title: Ethnic differences in factors associated with the use of contraception among 20- to 44-year-old women in Estonia and St. Petersburg, Russia.
abstract: BACKGROUND
  The aim of this study was to explore factors associated with contraception among 20- to 44-year-old women in different ethnic groups in two Eastern European countries.
  
  
  METHODS
  Data on sexually experienced women in need of contraception taken from population-based cross-sectional surveys, conducted in Estonia (n=1680) and in St. Petersburg (n=798), were analyzed. Factors associated with contraception nonuse or the use of unreliable contraceptive methods were explored using multivariate logistic regression analysis.
  
  
  RESULTS
  The age-standardized prevalence rate of contraception nonuse or the use of unreliable contraceptive methods was high (27.3% among Estonian-speaking women in Estonia, 39.9% and 42.5% among Russian-speaking women in Estonia and in St. Petersburg, respectively). Age, economic subsistence, high-risk sexual behavior and smoking did not correlate with contraception nonuse or the use of unreliable contraceptive methods among Russian-speaking women in Estonia and in St. Petersburg; this was in contrast to Estonian-speaking women in Estonia. Previous childbirth and abortion reduced the risk of contraception nonuse or the use of unreliable contraceptive methods among Estonian-speaking women in Estonia (adjusted odds ratio, 0.50; 95% confidence interval [CI], 0.31-0.81) but elevated the risk among Russian-speaking women in St. Petersburg (1.99; 1.17-3.40). Abortion, not previous childbirth, was associated with an increased risk among Russian-speaking women in Estonia (2.94; 1.25-6.95).
  
  
  CONCLUSIONS
  The importance of different risk factors associated with contraceptive use varies between different ethnic groups. Cross-national comparisons are essential for the design of public health policies that decrease the burden of sexual ill health.
authors.affiliation: Department of Obstetrics and Gynecology, University of Tartu, 50406 Tartu, Estonia. made.laanpere@ut.ee
authors.forename: Made
authors.initials: M
authors.lastname: Laanpere
authors.forename: Kaja
authors.initials: K
authors.lastname: Rahu
authors.forename: Kai
authors.initials: K
authors.lastname: Part
authors.forename: Tatiana
authors.initials: T
authors.lastname: Dubikaytis
authors.forename: Helle
authors.initials: H
authors.lastname: Karro
mesh_terms: D000028:Abortion, Induced / Q000523:psychology; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D003268:Contraception Behavior / Q000208:ethnology*; D003430:Cross-Sectional Studies; D004957:Estonia; D005260:Female; D006306:Health Surveys; D006801:Humans; D007802:Language; D015999:Multivariate Analysis; D020380:Needs Assessment; D010298:Parity; D011247:Pregnancy; D012307:Risk Factors; D012426:Russia; D021841:Safe Sex / Q000208:ethnology*; D012959:Socioeconomic Factors; D055815:Young Adult