Adherence and acceptability of the contraceptive ring compared with the pill among students: a randomized controlled trial.
OBJECTIVE
To compare satisfaction with and adherence to the contraceptive vaginal ring and a daily low-dose oral contraceptive pill (OCP) among college and graduate students using a novel method of electronic data collection.


METHODS
We randomly assigned 273 women to the contraceptive vaginal ring (n=136) or OCP (n=137) for three consecutive menstrual cycles. Participants completed daily Internet-based, online diaries regarding method adherence and satisfaction during cycles of use. At 3 months, they completed an online survey regarding intention to continue their method and overall acceptability. At 6 months, we surveyed participants to see whether they continued using contraception and, if so, which method.


RESULTS
Rates of loss to follow-up were similar between groups. Contraceptive vaginal ring users reported more perfect use in the first 2 months (P=.05). After the 3-month study period, 52 (43%) of 121 contraceptive vaginal ring users and 65 (52%) of 126 OCP users reported plans to continue their method (P=.16). However, at 6 months, only 31 (26%) of 117 contraceptive vaginal ring users and 36 (29%) of 123 OCP users had continued their assigned study method (P=.61). Almost 50% of both groups were using condoms or no method.


CONCLUSIONS
Contraceptive vaginal ring users were more likely to report perfect use during the 3-month trial period than were OCP users. Despite randomization, participants were equally satisfied with their assigned hormonal contraceptive method. At 6 months, less than 30% of participants were still using their assigned method.


BACKGROUND
ClinicalTrials.gov, www.clinicaltrials.gov, NCT00635570.
Gilliam
Melissa L
ML
From the Department of Obstetrics and Gynecology, The University of Chicago; and Department of Family Medicine, University of Illinois at Chicago, Illinois.
Neustadt
Amy
A
Kozloski
Michael
M
Mistretta
Stephanie
S
Tilmon
Sandra
S
Godfrey
Emily
E
D000293:Adolescent; D000328:Adult; D003278:Contraceptives, Oral, Hormonal / Q000627:therapeutic use*; D017135:Desogestrel / Q000031:analogs & derivatives / Q000627:therapeutic use; D004338:Drug Combinations; D004997:Ethinyl Estradiol / Q000627:therapeutic use; D005260:Female; D006801:Humans; D055118:Medication Adherence; D017060:Patient Satisfaction; D013334:Students; D014495:Universities; D055815:Young Adult
D003278:Contraceptives, Oral, Hormonal; D004338:Drug Combinations; C516519:NuvaRing; D004997:Ethinyl Estradiol; D017135:Desogestrel