TABLE 3.
Characteristics associated with discontinuation of baseline Zika Contraception Access Network (Z-CAN) contraceptive method,a Puerto Rico, 2016–2020
| Characteristic | 6 months |
24 months |
36 months |
|||
|---|---|---|---|---|---|---|
| (%) | aPRb | (%) | aPRb | (%) | aPRb | |
| Baseline Z-CAN method | ||||||
| Hormonal IUD | 8.0∗ | 0.15 (0.11, 0.20) | 23.3∗ | 0.32 (0.28, 0.37) | 30.2∗ | 0.38 (0.34, 0.43) |
| Copper IUD | 13.8 | 0.28 (0.19, 0.41) | 29.6 | 0.41 (0.33, 0.50) | 35.3 | 0.46 (0.38, 0.56) |
| Implant | 8.5 | 0.18 (0.13, 0.25) | 33.7 | 0.46 (0.40, 0.54) | 62.1 | 0.72 (0.65, 0.80) |
| Non-LARC | 48.5 | Referent | 68.7 | Referent | 77.6 | Referent |
| Age at initial visit (years) | ||||||
| 18–24 | 17.5 | 1.03 (0.83, 1.27) | 33.7 | 0.88 (0.78, 1.01) | 50.8∗ | 1.03 (0.93, 1.14) |
| 25–34 | 16.4 | Referent | 37.7 | Referent | 48.7 | Referent |
| 35+ | 15.8 | 1.18 (0.82, 1.69) | 32.8 | 0.98 (0.82, 1.17) | 33.5 | 0.88 (0.76, 1.03) |
| Relationship status at time of survey | ||||||
| Single | 20.2 | 1.15 (0.91, 1.46) | 37.7 | 1.09 (0.95, 1.25) | 47.4 | 1.03 (0.93, 1.15) |
| Married or partnered | 15.8 | Referent | 34.7 | Referent | 47.4 | Referent |
| Insurance statusc | ||||||
| Private or other | 14.3∗ | Referent | 33.7 | Referent | 44.0∗ | Referent |
| Public or none | 19.1 | 1.24 (0.99, 1.53) | 37.4 | 1.11 (0.98, 1.25) | 51.5 | 1.09 (0.99, 1.20) |
| Type of clinic where Z-CAN services received | ||||||
| Community Health Center | 20.5 | Referent | 40.7 | Referent | 55.2∗ | Referent |
| Private, academic, or public health | 16.1 | 1.13 (0.85, 1.50) | 34.4 | 1.02 (0.86, 1.21) | 46.1 | 0.96 (0.84, 1.09) |
| Trouble paying for basic needsd in past 6 months | ||||||
| Yes | 18.8∗ | 1.12 (0.91, 1.36) | 34.4 | 1.00 (0.89, 1.13) | 46.2 | 0.96 (0.87, 1.06) |
| No | 15.1 | Referent | 36.0 | Referent | 48.2 | Referent |
| Breastfeeding at initial visit | ||||||
| Yes | 14.4 | 1.07 (0.83, 1.38) | 36.6 | 1.13 (0.97, 1.30) | 49.8 | 1.11 (0.99, 1.25) |
| No | 16.9 | Referent | 35.2 | Referent | 46.9 | Referent |
| Want to prevent pregnancy at time of survey | ||||||
| No | 51.9∗ | Referent | 76.0∗ | Referent | 79.4∗ | Referent |
| Yes | 15.0 | 0.39 (0.28, 0.55) | 30.6 | 0.44 (0.39, 0.50) | 41.4 | 0.56 (0.51, 0.62) |
| Received contraceptive method most interested in after counseling at initial visite | ||||||
| Yes | 15.5∗ | 0.69 (0.52, 0.92) | 34.5∗ | 0.80 (0.65, 0.97) | 47.0∗ | 0.90 (0.75, 1.08) |
| No | 30.3 | Referent | 50.0 | Referent | 59.3 | Referent |
| Contraceptive method receivedf same as the primary method used before initial Z-CAN visit | ||||||
| Yes | 29.2* | 0.60 (0.43, 0.84) | 43.4* | 0.59 (0.46, 0.75) | 48.4 | 0.55 (0.42, 0.70) |
| No | 15.7 | Referent | 34.6 | Referent | 47.3 | Referent |
| Satisfaction with Z-CAN services at initial visite | ||||||
| Very satisfied | 15.8∗ | 0.66 (0.48, 0.90) | 35.0∗ | 0.85 (0.67, 1.07) | 47.2 | 0.93 (0.78, 1.10) |
| Somewhat or not at all satisfied | 25.5 | Referent | 43.5 | Referent | 56.8 | Referent |
Abbreviations: IUD, intrauterine device; LARC, long-acting reversible contraception (includes IUDs and implants); PR, prevalence ratio; Z-CAN, Zika Contraception Access Network.
Note: Boldface indicates statistical signficance (p < 0.05).
Defined as the contraceptive method received at or within 30 days of the initial Z-CAN visit. Excludes patients whose baseline method was condoms alone.
Multivariable model included baseline Z-CAN method, age, relationship status at time of survey, insurance status, type of clinic where Z-CAN services were received, trouble paying for basic needs in the past six months, breastfeeding at initial visit, received contraceptive method most interested in after counseling, contraceptive method received was the same as the method used before the initial Z-CAN visit, want to prevent pregnancy at time of survey, and satisfaction with Z-CAN services.
At time of the initial Z-CAN visit (six months) or at time of the survey (24 and 36 months).
Food, housing, transportation, or medical care.
Assessed using the patient two-week follow-up survey.
At or within 30 days of the initial Z-CAN visit.
p < 0.05 based on the chi-squared test comparing the distribution of discontinuation by characteristic.