Changes in contraceptive use during the second COVID-19 lockdown in Brazil: A web-based survey

Objective: We assessed contraceptive use changes during the second lockdown due to COVID-19 in Brazil and their associated factors. Study design: This was a longitudinal web-based study in which 725 non-pregnant Brazilian women aged 18 to 49 completed an online structured survey about their contraceptive practices in two rounds in 2021. Multivariate multinomial logistic regression was used to analyze factors associated with contraceptive use changes during COVID-19. Results: Sixty percent reported they changed their contraceptive use during COVID-19, especially starting to use a method or switching to a more effective one (32%). In adjusted analysis, women who were ambivalent about a future pregnancy were more likely to switch to a more effective method (adjusted odds ratio [aOR] 2.33, 95% CI 1.42–3.83) and to stop using contraceptive (aOR 3.64, 95% CI 1.91–6.91). Women with a partner were less likely to switch to a more effective method (aOR 0.61, 95% CI 0.39–0.93) and to stop using contraceptive (aOR 0.53, 95% CI 0.31–0.93), but more likely to switch to a less effective method (aOR 2.25, 95% CI 1.16–4.34). Age was also associated with contraceptive use changes. Conclusions: Contraceptive use among Brazilian women during COVID-19 depended on their age and partnership status. During the period of the highest peak in the number of cases and deaths in the country, ambivalence towards a future pregnancy increased changes in contraceptive use. Implications: Contraceptive changes were observed during a two-wave web-survey in Brazil depending on women's age and partnership status. Ambivalence towards a future pregnancy increased changes in contraceptive use and should be considered in future studies regarding sexual and reproductive health and COVID-19 as well as in family planning program implementation.