ISSN 3028-8940
JULY-DECEMBER 2025;2(2):92-109
O
RIGINAL ARTICLE https://doi.org/10.36097/rgcs.v2i2.3189
92 San Gregorio de Portoviejo University | Ecuador
Contraceptive preferences among female students of the Health area at San Gregorio de
Portoviejo University
Preferencias anticonceptivas en estudiantes del sexo femenino del área de Salud de la Universidad San
Gregorio de Portoviejo
Camila S. Aguirre
1
* , Kendry E. Cedeño
1
, Anthony V. Cornejo
1
, Aaron A. Falcones
1
Karen Valera
1
, Ariagna Martínez
1
, Rolando Sánchez
2
1
Carrera de Medicina, Universidad San Gregorio de Portoviejo, Manabí, Ecuador.
2
Universidad de Cuenca, Azuay, Ecuador.
*Corresponding author
Reception: 09-05-2025 Acceptance: 28-06-2025 Publication: 31-07-2025
ABSTRACT
In university students, the choice of contraceptive methods is influenced by academic, sociocultural, and economic
factors. This study analyzed contraceptive preferences among health science students to identify usage patterns and
access barriers, aiming to examine contraceptive preferences in female students at the Universidad San Gregorio de
Portoviejo and identify the factors influencing their choices. It was a descriptive, non-experimental, cross-sectional
study involving 85 students from Medicine, Dentistry, Nursing, Nutrition, and Integral Aesthetics programs. A digital
survey with single-choice and multiple-choice questions was administered. The male condom was the most commonly
used method, followed by oral contraceptives. Pharmacies were the primary source of acquisition, and most
participants received information from general practitioners. Therefore, it is recommended to strengthen sexual
education and improve access to information to optimize decision-making in reproductive health.
Keywords: contraception, family planning, reproductive health, university students, contraceptive methods.
RESUMEN
En estudiantes universitarias, la elección de métodos anticonceptivos está influenciada por factores académicos,
socioculturales y económicos. Este estudio analizó las preferencias anticonceptivas en estudiantes del área de la salud
para identificar patrones de uso y barreras de acceso, con el objetivo de examinar las preferencias anticonceptivas en
estudiantes mujeres de la Universidad San Gregorio de Portoviejo e identificar los factores que influyen en su elección.
Fue un estudio descriptivo, no experimental y de diseño transversal en 85 estudiantes de Medicina, Odontología,
Enfermería, Nutrición y Estética Integral. Se aplicó una encuesta digital con preguntas de selección única y múltiple.
El condón masculino fue el método más usado, seguido de anticonceptivos orales. La farmacia fue la principal fuente
de adquisición, y la mayoría recibió información de médicos generales. Por esto, se recomienda fortalecer la educación
sexual y mejorar el acceso a información para optimizar la toma de decisiones en salud reproductiva.
Palabras clave: anticoncepción, planificación familiar, salud reproductiva, estudiantes universitarias, métodos
anticonceptivos.
Cite as: Aguirre, C. S., Cedeño, K. E., Cornejo, A. V., Falcones, A. A., Valera, K., Martínez, A., & Sánchez, R. (2025).
Contraceptive preferences among female students of the Health area at San Gregorio de Portoviejo University. Revista Gregoriana
de Ciencias de la Salud, 2(2), 92-109. https://doi.org/10.36097/rgcs.v2i2.3189
© Author(s) 2025
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San Gregorio de Portoviejo University | Ecuador 93
INTRODUCTION
The World Health Organization (WHO) defines reproductive health as a condition of
physical, mental, and social well-being in all aspects related to reproduction at all stages of life.
Reproductive health implies that people can have a satisfactory and safe sexual life, the ability to
have children, and the freedom to decide if, when, how many, and how often they want to have
them. Implicit in this latter condition is the right of men and women to be informed and have access
to preferred methods of fertility regulation that are safe, effective, affordable, and acceptable, and
the right to access adequate health services that enable women to carry their pregnancies and
deliver children safely (National Institute of Statistics and Census [INEC], 2008).
