Factors influencing individual decision-making in contraceptive method selection: a comprehensive analysis

Contraceptive methods vary in effectiveness, side effects, cost, and other characteristics that influence individuals’ preferences. Understanding these preferences is essential for supporting patient-centered care and improving contraceptive decision-making. However, there remains a lack of comprehensive synthesis of the key attributes driving contraceptive choices across diverse populations. The aim of this systematic review was to identify the key attributes that are most important to individuals when selecting a contraceptive method. This review follows the PRISMA 2020 guidelines and includes studies published between 2000 and 2024. A comprehensive literature search was conducted across Embase, PubMed, and Web of Science databases. Studies that employed Discrete Choice Experiment (DCE), conjoint experiments, surveys, or structured interviews to assess contraceptive preferences were included. A total of 22 studies were included in the final analysis, encompassing 53,730 participants. We identified 44 distinct attributes related to contraceptive choice, which were grouped into eight categories: effectiveness and safety, convenience and suitability, economy and cost, social and interpersonal relationships, privacy and control, information and advice, lifestyle and behavior, and services and support. Among the most frequently assessed attributes were effectiveness, side effects, cost, convenience, safety, and privacy. Effectiveness and safety were consistently rated as the most important factors in contraceptive choice, followed by cost and privacy considerations. Variations were observed in preferences across regions, with cost being a primary concern in the United States and privacy being particularly important in African countries. This review identifies several key attributes associated with contraceptive choice, with consistent emphasis on effectiveness, safety, cost, and privacy. These findings may provide reference points for contraceptive counseling and the development of decision-support tools. However, further research is needed to better understand socio-cultural and emotional determinants of contraceptive decision-making, as well as the temporal dynamics of preference formation across life stages. The findings suggest several factors that may be associated with contraceptive choice and may inform the development of more individualized counseling approaches. Psychological, emotional, and socio-cultural influences, as well as regional heterogeneity in preferences, may interact in complex and not yet fully understood ways, limiting the direct applicability of simplified counseling frameworks. Further mixed-methods research, including qualitative approaches and discrete choice experiments, is warranted to better elucidate preference formation and to assess the robustness and transferability of these findings across settings before they can be reliably integrated into routine contraceptive counseling strategies.