Anticoncepción en la población gitana residente en dos barrios con bajo nivel de renta de Barcelona / Contraception in the Roma population living in two low-income neighborhoods of Barcelona (Spain)

Objetivo: Describir el conocimiento y el uso de anticonceptivos y de servicios sanitarios en la población gitana de dos barrios de renta baja de Barcelona (2011-2015). Método: Estudio de metodología mixta en el ámbito comunitario. 1) Estudio cuantitativo descriptivo transversal. Entrevista con cuestionario a una muestra de residentes en edad fértil. Comparación del conocimiento y el uso de anticonceptivos y de servicios según etnia y sexo con modelos ajustados de regresión logística para obtener odds ratios ajustadas (ORa) y sus intervalos de confianza del 95% (IC95%). 2) Estudio cualitativo descriptivo con método etnográfico. Entrevista a 10 residentes de etnia gitana y tres profesionales de salud para explorar aspectos de anticoncepción, familia y roles. Análisis narrativo de discurso de los textos. Resultados: Participaron 834 personas, de las que un 11,8% se autoidentificaron como gitanas. Las mujeres gitanas utilizaban más que las no gitanas la ligadura tubárica (ORa: 3,0; IC95%: 1,3-7) y el implante (ORa: 4,9; IC95%: 3,1-72), y conocían mejor el dispositivo intrauterino (ORa: 2,4; IC95%: 1,4-4,1), la obstrucción tubárica (ORa: 3,3; IC95%: 1,1-9,9) y los inyectables (ORa: 2,4; IC95%: 1,3-4,4). Los hombres gitanos utilizaban más frecuentemente la retirada (ORa: 3,6; IC95%: 1,3-10), práctica corroborada en el estudio cualitativo. Ambas poblaciones utilizaban similarmente la anticoncepción de emergencia y los servicios sanitarios. En la población gitana, la anticoncepción y la reproducción son responsabilidad de las mujeres. Aunque el aborto está culturalmente penalizado en la comunidad gitana, las mujeres gitanas lo utilizan, pero lo afrontan en soledad. Conclusiones: El género emergió como un determinante transversal en los aspectos explorados. En la población gitana el control reproductivo sigue siendo una responsabilidad femenina. Una vez completada la familia, las mujeres gitanas usan anticonceptivos de larga duración. Ambas poblaciones utilizan los servicios sanitarios

Objective: To describe the knowledge and use of contraceptive methods and health services in the Roma population (Kale/Spanish Gitanos) of two low-income neighbourhoods of Barcelona (2011-2015). Method: Mixed. Community setting. 1) Descriptive cross-sectional study. We interviewed with a questionnaire a sample of residents of childbearing age. We compared the knowledge and use of contraception and services by ethnic self-identification and sex with adjusted logistic regression models to obtain adjusted odds ratio (ORa) and 95% confidence interval (95%CI). 2) Qualitative descriptive study with ethnographic method. We interviewed 10 Roma residents and three health professionals to explore aspects of contraception, family and roles. We performed a narrative analysis of discourse from the recorded texts. Results: 834 people participated, with an 11.8% self-identified Roma population. With regard to the non-Roma population, more Roma women used tubal ligation (ORa: 3.0; 95%CI: 1.3-7)] and implant (ORa:4.9; 95%CI: 3.1-72), and had better knowledge of IUD (ORa: 2,4; 95%CI: 1,4-4,1), tubal obstruction (ORa: 3,3; 95%CI: 1,1-9,9) and injectables (ORa: 2,4; 95%CI: 1.3-4.4). Roma men used withdrawal more frequently (ORa: 3.6; 95%CI: 1.3-10), a practice confirmed in the qualitative study. Both communities used emergency contraception and health services. In the Roma population, contraception and reproduction are in the hands of women. As abortion is culturally penalized in the Roma population, women use it, but they face it alone. Conclusions: Gender emerged as a cross-cutting determinant in all issues explored. In the Roma population reproductive control and contraception remain the responsibility of women. Once the family is complete, Roma women use long-term contraception. Both populations use health services

[Contraception in the Roma population living in two low-income neighborhoods of Barcelona (Spain)]. / Anticoncepción en la población gitana residente en dos barrios con bajo nivel de renta de Barcelona.

OBJECTIVE: To describe the knowledge and use of contraceptive methods and health services in the Roma population (Kale/Spanish Gitanos) of two low-income neighbourhoods of Barcelona (2011-2015). METHOD: Mixed. Community setting. 1) Descriptive cross-sectional study. We interviewed with a questionnaire a sample of residents of childbearing age. We compared the knowledge and use of contraception and services by ethnic self-identification and sex with adjusted logistic regression models to obtain adjusted odds ratio (ORa) and 95% confidence interval (95%CI). 2) Qualitative descriptive study with ethnographic method. We interviewed 10 Roma residents and three health professionals to explore aspects of contraception, family and roles. We performed a narrative analysis of discourse from the recorded texts. RESULTS: 834 people participated, with an 11.8% self-identified Roma population. With regard to the non-Roma population, more Roma women used tubal ligation (ORa: 3.0; 95%CI: 1.3-7)] and implant (ORa:4.9; 95%CI: 3.1-72), and had better knowledge of IUD (ORa: 2,4; 95%CI: 1,4-4,1), tubal obstruction (ORa: 3,3; 95%CI: 1,1-9,9) and injectables (ORa: 2,4; 95%CI: 1.3-4.4). Roma men used withdrawal more frequently (ORa: 3.6; 95%CI: 1.3-10), a practice confirmed in the qualitative study. Both communities used emergency contraception and health services. In the Roma population, contraception and reproduction are in the hands of women. As abortion is culturally penalized in the Roma population, women use it, but they face it alone. CONCLUSIONS: Gender emerged as a cross-cutting determinant in all issues explored. In the Roma population reproductive control and contraception remain the responsibility of women. Once the family is complete, Roma women use long-term contraception. Both populations use health services.