Knowledge about the use of contraceptive methods allows for timely and appropriate
decisions to be made about reproduction in a free, responsible, and informed manner. It contributes
to the exercise of people's sexual and reproductive rights and to maintaining their health.
Reproductive health is a key factor in the social, economic, and political development of a region
(Ramírez & Torres, 2016), as well as nutrition and lifestyle choices, which can influence long-
term reproductive outcomes (Gallardo & García, 2024).
Contraceptive use offers a range of potential non-health benefits, such as increased
educational opportunities and greater empowerment for women. The number of women seeking
family planning has increased markedly over the past two decades, from 900 million in 2000 to
nearly 1.1 billion in 2021. Between 2000 and 2020, the number of women using a modern
contraceptive method increased from 663 million to 851 million. This number is projected to
increase by an additional 70 million women by 2030. Between 2000 and 2020, the contraceptive
prevalence rate (the percentage of women aged 15–49 years using some form of contraception)
increased from 47.7% to 49.0%. The percentage of women of reproductive age (15–49 years)
whose family planning needs are met by modern methods (Sustainable Development Goals [SDG]
indicator 3.7.1) is 77.5% globally in 2022, an increase of 10% since 1990 (67%) (WHO, 2023).
According to data from the 2018 National Health and Nutrition Survey (ENSANUT), in
Ecuador, 98.5% of women of reproductive age (15-49 years old) are familiar with some family
planning method, with modern methods being the most widely known (98.4%), compared to
traditional methods (67.5%). Likewise, a national study conducted by the INEC on the knowledge
and use of contraception among women of childbearing age between 2005 and 2006, as part of the
Contraceptive preferences among female students of the Health area at San Gregorio de Portoviejo University
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Living Conditions Survey, reported that 92.5% of women were aware of contraceptive methods,
with those between 25 and 39 years old and those with secondary and higher education being the
most knowledgeable. According to data reported by the United Nations Population Fund
(UNPFA), in 2024, in Ecuador, 92.5% of married or cohabiting women aged 15 to 49 met their
family planning needs. Of these, 92.2% used modern contraceptive methods, and 7.8% used
traditional methods (Jimbo-Sotomayor et al., 2024).
During college, sexuality takes on a significant role in students' lives, as they begin to make
more independent decisions regarding their health and personal relationships. During this period,
experiences related to sexuality can have repercussions, such as unplanned pregnancies,
interruptions in studies, and academic and emotional frustration.
This study identified choice patterns, access barriers, knowledge, and factors that influence
decisions about contraceptive methods in a population that, due to its academic background, has
greater access to health information. This study may contribute to the design of more effective
educational strategies tailored to their needs, improve access to evidence-based information, and
promote informed decision-making in the field of sexual and reproductive health. Furthermore, it
provides data to understand how sociodemographic characteristics, cultural, and academic
contexts can influence contraceptive practices in a population. Based on the aforementioned
factors, the objective was to analyze contraceptive preferences among the female student
population in the Health area at the San Gregorio de Portoviejo University (USGP).
METHODOLOGY
A descriptive, non-experimental field study with a cross-sectional design was conducted
on contraceptive preferences among female students in the Health Department at the USGP. The
population consisted of students enrolled in the Medicine, Dentistry, Nursing, Nutrition, and
Integral Aesthetics programs from October to March 2025. The formula for finite populations was
applied, yielding a sample of 370 participants, which is equivalent to 42% of the total population
of 960. However, due to a lack of participant cooperation, a sample of 85 was selected for the
study. Students from other areas, minors, and those who do not identify as women were excluded.
Responses with obvious bias were eliminated.
For data collection, a survey was applied based on those applied by Kopp et al. (2015),
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San Gregorio de Portoviejo University | Ecuador 95
New Zealand Family Planning (2020), and the United Nations (2019). It was designed on the
KoboToolbox platform and consisted of 20 single- and multiple-choice questions, some of which
were conditional, so not all participants answered all of them. Data collection was conducted using
digital links and QR codes distributed to student groups through institutional media and social
media. To control data quality, automatic restrictions were implemented on the platform to prevent
duplicate responses.
The study adhered to the ethical principles for research involving human subjects.
