Aim To describe prevalence and trends in contraceptive method use in Britain through a comparison of the second and third National Surveys of Sexual Attitudes and Lifestyles (Natsal-2 and Natsal-3).
Methods Cross-sectional probability sample surveys. General population sample of women aged 16–44 years, resident in Britain, with ever-experience of vaginal sex and, for analysis by sociodemographic characteristics, vaginal sex in the last year. Main outcome measure was current contraceptive method use (‘usual these days’), categorised by effectiveness.
Results Prevalence of current contraceptive use among women who had ever had vaginal sex declined between Natsal-2 and Natsal-3, 83.5% (95% CI 82.4 to 84.5) and 76.4% (95% CI 75.0 to 77.7), respectively. The condom and oral contraceptive pill remain the most commonly used methods. One in five women reported use of a most effective method. While no difference was found between surveys in use of most effective methods, a decline in sterilisation use was compensated by an increase in long-acting reversible contraceptive (LARC) use. Increased LARC use was particularly evident among under-25s compared with women aged 40–44 years (OR 11.35, 95% CI 3.23 to 39.87) and a decline was observed among those with two or more children relative to those with none (OR 0.21, 95% CI 0.13 to 0.35).
Conclusions Strategies to improve access to LARC methods have been particularly successful in increasing uptake among young people in the first decade of the 21st century. Whether this trajectory is maintained given changing sociodemographic characteristics and more recent financial cuts to sexual health service provision will warrant investigation.
- contraceptive methods
- probability sample survey
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Contributors RSF, AG and KW conceived the idea for the paper and planned the analysis. LG and RG advised on and conducted the analysis. RSF drafted the paper with input from all authors. All authors approved the final draft.
Funding Natsal-3 was supported by grants from the Medical Research Council (G0701757) and the Wellcome Trust (084840), with contributions from the Economic and Social Research Council and Department of Health.
Competing interests RSF has received an honorarium from Natural Cycles to attend a meeting on research needs in relation to fertility awareness apps and a grant to conduct a study exploring women’s use of Natural Cycles to help with conception. AG has done consultancies for HRA-Pharma Paris. None of the other authors have any conflicts of interest.
Patient and public involvement statement PPI was not conducted for the development and writing up of this article.
Patient consent for publication Not required.
Ethics approval The Natsal-3 study was approved by the Oxfordshire Research Ethics Committee (Reference: 09/H0604/27).
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available upon reasonable request. The Natsal-3 dataset has been archived at the UK Data Archive at the University of Essex and is accessible by academic researchers. All data will be anonymised so that participants cannot be identified. https://www.data-archive.ac.uk/
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