CONTRACEPTIVE PATTERNS AMONG WOMEN AND MEN IN LEON, NICARAGUA

The aim was to study the contraceptive patterns among men and women in Leon, Nicaragua. A questionnaire about sexual, contraceptive, reprodu ctive and socioeconomic issues was directed to 7,789 households includ ing 22% of all women of the municipality aged 15-49 years (n=10,867). A subsample of 388 men and 413 women aged 15-49 years was drawn at ran dom. Refusals were less than 2%. Private interviews revealed that amon g fertile women who had been sexually active within the last three mon ths, non-pregnant and wishing to avoid pregnancy, 77% were contracepti ng. Female sterilization was the most common contraceptive method (39% ), followed by intrauterine device (16%). Even though around 60% of wo men at some time had tried oral contraceptives, only 13% of contracept ors used them currently. The rhythm and interruption methods together constituted only 4%. Condom use was low and mainly occasional. Contrac eptive use in Sexually active women aged 15-44 years was lower among t hose having lower education, living in rural areas, and living under p overty conditions. The predominance of female sterilization and the oc casional condom use-mainly reported by men-reflects a situation of rel ative male control over contraception and reproduction. This probably originates from ''machista'' values where men having many children wit h different women are considered strong. There was also a significantl y higher use of contraceptives among the better-off women and men comp ared with the extremely poor. The situation of many poor women, in a c ountry with limited contraceptive services, is worrying considering th at abortion is illegal and the threat of HIV epidemic is growing. The situation for adolescents is particularly problematic with low experie nce in contraceptive use. (C) 1996 Elsevier Science Inc.