Participants' consent was obtained before completing the survey. Confidentiality and anonymity
of the data were guaranteed, and the data were stored in a secure database with restricted access to
the researchers.
RESULTS AND DISCUSSION
Figure 1 shows the distribution of responses from the different careers, with a
predominance of 76.47% for Medicine, followed by 17.65% for Dentistry, with 2.35% for both
Nutrition and Dietetics and Nursing, which contrasts with 1.18% for Integral Aesthetics.
Figure 1. Distribution of respondents by career.
Figure 2 shows the age distribution of the surveyed sample, which is divided into 64.71%
between 20 and 24 years old, followed by 25.88% under 20 years old, and 9.41% between 25 and
Contraceptive preferences among female students of the Health area at San Gregorio de Portoviejo University
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29 years old. These ages generally represent the student population, who, after high school, enter
university life. This is also stated by Bermeo and Rivera (2020), who mention that 66.6% of
university students are between 18 and 21 years old.
Figure 2. Age of the surveyed sample.
Of the 85 women surveyed, 82.35%, or 70, have had sexual relations, and the remaining
17.65%, or 15, have not. The university population tends to be more open to a sexually active life
during this stage, influenced by greater autonomy and irregular schedules. The reduction in
parental control and the new social environment can favor a more relaxed attitude toward sexuality.
In Latin America and the Caribbean, young people tend to become sexually active before the age
of 16, related to an increase in the trend of early sexual maturation, urbanization, the media, or
misinformation on the subject, which results in unplanned pregnancies, sexually transmitted
diseases, or psychological and emotional effects due to lack of support (Saeteros et al., 2019).
Table 1 illustrates the awareness of various contraceptive methods within a specific
population. The most widely known method is the male condom (82.35%), followed by the implant
(60%) and combined oral contraceptives (54.12%). Methods such as vasectomy (52.94%),
emergency contraception (51.76%), and the copper IUD (50.59%) are generally known. In
contrast, other methods, such as the intrauterine hormonal system (38.82%) and the progestin-only
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pill (40%), are less widely known.
Table 1. Knowledge about contraceptive methods
Worth
Frequency
Percentage
Male condom
70
82.35
Implant
51
60
Combined oral contraceptives
46
54.12
Vasectomy
45
52.94
Emergency contraceptives
44
51.76
Copper intrauterine device
43
50.59
Progestin injection
39
45.88
Sterilization
38
44.71
Coitus interruptus
37
43.53
Tubal ligation
36
42.35
Progestin-only pill
34
40
Intrauterine contraceptives
33
38.82
Intrauterine hormonal system
33
38.82
Several studies have found that the male condom is the most widely known contraceptive
method in the general population, which is consistent with the data presented. According to the
study by Bravo et al. (2020) , 85% of young people surveyed were familiar with condom use, while
knowledge about long-acting methods, such as the IUD and implant, was significantly lower. This
suggests that there is greater awareness about barrier methods, but more education on long-acting
methods is still needed. The low familiarity with tubal ligation and vasectomy (less than 53% in
this study) could be related to the perception of these methods as irreversible, which raises doubts
about their use in young people, as indicated by the research by Sepúlveda et al. (2024).
Table 2 shows that 61.18% of respondents had their first sexual relationship between the
ages of 15 and 20, while 15.29% began it between the ages of 20 and 25. A further 5.88% reported
having started their sexual life before the age of 15.
The onset of sexual activity varies across regions. In some Asian countries, sexual debut
tends to occur after age 18. At the same time, in the United States, differences are observed
according to cultural context, with African Americans and Hispanics reporting an average onset at
age 17, compared to a later onset among Asians and Caucasians. In Colombia, sexual debut is most
prevalent between the ages of 14 and 16. Factors associated with the onset of sexual activity in
Contraceptive preferences among female students of the Health area at San Gregorio de Portoviejo University
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adolescence include cultural aspects, family type, socioeconomic status, and parental influence on
decision-making. Earlier onset has also been identified in cases of reconstituted, single-parent, or
extended families, as well as in situations of violence, low educational level, drug and alcohol use,
and permissive parental attitudes (Kostrzewa, 2008). The percentage of people who had sexual
relations before age 15, that is, 5.88%, represents a problem, since the World Health Organization
(2024) points out that sexual activity at early ages is associated with a higher risk of unplanned
pregnancies and sexually transmitted diseases. This highlights the importance of strengthening
sexual education at an early age.
