Knowledge about the intrauterine device and interest in using it among women users of primary care services

Borges, Ana Luiza Vilela; Araújo, Karina Simão; Santos, Osmara Alves dos; Gonçalves, Renata Ferreira Sena; Fujimori, Elizabeth; Divino, Eveline do Amor

doi:10.1590/1518-8345.3140.3232

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Revista Latino-Americana de Enfermagem

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Original Article • Rev. Latino-Am. Enfermagem 28 • 2020 • https://doi.org/10.1590/1518-8345.3140.3232 copy

Knowledge about the intrauterine device and interest in using it among women users of primary care services^* * Supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico - CNPq (Grant 440577/2014-4) and by Fundação de Amparo à Pesquisa do Estado de São Paulo - FAPESP (Grant 2014/02447-5), Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective:

to analyze the level of knowledge about the intrauterine device, the interest in using it and the relationship between these events among women in reproductive age.

Method:

cross-sectional study conducted with 1858 women between 18 and 49 years old, attending Primary Health Care Facilities. Data were obtained in face-to-face interviews. The level of knowledge was evaluated by items with answers options “agree”, “disagree” and “I don’t know”. Knowledge was categorized as below/equal and above the median. Chi-square and multiple logistic regression were used in Stata 14.2 (95% confidence level).

Results:

intrauterine device current use was not frequent (1.7%; n=32) and the level of knowledge was higher among women between 25 and 34 years old, white, living in Aracaju (Sergipe), who were more educated, and who were currently using or had already used the intrauterine device. Interest in using the intrauterine device (38.0%; n=634) was higher among younger women, single, more educated, had health insurance, no children and with higher level of knowledge about the intrauterine device.

Conclusion:

the level of knowledge about the intrauterine device was associated with the interest in using it.

Descriptors:
Contraception; Intrauterine Devices; Sexual and Reproductive Health; Women’s Health; Primary Health Care; Nursing

Variables	Total
Variables	n	%
Age (years)
18-24	496	26.7
25-29	425	22.9
30-34	370	19.9
35 or more	567	30.5
Race/skin color
White	469	25.3
Brown	964	52.0
Black	323	17.4
Asian/indigenous	99	5.3
Level of education (years)
Up to 8	468	25.2
9-11	1099	59.1
12 or more	291	15.7
Paid job
No	867	46.7
Yes	991	53.3
Health insurance
No	1530	82.3
Yes	328	17.6
Stable relationship
No	479	25.8
Yes	1379	74.2
Number of children
None	407	21.9
One	672	36.2
Two	455	24.5
Three or more	324	17.4
Previous abortion^* * Previous abortion = Includes women who had never been pregnant;
No	1426	76.7
Yes	432	23.3
Reproductive intention
Wants (more) children	623	33.5
Does not want (more) children	1118	60.2
Does not know	117	6.3
Contraceptive method use^† † Use of contraceptive method = Does not consider women who were pregnant at the moment of the interview;
None	305	21.6
Irreversible	99	7.0
Hormonal	697	49.3
IUD^‡ ‡ IUD = Intrauterine device and implant	34	2.4
Barrier	238	16.8
Traditional	41	2.9
Total	1858	100

Statements	Agrees		Does not agree		Does not know
Statements	n	%	n	%	n	%
The IUD^* * IUD = Intrauterine device; is abortive^† † Statement = One woman did not answer	255	13.7	1002	54.0	600	32.3
After IUD removal^* * IUD = Intrauterine device; , women have difficulty getting pregnant^† † Statement = One woman did not answer	247	13.3	983	52.9	627	33.8
The IUD^* * IUD = Intrauterine device; is inserted through surgery	450	24.2	924	49.7	484	26.1
The man feels the IUD^* * IUD = Intrauterine device; during sexual intercourse	92	4.9	768	41.3	998	53.7
The IUD^* * IUD = Intrauterine device; increases the risk of uterine cancer^† † Statement = One woman did not answer	391	21.0	698	37.6	769	41.4
The IUD^* * IUD = Intrauterine device; has many unpleasant side effects	581	31.3	538	28.9	739	39.8

