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User interest in a new non-hormonal long-acting reversible contraceptive: what impact does mechanism of action have on past and future contraceptive decision-making?
  1. Kirsten Norma Shankie-williams1,
  2. Sarah E Ratcliffe2,
  3. Samson N Dowland1,
  4. Kirsten Black3,4
  1. 1School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
  2. 2Centre for Medical Psychology & Evidence-based Decision-making, School of Psychology, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia
  3. 3Speciality of Obstetrics, Gynaecology and Neonatology, Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, New South Wales, Australia
  4. 4Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, New South Wales, Australia
  1. Correspondence to Kirsten Norma Shankie-williams, School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia; kirsten.shankie-williams{at}sydney.edu.au

Abstract

Background We are in the process of developing a new non-hormonal long-acting reversible method of contraception (LARC) in recognition of the fact that a significant minority of users are unhappy with their current method. Our method has a novel (post-fertilisation) mechanism of action (MOA), but little is known about the value users place on this.

Methods Using in-depth interviews, we explored 30 Australian end-users’ experiences of contraception, recruited via social media. A thematic approach was taken to examine the influence the MOA has on choice and factors affecting willingness to try current methods and a novel non-hormonal LARC with a post-fertilisation effect.

Results We identified two themes that were the most salient across all interviews: that contraceptive decision-making involves a trade-off of priorities, influenced by contraceptive properties (including MOA) and the context in which contraception is used; and views on novel methods of contraception were influenced by willingness to trial new products and interest in non-hormonal options. Side effects, efficacy, and the financial burden of contraceptives were all considered more important than MOA during decision-making. Participants were willing to try a new method if endorsed by trusted sources, including friends and medical practitioners, and were enthusiastic to try a novel LARC with no hormones.

Conclusion This study found that the MOA had minimal impact on participants’ choice of contraception. Rather, avoidance of hormones and side effects influenced willingness to try a novel method over any unacceptable aspects of a post-fertilisation MOA.

  • contraception behavior
  • contraceptive agents, female
  • long-acting reversible contraception
  • qualitative research
  • intrauterine devices
  • hormonal contraception

Data availability statement

Data sharing not applicable as no datasets generated and/or analysed for this study.

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Data availability statement

Data sharing not applicable as no datasets generated and/or analysed for this study.

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Footnotes

  • Twitter @sarahratcliffe0

  • Contributors KSW, SND, KIB: designed the study protocol and interview guide. KSW, KIB: conducted interviews with participants. KSW, SER, KIB: analysed and interpreted the qualitative interviews. KSW: took the lead in writing the manuscript. KSW, SER, SND, KIB: revised the manuscript. All authors read and approved the final manuscript. KB isthe study guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.