Table 2. Age of first sexual relations
Worth Frequency Percentage*
Between 15 and 20 years old
52
74.28
Between 20 and 25 years old
13
18.57
Before the age of 15
5
7.14
*Percentage of a sample of 70 people.
Figure 3 shows the number of sexually active people, representing 64.71%, compared to
those who are not, being the remaining 32.29%. When comparing these data with those provided
by Spindola et al. (2020), which had a representation of 48.62% of sexually active women from a
Brazilian university, the results are similar, based on cultural similarities between Latin American
countries. The number of people who use some contraceptive method represented 63.53%, while
36.47% do not use any. These results are related to the percentages of sexually active women,
indicating that almost all of those who are sexually active use contraceptive methods, except for
one, which reflects healthy sexual practices. The educational level of the population could explain
this finding, since their access to information on the importance and use of contraceptives may be
greater.
On the other hand, a study by Nsubuga et al. (2015) conducted on female university
students in Uganda found that 46.6% of them used some form of contraception, out of a sample of
1,008 students. This shows that, while university students globally tend to be informed about the
different contraceptive methods and where to access them, depending on the region, there are still
sociocultural barriers that can influence their use, and are shaped, especially among young women,
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San Gregorio de Portoviejo University | Ecuador 99
by cultural norms and identity aspects, as seen in health practices within traditional communities
(Alvarado & Zambrano, 2023).
Figure 3. Active sexuality compared with the use of contraceptive methods.
Figure 4 shows that 53.70% of students use contraceptives primarily to prevent pregnancy,
while 20.37% use them both to prevent pregnancy and to prevent sexually transmitted infections
(STIs). These results could be related to the impact that pregnancy during college can have on
academic life, as, in many cases, it can cause difficulties that even lead to dropping out of school.
Furthermore, the fact that some students use contraceptives for the additional purpose of
preventing STIs may be due to their training in health, which gives them greater knowledge about
the transmission and consequences of these diseases.
Similarly, in a study by Sweya et al. (2016), in university students in the Kilimanjaro region
of Tanzania, it was determined that the reasons attributed to the use of contraceptives were: fear
of pregnancy (72; 35.6%), fear of contracting sexually transmitted diseases (35; 17.3%) and
spacing of pregnancies (35; 17.3%).
Contraceptive preferences among female students of the Health area at San Gregorio de Portoviejo University
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Figure 4. Reasons for using the contraceptive method.
Table 3 shows that the most commonly used contraceptive method is the male condom
(45.28%), followed by combined oral contraceptives (16.98%), while the hormonal intrauterine
device (IUD) is the least commonly used (1.88%). The preference for the male condom can be
explained by its easy accessibility, low cost, and dual function, as it not only prevents pregnancies
but also STIs. On the other hand, although oral contraceptives require a prescription or medical
advice in most cases, they remain an accessible method for many users. In contrast, the hormonal
intrauterine device (IUD) may be unfamiliar or considered an invasive method.
Table 3. Contraceptive method used
Answer Frequency Percentage*
Male condom
24
45.28
Combined oral contraceptives
9
16.98
Injectable contraceptive
7
13.20
Implant
3
5.66
Oral contraceptive
3
5.66
Abstinence
2
3.77
Copper intrauterine device
2
3.77
Natural family planning
2
3.77
Intrauterine hormonal system
1
1.88
*Percentage of a sample of 53 people.
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These findings are consistent with the study by Sweya et al. (2016), which found that
condoms were the most commonly used contraceptive method among married (37.7%) and single
(27.5%) female university students. Periodic abstinence was the most common contraceptive
currently used by married respondents (20.8%), followed by condom use (18.2%).