Variables	Level of knowledge about the IUD^* * IUD = Intrauterine device; ^† † Hosmer-Lemeshow Test (p=0.2376);
	≤ median		> median		p	ORa^‡ ‡ ORa = Adjusted odds ratio;	95% CI^§ § CI = Confidence interval
	n	%	n	%	p	ORa^‡ ‡ ORa = Adjusted odds ratio;	95% CI^§ § CI = Confidence interval
City
São Paulo	479	51.7	478	51.3	0.945	1.00	-
Aracaju	217	24.9	224	24.1		1.30	1.01-1.66
Cuiabá	231	23.4	229	24.6		1.02	0.80-1.31
Age (years)
18-24	282	30.4	214	23.0	<0.001	1.00	-
25-29	213	23.0	212	22.8		1.17	0.89-1.55
30-34	155	16.7	215	23.1		1.59	1.18-2.15
35 or more	277	29.9	290	31.1		1.20	0.90-1.61
Race/skin color
White	193	20.8	276	29.7	<0.001	1.00	-
Brown	506	54.6	458	49.3		0.67	0.53-0.86
Black	172	18.6	151	16.3		0.63	0.46-0.85
Asian/indigenous	55	5.9	44	4.7		0.59	0.37-0.93
Level of education (years)
Up to 8	298	32.1	170	18.3	<0.001	1.00	-
9-11	552	59.6	547	58.7		1.88	1.48-2.40
12 or more	77	8.3	214	23.0		4.84	3.38-6.91
Paid job
No	450	48.5	417	44.8	0.105	1.00	-
Yes	477	51.5	514	55.2		0.99	0.81-1.21
Health insurance
No	791	85.3	739	79.4	0.001	1.00	-
Yes	136	14.7	192	20.6		1.26	0.96-1.64
Stable relationship
No	235	25.3	244	26.2	0.673	1.00	-
Yes	692	74.7	687	73.8		1.00	0.80-1.26
Number of children
None	194	20.9	213	22.9	0.005	1.00	-
One	354	38.2	318	34.1		0.88	0.67-1.16
Two	200	21.6	255	27.4		1.34	0.96-1.87
Three or more	179	19.3	145	15.6		0.99	0.68-1.45
Previous abortion
No	722	77.9	704	75.6	0.247	1.00	-
Yes	205	22.1	227	24.4		1.11	0.88-1.41
Reproductive intention
Wants (more) children	312	33.7	311	33.4	0.983	0.94	0.74-1.21
Does not want (more) children	556	60.0	562	60.4		1.00	-
Does not know	59	6.3	58	6.2		0.89	0.58-1.35
Current or previous use of IUD^* * IUD = Intrauterine device;
No	911	98.3	848	91.1	<0.001	1.00	-
Yes	16	1.7	83	8.9		4.92	1.84-13.16
Total	927	49.9	931	50.1

Variables	Interest in using IUD^* * IUD = Intrauterine device; ^† † Hosmer-Lemeshow Test (p=0.2595);
	No		Yes		P	ORa^‡ ‡ ORa = Adjusted odds ratio;	95%CI^§ § CI = Confidence Interval;
	n	%	n	%	P	ORa^‡ ‡ ORa = Adjusted odds ratio;	95%CI^§ § CI = Confidence Interval;
City
São Paulo	533	51.6	318	50.2	<0.001	1.00	-
Aracaju	274	26.5	125	19.7		0.82	0.62-1.07
Cuiabá	227	21.9	191	30.1		1.21	0.93-1.59
Age (years)
18-24	253	24.5	234	36.9	<0.001	1.00	-
25-29	221	21.4	173	27.3		0.73	0.54-0.97
30-34	205	19.8	109	17.2		0.45	0.32-0.62
35 or more	355	34.3	118	18.6		0.27	0.19-0.38
Race/skin color^\|\| \|\| Race/skin color = Two women refused to answer
White	279	27.0	151	23.9	0.085	1.00	-
Brown	521	50.4	335	52.9		1.17	0.89-1.53
Black	166	16.1	119	18.8		1.32	0.94-1.85
Asian/indigenous	67	6.5	28	4.4		0.74	0.44-1.24
Level of education (years)
Up to 8	284	27.5	126	19.9	0.001	1.00	-
9-11	602	58.2	392	61.8		1.23	0.93-1.61
12 or more	148	14.3	116	18.3		1.48	1.01-2.18
Paid job
No	479	46.3	293	46.2	0.965	1.00	-
Yes	555	53.7	341	53.8		1.12	0.89-1.39
Health insurance
No	874	84.5	495	78.1	0.001	1.00	-
Yes	160	15.5	139	21.9		1.38	1.04-1.83
Stable relationship
No	262	25.3	182	28.7	0.131	1.00	-
Yes	772	74.7	452	71.3		0.67	0.52-0.86
Number of children
None	262	25.3	142	22.4	0.031	1.00	-
One	380	36.7	262	41.3		1.78	1.32-2.42
Two	223	21.6	152	34.0		2.20	1.50-3.23
Three or more	169	16.3	78	12.3		1.67	1.07-2.59
Previous abortion
No	810	78.3	493	77.8	0.782	1.00	-
Yes	224	21.7	141	22.2		1.25	0.97-1.62
Reproductive intention
Wants (more) children	595	57.5	355	56.0	0.192	0.79	0.60-1.04
Does not want (more) children	378	36.6	227	35.8		1.00	-
Does not know	61	5.9	52	8.2		1.20	0.77-1.86
Knowledge on the IUD^* * IUD = Intrauterine device;
Below median	577	55.8	285	44.9	<0.001	1.00	-
Above or equal to median	457	44.2	349	55.1		1.60	1.29-1.99
Total	1034	62.0	634	38.0

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[1] Corresponding author: Ana Luiza Vilela Borges. E-mail: alvilela@usp.br