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Abstract
Objective Male permanent contraception (PC), that is, vasectomy, is an effective way of preventing pregnancy. In the United States, male PC use has historically been concentrated among higher-educated/higher-income males of White race. In the last decade, use of long-acting reversible contraception (LARC) has increased dramatically. We sought to understand how sociodemographic patterns of male PC have changed in the context of rising LARC use.
Study design We examined the nationally representative male public use files of the National Survey for Family Growth (NSFG) across five survey waves. Our outcome was primary contraceptive use at last sexual encounter within 12 months. Using four-way multinomial logistic regressions (male PC, female PC, LARC, lower-efficacy methods), we compared sociodemographic factors predictive of male PC use versus reported partner LARC use between 2006–2010 (early) and 2017–2019 (recent) waves.
Results We included 15 964 participants. From 2006 to 2019, there were absolute declines in male PC from 8.0% to 6.8%, while male-reported partner LARC use increased three-fold, from 3.4% to 11.0%. Among the highest economic strata, use of LARC converged with male PC. In adjusted analyses, high income significantly associated with male PC use in the early wave (OR 4.6 (1.4, 14.8)), but no longer in the recent wave (OR 0.9 (0.2, 4.2)). Marital status remained a significant but declining predictor of male PC across survey waves, and instead, by 2019, number of children newly emerged as the strongest predictor of male PC use.
Conclusion Sociodemographic variables associated with vasectomy use are evolving, especially among high-income earners.
- Contraceptive Agents, Male
- Contraceptive Agents, Female
- long-acting reversible contraception
- intrauterine devices
Data availability statement
Data are available in a public, open access repository. The National Survey for Family Growth (NSFG) is a publicly available dataset.
Statistics from Altmetric.com
- Contraceptive Agents, Male
- Contraceptive Agents, Female
- long-acting reversible contraception
- intrauterine devices
Data availability statement
Data are available in a public, open access repository. The National Survey for Family Growth (NSFG) is a publicly available dataset.
Footnotes
X @isabelbeshar, @drericacahll
Presented at Published following the American College of Obstetricians and Gynaecologists Annual Clinical Meeting (May 2021, virtual format) and Stanford Maternal and Child Health Research Symposium (October 2023, in-person event).
Contributors IB and JGS conceptualised the study and its methodology. JYS contributed to the statistical analysis. JGS, EPC and KAS contributed substantive editorial input. IB submitted the study. IB is the 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 not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Not commissioned; externally peer reviewed.
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