: 12 March 2020 Published: 26 June 2020
Abstract
Background: Reducing pregnancy risk requires a multidimensional approach to sexual and reproductive health product development. The purpose of this analysis is to identify, compare, and contrast women’s pre-use beliefs and attitudes about three different forms of contraceptives: intravaginal rings; spermicide in conjunction with condoms; and oral contraceptive pills – and explore how those attitudes and beliefs, along with actual method-use experience, may affect potential choices in contraceptive method moving forward. The relationship of beliefs and attitudes to their risk–benefit calculations when using these methods was also considered.? Methods: Women used one or more contraceptive methods, each for 3–6 months. Qualitative data from individual in-depth interviews completed after each 3-month use period were analysed using a summary matrix framework. Data were extracted and summarised into themes. Each woman’s experiences were compared among the methods she used; comparisons were also made across participants. Results: The data consist of 33 90–120 min in-depth qualitative interviews from 16 women aged 20–34 years, in which they discussed various elements of their method use experience. One prominent theme was identified: the influence of attitudes and beliefs on the risk–benefit calculus. There were six key elements within the theme: pregnancy prevention; dosing and the potential for user error; side-effects; familiarity; disclosure; and sexual partnerships. Conclusions: Women weighed perceived risks and benefits in their decision-making and, ultimately, their contraception choices. Understanding women’s beliefs and attitudes that contribute to a calculation of risk–benefit can inform the development of sexual and reproductive health products.
Additional keywords: contraception attitudes, contraception beliefs, intravaginal rings, oral contraceptive pills, spermicide and condoms.
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