3133 — Associations between Contraceptive Knowledge and Use of Prescription Contraception among Women Veterans

Rosenfeld EA, Postdoctoral Fellow, Women's Health, VA Pittsburgh Healthcare System; Callegari LS, Staff Gynecologist, VA Puget Sound Health Care System; Schwarz EB, Department of Medicine, University of California, Davis; Zhao X, Center for Health Equity Research and Promotion (CHERP), VA Pittsburgh Healthcare System; Mor MK, Center for Health Equity Research and Promotion (CHERP), VA Pittsburgh Healthcare System; Borrero S, Center for Health Equity Research and Promotion (CHERP), VA Pittsburgh Healthcare System;

Objectives:
Unintended pregnancy can be averted by consistent use of prescription contraception. The aim of this study was to examine the relationship between contraceptive knowledge and use of prescription contraception among women Veterans.

Methods:
We analyzed preliminary data from an ongoing telephone-based survey of a national sample of women Veterans aged 18-45 years who had received primary care within the VA Healthcare System in the 12 months prior to interview. Our sample included the 583 women at risk for unintended pregnancy, defined as women who had been sexually active with a man in the prior 3 months, had not had a hysterectomy, and were not infertile, pregnant, or trying to get pregnant. Knowledge questions assessed women's understanding of contraceptive efficacy and safety, correct use of contraception, and risk of pregnancy with unprotected intercourse. Multivariable logistic regression was used to examine associations between contraceptive knowledge items and use of prescription contraception [sterilization, intrauterine devices (IUD), implant, pill, patch, injection, and contraceptive ring], after adjusting for age, marital status, income, military branch, education level, and history of pregnancy.

Results:
Overall, anywhere from 26%-89% of women Veterans correctly answered the various knowledge questions, and 71% were using prescription contraception. Correct knowledge about contraception was associated with increased likelihood of using prescription contraception. Specifically, compared to women who answered incorrectly, use of prescription contraception was more common among women who knew that IUDs do not need to be replaced yearly (aOR: 2.0; 95% CI: 1.3-2.9); that copper IUDs do not contain hormones (aOR: 1.9; 95% CI: 1.3-2.8); and that it is safe to use birth control to suppress menses (aOR: 1.8; 95% CI: 1.2-2.6). In addition, compared to women who incorrectly estimated the risk of pregnancy with unprotected intercourse, women who correctly estimated the risk were more likely to use prescription contraception (aOR: 1.8; 95% CI: 1.2-2.6).

Implications:
Greater knowledge about contraception and the risk of pregnancy with unprotected intercourse is associated with increased likelihood of using prescription contraception among women Veterans.

Impacts:
Improving contraceptive knowledge and awareness of the risk of pregnancy with unprotected intercourse may increase women Veterans' use of prescription contraception and reduce risk for unintended pregnancy