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Who is using the morning-after pill?: Inequalities in emergency contraception use among ever partnered Nicaraguan women; findings from a national survey
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).ORCID iD: 0000-0003-3083-106X
2014 (English)In: International Journal for Equity in Health, ISSN 1475-9276, E-ISSN 1475-9276, Vol. 13, no 1, 61- p.Article in journal (Refereed) Published
Abstract [en]

IntroductionFew studies have described the inequalities in hormonal emergency contraception (HEC) use in developing countries. Thus, the main aim of this manuscript is to study socio-demographic inequalities in HEC use among Nicaraguan women, and to study if inequalities in HEC use arise from exposure to different forms of intimate partner violence (IPV).MethodsData from a national cross-sectional study conducted from 2006 to 2007 was used. This study included data from 8284 ever partnered, non-sterilized women. Separate multivariate logistic regressions with each form of IPV were conducted to study how different forms of IPV were associated with HEC. Women¿s age, residency, education, socioeconomic status, parity, and current use of reversible contraception were included in the multivariate logistic regressions to obtain adjusted odds ratios showing inequalities in HEC use.ResultsSix percent of the women had ever used HEC (95% CI 5.1-6.9). Multivariate analyses showed that urban residency, higher education, and higher socioeconomic status were significantly associated with higher odds of ever using HEC, and age was associated with decreased odds of HEC use. A key finding of this study is that after controlling for socio-demographic factors, the odds of using HEC were higher for those women ever exposed to emotional IPV (AOR 1.58, 95%CI 1.16-2.00), physical IPV (AOR 1.82, 95%CI 1.30-2.55), sexual IPV (AOR 1.63, 95%CI 1.06-2.52), and controlling behavior by partner (AOR 1.51 95%CI 1.13-2.00) than those not exposed.ConclusionsThis study provides sound evidence supporting the hypothesis that there are inequalities in HEC use even in countries where inequalities in use to other forms of contraceptive technology has been reduced. HEC use among Nicaraguan women is strongly influenced by individual factors such as age, residency, educational level, socioeconomic status, and exposure to different forms of IPV. It is paramount that actions are taken to diminish these gaps.

Place, publisher, year, edition, pages
BioMed Central, 2014. Vol. 13, no 1, 61- p.
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-91964DOI: 10.1186/s12939-014-0061-yISI: 000341668200001PubMedID: 24989177OAI: oai:DiVA.org:umu-91964DiVA: diva2:738727
Available from: 2014-08-19 Created: 2014-08-19 Last updated: 2017-12-05Bibliographically approved

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