Figure 5, which refers to the place where contraceptives are obtained, shows a
predominance of pharmacies, with a total of 31 people (58.49%), compared to a minority who
purchase them at the local grocery store, that is, 2 people (3.77%). The inclination toward this
entity is explained by the ease and speed of its service, which is based on the number of these
services in most sectors. These services generally require prior appointments and are more
expensive than desired, compared to gynecological or general medical services. Furthermore,
obtaining it from family or friends can generate moments that could be uncomfortable for the
person purchasing it, similar to the case with local stores, which are generally located near the
person's place of residence. Similar situations occur in countries like Mexico, where adolescents
between 15 and 19 years old, according to Gómez et al. (2017), know the places where
contraceptive methods are obtained, with a preference for pharmacies, self-service stores, some
convenience store chains, and health centers.
Figure 5. Sources of obtaining contraceptive methods.
Figure 6, which describes the feeling of safety concerning the method used, shows a
predominance of high perceptions, at 42.59%, followed by very high perceptions at 29.63%, with
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only one person perceiving it as low (1.85%). The majority's perception of high safety in the
contraceptive used by women is because they generally choose the method themselves, based on
their confidence in its effectiveness in protecting against a possible pregnancy, STIs, or both,
influenced by personal experience and available information. In some cases, the perception of
safety may be overestimated, as seen in the use of the natural method, which involves controlling
the menstrual cycle and abstaining from sex. Despite having a relatively high failure rate (>20%),
this method remains in use. Furthermore, this sense of safety can lead to underestimations related
to the importance of following the method's exact instructions, as is the case with combined oral
contraceptives (Yi et al., 2022).
Figure 6. Perception of safety of the contraceptive method.
Of the 53 respondents, 88.67% used their preferred contraceptive method, while the
remaining 11.32% did not. The ability to choose and use the desired contraceptive method is
multifactorial. It may be determined by factors such as education on the subject, its accessibility
or availability, deep-rooted social beliefs, or cultural aspects. In our setting, the partner is also a
fundamental part of this process, participating according to their own preferences or according to
the duration of the relationship, as explained by Upadhyay et al. (2016) , who recognized that in
couples of 0 to 3 months duration, there was a lower probability of using an effective contraceptive
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method.
Another important consideration is product cost, especially for low-income or uninsured
women, who face difficulties accessing a wider range of contraceptive methods. Furthermore,
provider recommendation influences method choice, as approximately 20% of women who do not
use their preferred method justify it by having been recommended a different one. This underscores
the need for quality contraceptive counseling that respects patient autonomy regarding their
reproductive health (Frederiksen et al., 2021).
Table 4, referring to the reason why they do not use a contraceptive method, shows a
predominance of women who are not sexually active with 51.72%, followed by 13.79% who do
so because they do not want to use hormonal contraceptives, with a minority who do not use
contraceptive methods because they have infrequent sex representing 3.44%. The main reason
identified by the respondents for not using contraceptive methods is the absence of sexual activity.
This behavior may be influenced by the prioritization of academic and personal goals during the
university stage (Chiliquinga et al., 2021). Furthermore, some women avoid hormonal
contraceptives due to concerns about possible side effects, such as mood swings or physical
changes.
Table 4. Reasons why respondents do not use contraceptive methods
Answer
Frequency
Percentage*
I am not sexually active
15
51.72
I do not want to use hormonal contraceptives
4
13.79
Other
2
6.89
Side effects
2
6.89
I have not found a good method.
2
6.89
I do not need it
2
6.89
Infrequent sex
1
3.44
Same-sex sex
1
3.44
I want to have children
0
0
Menopause
0
0
My partner is sterile/infertile
0
0
Laziness
0
0
*Percentage of a sample of 29 people.
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Another group of participants mentioned difficulty in finding a suitable method or the
perception that one is not needed. This could be related to a lack of adequate information about
available options or a misperception of pregnancy risk. Previous research has found that many
young women are unaware of the variety of contraceptives available, which can lead to
underutilization of these methods (Muñoz & Calero, 2025).
