title: Survival analysis of time to uptake of modern contraceptives among sexually active women of reproductive age in Nigeria.
abstract: OBJECTIVE
  To assess the timing of modern contraceptive uptake among married and never-married women in Nigeria.
  
  
  METHODS
  A retrospective cross-sectional study.
  
  
  METHODS
  We used nationally representative 2013 Demographic and Health Survey data in Nigeria. Modern contraceptive uptake time was measured as the period between first sexual intercourse and first use of a modern contraceptive. Non-users of modern contraceptives were censored on the date of the survey. Kaplan-Meier survival curves were used to determine the rate of uptake. A Cox proportional-hazards model was used to determine variables influencing the uptake at 5% significance level.
  
  
  METHODS
  A total of 33,223 sexually active women of reproductive age.
  
  
  METHODS
  Time of uptake of a modern contraceptive after first sexual intercourse.
  
  
  RESULTS
  The median modern contraceptive uptake time was 4 years in never-married and 14 years among ever-married women. Significant differences in modern contraceptive uptake existed in respondents' age, location, education and wealth status. Never-married women were about three times more likely to use a modern contraceptive than ever-married women (aHR=3.24 (95% CI 2.82 to 3.65)). Women with higher education were six times more likely to use a modern contraceptive than those without education (aHR=6.18 (95% CI 5.15 to 7.42)).
  
  
  CONCLUSIONS
  The rate of modern contraceptive uptake is low, and timing of contraceptive uptake during or after first sexual intercourse differed according to marital status. Age and number of children ever born influenced modern contraceptive uptake among the never-married women, but religion and place of residence were associated with the probability of modern contraceptive uptake among ever-married women.
authors.affiliation: Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria Faculty of Human and Social Sciences (HSS), School of Research and Postgraduate Studies (SoRPS), North West University, Mafikeng, South Africa.
authors.forename: Adeniyi Francis
authors.identifier: http://orcid.org/0000-0001-9184-8258
authors.initials: AF
authors.lastname: Fagbamigbe
authors.affiliation: Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria.
authors.forename: Ayo Stephen
authors.initials: AS
authors.lastname: Adebowale
authors.affiliation: Department of Obstetrics and Gynaecology, Faculty of Clinical Sciences, College of Medicine, University of Ibadan/University College Hospital, Ibadan, Nigeria.
authors.forename: ImranOludare
authors.initials: I
authors.lastname: Morhason-Bello
mesh_terms: D000293:Adolescent; D000328:Adult; D003267:Contraception; D003268:Contraception Behavior / Q000523:psychology / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D004522:Educational Status; D005193:Family Planning Services / Q000706:statistics & numerical data; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D009549:Nigeria / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012725:Sexual Behavior; D012959:Socioeconomic Factors; D016019:Survival Analysis
keywords: EPIDEMIOLOGY; PUBLIC HEALTH; REPRODUCTIVE MEDICINE; SEXUAL MEDICINE; STATISTICS & RESEARCH METHODS