Covert use of contraception is a common but underreported and understudied phenomenon where one partner uses contraception without the other's knowledge. We used Demographic and Health Survey couple data to examine the relationship between wives’ perceptions of husbands’ fertility preferences and type of contraceptive use (overt vs. covert) in Benin, Ethiopia, Kenya, Mali, Nigeria, Sierra Leone, Uganda, and Zambia using logistic regression. Wives who perceived that their husbands wanted more children than them had increased odds of using covertly, compared to those who perceived that husbands wanted the same number of children in all countries except Benin, and the strength of the relationships ranged from adjusted odds ratio (aOR) 2.89 (95 percent confidence interval (CI) 1.75–4.76) in Zambia to aOR 4.01 (95 percent CI 1.68–9.58) in Mali. Wives who reported not knowing their husbands’ fertility preferences had increased odds of using covertly compared to wives who perceived that their husbands wanted the same number of children in all countries except Zambia, ranging from aOR 2.02 (95 percent CI 1.11–3.69) in Ethiopia to aOR 3.82 (95 percent CI 2.29–6.37) in Kenya. Our findings indicate that efforts to increase partner engagement to align couple's fertility preferences may encourage overt use.

中文翻译：

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八个撒哈拉以南非洲国家对合作伙伴生育偏好和女性秘密避孕药具使用的看法

秘密使用避孕措施是一种常见但未被充分报道和研究的现象，其中一方在另一方不知情的情况下使用避孕措施。我们使用人口和健康调查夫妇数据来检查贝宁、埃塞俄比亚、肯尼亚、马里、尼日利亚、塞拉利昂、乌干达和赞比亚的妻子对丈夫生育偏好的看法与避孕药具使用类型（公开与秘密）之间的关系使用逻辑回归。在除贝宁以外的所有国家，与那些认为丈夫想要相同数量孩子的妻子相比，认为丈夫想要的孩子比自己多的妻子增加了秘密使用的几率，并且关系的强度范围从调整后的优势比（aOR ) 在赞比亚为 2.89（95% 置信区间 (CI) 1.75–4.76），在马里为 4.01（95% CI 1.68–9.58）。在除赞比亚以外的所有国家，与认为丈夫想要相同数量孩子的妻子相比，报告不知道丈夫生育偏好的妻子增加了秘密使用的几率，埃塞俄比亚的 aOR 为 2.02 (95% CI 1.11–3.69)肯尼亚的 aOR 3.82 (95% CI 2.29–6.37)。我们的研究结果表明，增加合作伙伴参与以调整夫妇的生育偏好可能会鼓励公开使用。