Effects of relationship context on contraceptive use among young women

Abstract

Objectives To understand how relationship status influences contraceptive use among young people. Study Design Data were collected as part of a longitudinal study on hormonal contraception among unmarried adolescent and young women who wanted to avoid pregnancy for at least one year, recruited at family planning clinics in the San Francisco Bay area. Follow-up surveys were completed at 3, 6, and 12 months. Longitudinal analysis was used to examine whether relationship characteristics, including type and length of sexual relationship are associated with current use of effective contraception. Results Among women with a partner at baseline, 78%, 70%, and 61% had the same partner at 3, 6, and 12 months follow up, respectively. Women in casual relationships were less likely to use effective contraceptive methods, compared to women in consistent relationships (AOR=0.67, p<0.01). Women in new relationships (0–3 months) were less likely to use effective contraceptive methods (AOR=0.60, p<0.001) compared to women in relationships more than one year in length. Younger women (AOR=0.76, p<0.05), black women (AOR=0.67, p<0.05) and Latina women (AOR=0.73, p<0.05) were also significantly less likely to use effective contraception. These effects remained even after controlling for condom use. Conclusions Relationship type and length are independently significantly associated with current effective contraceptive use among adolescent and young women. Women in casual relationships and new relationships were significantly less likely to use effective contraceptive methods. Implications Family planning providers should discuss women’s relationship context and association with contraceptive use in order to help women think of contraception as a long term personal strategy. Since relationship status affects contraceptive use, providers and programs that aim to reduce unintended pregnancy can consider strategies to create a paradigm shift around contraceptive use that focuses on the woman’s reproductive goals, current life stage, and life goals.

Relationship between self-efficacy and patient knowledge on adherence to oral contraceptives using the Morisky Medication Adherence Scale (MMAS-8)

“…While there was no difference in age, years in college, or use of OCP for pregnancy prevention, a higher proportion of those in the high adherence group reported being in a relationship. This latter finding is consistent with other research demonstrating that women in consistent relationships are more likely to use effective contraception when compared to women in casual relationships [ 27 ]. As expected, proportionally fewer individuals in the high adherence group reported missing 2 or more doses in both a typical month and last month, and the high adherence group exhibited a higher mean perceived knowledge and higher mean perceived self-efficacy when compared to the low adherence group.…”

Contraceptive method use among women and its association with age, relationship status and duration: findings from the third British National Survey of Sexual Attitudes and Lifestyles (Natsal-3)

“…Typically, studies that have compared contraceptive method use in different age groups, 4 24 have not taken relationship characteristics into account and, conversely, studies that compared contraceptive method use by relationship characteristics have not done so in different age groups. 6–10 13 14 16 25 These differences in study design are likely to partially explain the equivocal nature of findings of many previous studies 14 and also apparent anomalies between other studies and our own. At the aggregate level, we did not find higher levels of LARC use among younger participants than older ones, as others have.…”

Changes in the prevalence and profile of users of contraception in Britain 2000–2010: evidence from two National Surveys of Sexual Attitudes and Lifestyles

“…More effective contraceptive use could potentially have a negative consequence on STI rates if use of condoms declines as a consequence, so it is important that any education about these methods is given alongside messages on reducing risk of STIs. For the most part, it is still women who take responsibility for pregnancy prevention, and couples tend to move from condom to pill use as the relationship becomes more permanent and trusting 23…”