title: Adherence and acceptability of the contraceptive ring compared with the pill among students: a randomized controlled trial.
abstract: 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.
authors.affiliation: From the Department of Obstetrics and Gynecology, The University of Chicago; and Department of Family Medicine, University of Illinois at Chicago, Illinois.
authors.forename: Melissa L
authors.initials: ML
authors.lastname: Gilliam
authors.forename: Amy
authors.initials: A
authors.lastname: Neustadt
authors.forename: Michael
authors.initials: M
authors.lastname: Kozloski
authors.forename: Stephanie
authors.initials: S
authors.lastname: Mistretta
authors.forename: Sandra
authors.initials: S
authors.lastname: Tilmon
authors.forename: Emily
authors.initials: E
authors.lastname: Godfrey
mesh_terms: 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
chemical_list: D003278:Contraceptives, Oral, Hormonal; D004338:Drug Combinations; C516519:NuvaRing; D004997:Ethinyl Estradiol; D017135:Desogestrel