title: Informing the introduction of contraceptive implants in the Pacific: a mixed methods study of contraceptive beliefs and behaviours in Tonga.
abstract: OBJECTIVE
  To explore the knowledge and attitudes underlying contraceptive use and non-use among Tongan adults and investigate the potential acceptability of contraceptive implants.
  
  
  METHODS
  A mixed methods study was conducted that used two focus groups and a short self-completed survey (n=109). Participants were recruited from a Tongan non-governmental sexual and reproductive health clinic.
  
  
  RESULTS
  Contraceptive method discontinuation was high among the study group, with reasons for discontinuation often relating to misconceptions circulating in the community about the side effects of contraceptives. A high proportion (38%) reported using 'natural' contraceptive methods. A total of 47% of survey participants reported having heard of implants and 37% indicated they would be willing to try them.
  
  
  CONCLUSIONS
  Current Tongan contraceptive uptake and continuation is hampered by misconceptions about side effects of methods and their risks, particularly among long-acting and reversible methods. Contraceptive implants may be acceptable to Tongans given their arm placement, reversibility and long-lasting effect.
  
  
  CONCLUSIONS
  Efforts to improve contraceptive continuation in Tonga should focus on improving counselling on potential side effects for all methods. The introduction of contraceptive implants as an additional long-acting reversible method should be considered.
authors.affiliation: The Kirby Institute, University of New South Wales.
authors.forename: Edward A
authors.initials: EA
authors.lastname: Winn-Dix
authors.affiliation: School of Public Health and Community Medicine, University of New South Wales.
authors.forename: Sally A
authors.initials: SA
authors.lastname: Nathan
authors.affiliation: School of Public Health and Community Medicine, University of New South Wales.
authors.forename: Patrick
authors.initials: P
authors.lastname: Rawstorne
mesh_terms: D000293:Adolescent; D000328:Adult; D003258:Consumer Behavior; D003267:Contraception / Q000379:methods / Q000523:psychology*; D003268:Contraception Behavior / Q000208:ethnology / Q000523:psychology*; D003271:Contraceptive Agents, Female / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D004343:Drug Implants; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000523:psychology*; D036301:Qualitative Research; D014058:Tonga / Q000453:epidemiology; D055815:Young Adult
chemical_list: D003271:Contraceptive Agents, Female; D004343:Drug Implants
keywords: Pacific Islands; acceptability; contraception; long-acting reversible contraceptives