Figure 7, which refers to the sources from which women obtain information about
contraceptive methods, shows a predominance of 53.52% from a general practitioner, while a
minority of 11.27% obtain information from a pharmacy. The preference for obtaining information
about contraceptives from a general practitioner may be due to the trust that people place in health
professionals as authoritative and reliable sources. General practitioners are often the first point of
contact in the health system and can provide accessible and personalized information according to
the patient's needs. Although medical advice influences the choice of contraceptive method, many
providers lack the confidence and knowledge necessary for adequate guidance (Akers et al., 2010).
Figure 7. Place to obtain information on contraceptive methods.
Table 5, referring to the health personnel who have refused to provide a contraceptive
method to the surveyed sample, reveals a predominance of no one doing so, representing 89.41%,
followed by denial by a general practitioner (7.06%). The majority of respondents have not faced
refusals from health personnel when requesting contraceptive methods. However, a smaller
percentage reported refusals, especially from general practitioners. This phenomenon could be
associated with insufficient training in sexual and reproductive health among some professionals,
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which affects their willingness to provide specific contraceptive methods (Espinoza et al., 2025).
Table 5. Health professionals who have not provided contraceptive methods
Answer
Frequency
Percentage
None
76
89.41
General practitioner
6
7.06
Gynecologist
2
2.35
Pharmacist
1
1.18
Nurse
1
1.18
Comprehensive education should not be limited to teaching contraceptive methods, but
should also address the factors that influence their acceptance or rejection, from a perspective that
includes the nutritional dimension. The integration of sexual and nutritional education is key, given
their combined impact on reproductive health and quality of life, especially during adolescence
and early adulthood. In this regard, Forbes-Hernández et al. (2020) emphasize that diets with high
antioxidant capacity support redox homeostasis, which is essential for reproductive and cellular
health, particularly during adolescence and early adulthood. Promoting healthy eating habits is
therefore an essential preventive measure, including nutritional education, which influences long-
term reproductive health and well-being (Angulo et al., 2024).
CONCLUSIONS
Contraceptive preferences among female students in the health field at the USGP show that
the most commonly used method is the male condom, followed by combined oral contraceptives,
while the intrauterine hormonal contraceptive system is the least commonly used. It was found
that the majority of students who use contraceptives do so to prevent pregnancy, while a smaller
percentage also use them as a preventative method for STIs. Furthermore, it was observed that
pharmacies are the most common place for purchasing contraceptives, reflecting a preference for
accessibility and immediacy in obtaining these products. It is recommended to delve deeper into
the factors that influence the choice or rejection of specific contraceptive methods and evaluate
the impact of educational strategies on contraception in university populations. The findings can
serve as a basis for developing sexual health education and promotion strategies, improving access
to and correct use of contraceptive methods, to reduce unplanned pregnancies and promote a
Contraceptive preferences among female students of the Health area at San Gregorio de Portoviejo University
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healthy and informed sex life.
ACKNOWLEDGMENTS
We thank Dr. Mario A. García for his critical review of the manuscript.
CONFLICTS OF INTEREST
The authors declare that they have no conflicts of interest.
AUTHOR CONTRIBUTIONS
Conceptualization: Camila S. Aguirre and Karen Valera. Data curation: Kendry E.
Cedeño, Anthony V. Cornejo, and Aaron A. Falcones. Formal analysis: Camila S. Aguirre and
Karen Valera. Investigation: Camila S. Aguirre, Kendry E. Cedeño, Anthony V. Cornejo, Aaron
A. Falcones, and Karen Valera. Methodology: Ariagna Martínez and Rolando Sánchez. Software:
Aaron A. Falcones. Supervision: Ariagna Martínez and Rolando Sánchez. Validation: Ariagna
Martínez and Rolando Sánchez. Visualization: Kendry E. Cedeño, Anthony V. Cornejo, and Aaron
A. Falcones. Writing – original draft: Camila S. Aguirre, Kendry E. Cedeño, Anthony V.
Cornejo, Aaron A. Falcones, and Karen Valera. Writing – original draft: Camila S. Aguirre,
Kendry E. Cedeño, Anthony V. Cornejo, Aaron A. Falcones, Karen Valera, Ariagna Martínez,
and Rolando Sánchez.
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