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

Abstract

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.