Association Between Negative Pregnancy Desires and Recent Condomless Sex Among Couples in Vietnam

This is the authors' abstract. We don't add key points for this paper.

We examined the association between negative pregnancy desires and women's semen exposure, a measure of recent condomless sex, among 500 different-sex couples using condoms for contraception. We analyzed data from a trial in Thanh Hoa, Vietnam which longitudinally assessed women's semen exposure via prostate-specific antigen in vaginal fluid. At enrollment, partners independently reported the importance of avoiding pregnancy for the next six months. Assessing negative pregnancy desires as strong-negative (very important) versus not strong-negative (important/neutral), we evaluated partner concordance of desires and compared this against semen exposure using log-binomial generalized estimating equations. While 59% of men and 58% of women reported strong-negative pregnancy desires, 45% of couples had partner-concordant strong-negative desires. Couples with partner-concordant strong-negative desires had reduced risk of semen exposure (aRR 0.58, 95% CI [0.34, 0.99]) compared to couples without strong-negative desires. Similarly, couples where only one partner had a strong-negative desire had lower semen exposure than couples without strong-negative desires (aRR 0.60, 95% CI [0.38, 0.95]). Couples were less likely to engage in condomless sex when either partner had strong desires to prevent pregnancy, regardless of the gender of the partner with strong-negative desires. This highlights the importance of considering both partners' desires in contraceptive counseling to prevent condomless sex and unintended pregnancy.