Adolescent Dual Method Use: Relevant Attitudes, Normative Beliefs and Self-Efficacy

Abstract

Purpose-To encourage dual contraceptive method use --protection from both STD and pregnancy --health behavior change efforts must target powerful risk and protective factors that are amenable to change. This study examines longitudinal relationships between adolescents' contraceptive-related cognitions and dual method use.Methods-Data are from 1,123 sexually active 7-11 th grade participants in the National Longitudinal Study of Adolescent Health, Waves 1 and 2 (W1, W2). A series of nested path models examined relationships between participants' contraceptive use level at most recent intercourse (zero, one, two methods) and contraceptive-related cognitions. Parallel analyses were completed with four grade/gender groups.Results-Dual method use at most recent intercourse ranged from 14.3% to 25.0%. Path models suggested that contraceptive use patterns and contraceptive-related cognitions were moderately stable over time. Cross-sectionally, contraceptive use level was associated with parent approval of birth control (older youth, younger girls), birth control attitudes (older youth, younger boys), perceived pregnancy consequences (older youth), perceived STD risk (older girls), perceived benefits of sex (younger girls), and contraceptive self-efficacy (older youth). W1 father approval of birth control (younger girls), mother disapproval of sex (older girls), and birth control attitudes (older boys) predicted W2 contraceptive use levels. W1 contraceptive use levels predicted several W2 cognitions among older youth.Conclusions-Sexually active adolescents' perceptions of parent expectations about sex and contraception have important links to dual method use. Adolescents' attitudes about practical, social and moral implications of using birth control are also linked to their use of dual contraceptive methods. KeywordsAdolescents; Dual method use; Contraceptive attitudes and beliefs; Path models There is growing interest in promoting dual method contraceptive use as a means of preventing both pregnancy and sexually transmitted diseases (STD). This goal is particularly worthy among sexually active adolescents, a group that experiences relatively high pregnancy and STD rates. While pregnancy rates among 15-19 year olds showed sustained declines during the 1990s, current rates remain among the highest in the industrialized world [1,2]. U.S. . Even with these increases, the proportion of adolescents using dual protection lags behind the proportion of youth at risk for pregnancy and STD.To be more effective in promoting dual method use among sexually active adolescents, we must understand antecedents of dual method use. To impact dual method use, our health behavior change efforts must target risk and protective factors determined to be most powerful and amenable to change through intervention. While clinic and community-based interventions are not well suited to address overarching socio-cultural antecedents of unprotected intercourse (e.g., poverty), these efforts can effectively shape attitudes, beliefs and skills...

Contraceptive Use by 15-Year-Old Students at Their Last Sexual Intercourse

“…32 In particular, the role of parents in terms of communication with adolescents and monitoring has recently been highlighted. [33][34][35] Accurate information about adolescents' sexual practices and readiness to use specific contraceptive methods for birth control and STI prepoa70081f2 Figure 2. Prevalence of reported unprotected participants (sexually active participants who reported no use of any contraception at last intercourse) and poorly protected participants (sexually active participants who reported use of withdrawal, the morning-after pill, or natural or biological methods of contraception but not use of contraceptive pills or condoms at last intercourse) at last intercourse by country according to the 2002 World Health Organization Health Behaviour in School-aged Children study.…”

How well protected are sexually active 15-year olds? Cross-national patterns in condom and contraceptive pill use 2002–2006

“…A similar range of predictors has been associated with the non-use of appropriate contraception during adolescence. Aside from not having access to contraception and actively wanting to achieve pregnancy, non-use of contraception has been associated with knowledge of and attitudes to contraceptive methods, such as perceiving condom users as 'unclean' and perceived difficulty of contraceptive use 17,18 and characteristics of relationships with sexual partners. Poor communication with sexual partner in relation to contraception and not wanting to appear too knowledgeable or 'forward' have been linked with inconsistent or non-use of appropriate contraception 17,19 .…”

Sex, Condoms and Sexually Transmissible Infections: A Qualitative Study of Sexual Health in Young Australian Men

“…Infrequent accounts of dual method use, now widely regarded as the public health ideal for young people (Bearinger & Resnick, 2003;Sieving, Bearinger, Resnick, Pettingell, & Skay, 2007), corresponds with the low prevalence of this behavior recorded in population-based studies (Agius, Pitts, Dyson, Mitchell, & Smith, 2006;De Visser, 2007;Sievingetal.,2007).Ourresearch,however,offersfurtherinsightinto the personal meanings and mechanisms that lead to dual method use. Of interest was the variation in motivation leading to concurrent method use, from those who regarded condom use as a''backup''strategy for preventing pregnancy to those who emphasized its unique role in STI prevention.…”