By using data from the National Longitudinal Study of Adolescent Health, we examine how adolescent relationship characteristics, partner attributes, and sexual relationship histories are associated with contraceptive use and consistency, incorporating random effects to control for respondent-level unobserved heterogeneity. Analyses show that teens' contraceptive use patterns vary across relationships. Teens with more-homogamous partners, with more-intimate relationships, and who communicate about contraception before sex have greater odds of contraceptive use and/or consistency. Teens in romantic relationships, and who are older when engaging in sex for the first time, have greater odds of ever using contraceptives but reduced odds of always using contraceptives. Teens continue habits from previous relationships: teens with experience practicing contraceptive consistency and females who previously have used hormonal contraceptive methods are better able to maintain consistency in subsequent relationships. Also, relationship and partner characteristics are less important for females who previously used hormonal methods.

Parents and programs should encourage teenagers to delay sexual intercourse, discuss contraception with partners before initiating sex and be vigilant about contraceptive use, particularly in long-term sexual relationships and in relationships with older partners.

CONTEXT: Teenagers have a high unintended pregnancy rate, in part because of inconsistent use or nonuse of contraceptives. It is important to determine how partner and relationship characteristics are related to contraceptive use and consistency within adolescents' first sexual relationships. METHODS:Logistic and multinomial logistic regression analyses of data from 1,027 participants in the first two waves of the National Longitudinal Study of Adolescent Health examined the influence of relationship and partner characteristics on ever-use and consistent use of contraceptive methods during teenagers' first sexual relationships. RESULTS:Teenagers who had waited a longer time between the start of a relationship and first sex with that partner, discussed contraception before first having sex or used dual contraceptive methods had significantly increased odds of ever or always using contraceptives. Adolescents who had taken a virginity pledge, had an older partner, had a greater number of close friends who knew their first partner, or reported having a relationship that was not romantic but that involved holding hands, kissing and telling their partners they liked or loved them had decreased odds of contraceptive use or consistency. As relationship length increased, teenagers were more likely to ever have used a method, but less likely to always have used a method.CONCLUSIONS: Parents and programs should encourage teenagers to delay sexual intercourse, discuss contraception with partners before initiating sex and be vigilant about contraceptive use, particularly in long-term sexual relationships and in relationships with older partners.

Teenagers must use contraception consistently over time and across relationships despite pressure not to. Therefore, they must learn to negotiate sexual and contraceptive decisions in each relationship.

By increasing teenagers' knowledge about condoms and other methods of contraception, pregnancy and STD prevention programs can help to encourage communication among teenage partners before the initiation of sexual intercourse. Programs should also encourage conversations between parents and teenagers, even when not about sex.