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No Perfect Method: Exploring How Past Contraceptive Methods Influence Current Attitudes Toward Intrauterine Devices

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Abstract

Little research on contraceptive decision-making takes a holistic perspective to understand women’s contraceptive journeys throughout the reproductive life course. This analysis investigated how Black and Latina women’s past experiences with contraceptive use and acquisition impact their feelings and attitudes toward future use of intrauterine devices (IUDs). We utilized data from in-depth interviews that explored contraceptive decision-making and knowledge of, interest in, and attitudes toward IUDs among 38 young Black and Latina women collected in 2013 in the San Francisco Bay Area. Here, we focused on the IUD decision-making process among a subsample of 32 women who were not using or had not previously used an IUD. Overall, we found a strong link between past contraceptive experiences and attitudes regarding future use of IUDs. Notably, participants often referenced experiences of side effects with previous methods when explaining their interest—or lack thereof—in IUD use, as well as made links between contraceptive attributes they had experienced positively and attributes of the IUD. A minority of participants described being satisfied with their current method, resulting in a lack of interest in considering IUD use. More than half of participants described distrust, either in healthcare providers owing to previous negative interactions and contraceptive failures of provider-recommended methods or owing to family members’ and friends’ negative experiences with IUDs. This distrust undergirded their lack of interest in the IUD. These findings highlight the importance of locating contraceptive decision-making in the broader context of reproductive journeys.

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Acknowledgements

Research reported in this article was supported by an individual investigator grant from the Office of Research and Sponsored Programs at San Francisco State University. The authors thank Kelly Bermudes, Vanessa Cardona, Airial Clark, and Vanessa Torres for their work in designing the study, interviewing participants, and cleaning the data.

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Correspondence to Anu Manchikanti Gomez.

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Arteaga, Aronson, Houston, Goodkind, and West declare that they have no conflict of interest. Gomez has served as an advisor for and received grant funding from Gilead Sciences.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Gomez, A.M., Arteaga, S., Aronson, N. et al. No Perfect Method: Exploring How Past Contraceptive Methods Influence Current Attitudes Toward Intrauterine Devices. Arch Sex Behav 49, 1367–1378 (2020). https://doi.org/10.1007/s10508-019-1424-7

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  • DOI: https://doi.org/10.1007/s10508-019-1424-7

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