Objectives: Although a sizeable percentage of minority women use fertility awareness methods (FAM), little is known about their use in the United States. We sought to fill this gap by examining FAM use among Latina and black women - groups that have high rates of unintended childbearing and FAM use - focusing on knowledge, sources of information and accuracy of use. Unlike other methods, accurate use of FAM requires relatively high levels of knowledge. Study Design: In-depth, semistructured interviews were conducted with 58 Latina and black women who were current or past users of FAM. Participants were recruited through local clinics and ads posted in neighborhoods and local Web sites. A purposive sample design was used to ensure that the sample included individuals with characteristics associated with FAM use. An inductive approach was used in the data analysis. Results: Women learned about FAM from family, professionals and the Internet. In general, what they learned fell into one of two levels of information - basic or in-depth - and many women possessed moderate to low levels of knowledge. By decomposing accuracy of use into its components, we find that it is driven largely by knowledge. While the vast majority of women were abstaining from unprotected sex during what they believed to be their fertile window, only 34 of the 58 participants accurately identified their fertile period. Conclusions: Findings speak to a gap in reproductive literacy that has important implications for FAM users. The gap between behavior and knowledge could help account for high failure rates associated with FAM use. (c) 2013 Elsevier Inc. All rights reserved.
