Preferences between injectable contraceptive methods among South African women

ObjectiveTo examine South African women's preferences between depot medroxyprogesterone acetate (DMPA) and norethisterone enanthate (NET-EN), as well as the reasons for and correlates of these preferences.Study DesignA cross-sectional study among women attending 26 primary health care clinics across the Western Cape Province.ResultsOf 893 women participating in the survey, 57% (n=511) and 45% (n=399) had ever used DMPA and NET-EN, respectively. Among women who knew of both injectables, 46% stated a preference for DMPA (n=365) and 37% stated a preference for NET-EN (n=297). Most women who preferred DMPA thought that it was more effective in preventing pregnancy, while women who preferred NET-EN stated that it was preferable for women who wanted children in the future. Preferences for NET-EN were independently associated with younger age, higher education and living in an urban area.ConclusionThese findings suggest that there are significant misperceptions among women regarding the differences between DMPA and NET-EN, which may have important resource implications for contraceptive services. It is likely that these misperceptions arise from popular discourse and individual user experiences, as well as poor communication with and counseling of women on the part of providers. Interventions aimed at both users and providers are required to dispel the myths and misinformation regarding progestogen-only injectable methods.