Pregnancy risk among oral contraceptive pill, injectable contraceptive, and condom users in Uganda, zimbabwe, and Thailand.
OBJECTIVE
To estimate the probability of pregnancy for oral contraceptive pill (OCP), injectable contraceptive, and condom users in Uganda, Thailand, and Zimbabwe.


METHODS
This study is a secondary analysis of 5,224 women who participated in a prospective study evaluating the association between hormonal contraception and human immunodeficiency virus (HIV) acquisition.


RESULTS
The overall 12-month cumulative probability of pregnancy of injectable contraceptive users was 0.6% (95% confidence interval [CI] 0.3-1.0), with similar risks in Uganda (0.3%, 95% CI 0-0.7), Thailand (0.6%, 95% CI 0-1.2), and Zimbabwe (1.0%, 95% CI 0.3-1.7). The 12-month cumulative probability of pregnancy for OCP users was 9.5% (95% CI 8.1-11.0%), with similar risks of pregnancy in Uganda and Zimbabwe (14.6%, 95% CI 11.7-17.4; and 10.2%, 95% CI 8.0-12.5, respectively) but substantially lower risk in Thailand (0.5%, 95% CI 0-1.2). The overall 12-month cumulative probability of pregnancy for women intending to use a given method at baseline was 2.0% (95% CI 1.4-2.6%) for injectable contraceptives, 15.7% (95% CI 14.1-17.3%) for OCPs, and 25.8% (95% CI 23.2-28.4) for condoms. Women in Thailand experienced lower pregnancy risk with condoms (18.4%, 95% CI 11.1-25.7) than in Uganda (29.5%, 95% CI 25.7-33.4), and Zimbabwe (23.3%, 95% CI 19.4-27.2).


CONCLUSIONS
The overall risk of pregnancy for injectable contraceptive users was substantially lower than for oral contraceptive pill users. However, Thai participants had similarly low cumulative pregnancy probabilities for both methods. Women receiving contraceptive counseling should be informed that their experience with a given method may differ from the average or typical-use pregnancy rates often discussed during contraceptive counseling. Tailored counseling is necessary for women to make informed choices.


METHODS
II.
Steiner
Markus J
MJ
Family Health International, Research Triangle Park, North Carolina 27709, USA. msteiner@fhi.org
Kwok
Cynthia
C
Dominik
Rosalie
R
Byamugisha
Josaphat K
JK
Chipato
Tsungai
T
Magwali
Thulani
T
Mmiro
Francis
F
Rugpao
Sungwal
S
Sriplienchan
Somchai
S
Morrison
Charles S
CS
D000293:Adolescent; D000328:Adult; D017280:Condoms; D003271:Contraceptive Agents, Female / Q000008:administration & dosage*; D003277:Contraceptives, Oral, Combined / Q000627:therapeutic use*; D003376:Counseling; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D053208:Kaplan-Meier Estimate; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage*; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D013785:Thailand; D016896:Treatment Outcome; D014454:Uganda; D015030:Zimbabwe
D003271:Contraceptive Agents, Female; D003277:Contraceptives, Oral, Combined; D017258:Medroxyprogesterone Acetate