Change in Sexual Behavior With Provision of No-Cost Contraception

Abstract

Objective To estimate whether providing no-cost contraception is associated with the number of sexual partners and frequency of intercourse over time. Methods This was an analysis of the Contraceptive CHOICE Project, a prospective cohort study of 9,256 adolescents and women at risk for unintended pregnancy. Participants were provided reversible contraception of their choice at no cost and followed with telephone interviews at 6 and 12 months. We examined the number of male sexual partners and coital frequency reported during the previous 30 days at baseline compared to 6 and 12-month time points. Results From our total cohort, 7,751 (84%) women completed both 6 and 12-month surveys and were included in this analysis. We observed a statistically significant decrease in the fraction of women who reported more than one sexual partner during the past 30 days from baseline to 12 months (5.2% to 3.3%, p<0.01). Most women (70–71%) reported no change in their number of sexual partners at 6 and 12 months; whereas 13% reported a decrease and 16% reported an increase (p<0.01). Over 80% of participants who reported an increase in the number of partners experienced an increase from 0 to 1 partner. Frequency of intercourse increased during the past 30 days from baseline (median = 4) to 6 and 12 months (medians = 6; p<0.01). However, greater coital frequency did not result in greater sexually transmitted infection incidence at 12 months. Conclusion We found little evidence to support concerns of increased sexual risk-taking behavior subsequent to greater access to no-cost contraception.

Preventing Unintended Pregnancy: The Contraceptive CHOICE Project in Review

“…We found that 71% of study participants reported no change in the number of sexual partners at 12 months compared with baseline, and only 16% reported an increase. 17 Of those reporting an increase in sexual partners, more than 80% reported a change from zero partners to one partner.…”

“…21 In addition, we did not find an increase in risky sexual behavior or more STIs with increased LARC use. 17 Thus, increased utilization of LARC methods is an important strategy to reduce unintended pregnancies, which would both improve women's health and save health care dollars. 22 The CHOICE Project provided a model of contraceptive provision that was unique but adaptable.…”

Authors' reply re: Transvaginal prolapse repair with or without the addition of a midurethral sling in women with genital prolapse and stress urinary incontinence: a randomised trial

“…Urodynamics were not obligatory because there is no evidence that urodynamics will improve treatment outcome, and it could only hinder inclusion in the study. 2,3 Jha showed that prolapse surgery was altered by the results of urodynamics investigation in just 7% of cases. 4 In conclusion, we are confident that the study is a good reflection of daily practice.…”

“…3 Even if it did not affect young women's decisions, knowing that girls are routinely made infertile may well affect the behaviour of men. Coercion of young women at first sex is higher the younger the age at first sex, and the majority of those who report first sex before age 16 regret the timing.…”

“…Anterior repair and bladderneck buttressing are no longer regarded as standard surgical management of (urodynamic) stress incontinence. 3 The lack of any repeat continence surgery within the (relatively short) duration of the study is noted.…”