Norms and beliefs toward contraception, both positive and negative, motivate contraceptive use; however, they have seldom been explored longitudinally in low- and middle-income countries, limiting our understanding of their influence on contraceptive dynamics. We used PMA2020 Uganda national longitudinal data of reproductive aged women in 2018 (baseline) and 2019 (follow-up) to explore discontinuation and switching among modern contraceptive users at baseline (n = 688) and contraceptive use at follow-up among nonusers at baseline (n = 1,377). Multivariable simple and multinomial logistic regressions assessed the association of individual and community-level contraceptive beliefs with contraceptive uptake, discontinuation and switching. One-quarter of nonusers at baseline were using contraception at follow-up, while 37 percent of users at baseline had discontinued and 28 percent had switched methods at follow-up. The odds of contraceptive uptake were lower among women who strongly agreed that contraception impacted future fertility or caused conflict within a couple, relative to those who strongly disagreed (adjusted odds ratio (aOR): 0.7 and aOR: 0.6, respectively), but higher among women who strongly agreed that contraception preserved beauty (aOR: 1.6). Women who strongly agreed that it was acceptable to use contraception before having children were less likely to discontinue their method than those who strongly disagreed (adjusted relative risk ratio (aRRR): 0.5), though living in a community where more women agreed with this statement was associated with higher discontinuation (aRRR: 6.0). Family planning programs that promote positive beliefs toward family planning could improve contraceptive uptake and continuation. More research is needed to understand how contraceptive beliefs shape contraceptive decisions across the life course.

中文翻译：

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计划生育信念及其与避孕药具使用动态的关联：乌干达纵向研究的结果

对避孕的规范和信念，无论是积极的还是消极的，都会促使人们使用避孕药具；然而，它们很少在低收入和中等收入国家进行纵向探索，这限制了我们对其对避孕动态影响的理解。我们使用 PMA2020 乌干达 2018 年（基线）和 2019 年（随访）的育龄妇女国家纵向数据来探讨现代避孕药使用者在基线时（n = 688）的停药和转换以及基线时非使用者中避孕药的使用情况（n = 1,377）。多变量简单和多项逻辑回归评估了个人和社区层面的避孕信念与避孕药的摄取、停药和转换之间的关联。基线时四分之一的非使用者在随访时使用避孕措施，而基线时 37% 的用户已经停止使用，28% 的用户在随访时改变了方法。与强烈反对避孕的女性相比，强烈同意避孕会影响未来生育能力或导致夫妻内部冲突的女性使用避孕药具的几率较低（调整优势比（aOR）分别为 0.7 和 aOR：0.6），但在强烈同意避孕可以保持美丽的女性（aOR：1.6）。强烈同意在生育前使用避孕方法是可以接受的女性比强烈反对的女性更不可能停止使用避孕方法（调整后的相对风险比（aRRR）：0.5），尽管生活在更多女性同意这一说法的社区与更高的停药相关（aRRR：6.0）。促进对计划生育的积极信念的计划生育计划可以提高避孕药具的吸收和持续使用。需要更多的研究来了解避孕信念如何影响整个生命过程中的避孕决定。