Contraception. 2016 Jul;94(1):68-73.

Effects of relationship context on contraceptive use among young women

Upadhyay UD, Raifman S and Raine-Bennett T

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.

Conclusion: 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.

Comment: This is another article about education and counseling of adolescents. Here we see that it is important not only to discuss the medical aspects of different contraceptive methods and the health of mother and child in case of pregnancy, but also to give adequate attention to the relationship situation of the young women. (HMV)