Matern Child Health J. 2017 Jul 28. doi: 10.1007/s10995-017-2351-7

Adolescent reproductive and contraceptive knowledge and attitudes and adult contraceptive behavior

Guzzo KB and Hayford SR


Objectives: Ineffective and inconsistent contraceptive use is common among adults, perhaps due to limited knowledge about reproduction and unfavorable attitudes toward contraception. Knowledge and attitudes are first developed in adolescence. We test whether adolescent knowledge and attitudes have long-term implications for adult contraceptive behavior.

Methods: Using the National Longitudinal Survey of Adolescent to Adult Health, our analytical sample (n?=?6662) consists of those asked sex and contraception questions at Wave I (1995; students aged 15 and older) and who were sexually active and not pregnant at the time of the Wave IV (2007-2008) survey. We examined whether adolescent attitudes toward contraception, knowledge of condoms and reproduction, and confidence in contraceptive knowledge were predictive of adult contraceptive efficacy and consistency using logistic regression.

Results: In models adjusted for a range of socioeconomic, demographic, and life course factors, favorable attitudes toward contraception in adolescence increased the odds (aOR 1.21, CI 1.08-1.36) of using more effective methods rather than a less effective or no method of contraception in adulthood, as did more accurate condom knowledge (aOR 1.07, CI 1.00-1.14) and more accurate reproductive knowledge (aOR 1.07, CI 1.00-1.13). Adolescents with more favorable attitudes toward contraception also used contraception more consistently as adults (aOR 1.27, CI 1.14-1.43), as did those with more accurate condom knowledge (aOR 1.10, CI 1.03-1.18).

Conclusion: Attitudes towards contraception and knowledge about condoms and reproduction acquired during adolescence are predictive of adult contraceptive behavior. Results suggest that comprehensive sex education during adolescence could improve effective contraceptive behavior throughout the life course.

Comment: We see here that sex education for adolescents should not only focus on the biological and social aspects of reproduction, but also on the pros and cons of the different contraceptives available. That appears to have life-long benefits. (HMV)