Contraceptive Use and Consistency Among U.S. Adolescents

Almost half of U.S. high school students were sexually active in 2003, and despite dramatic declines in the years before, the teenage pregnancy rate was much higher in the U.S. than in other industrialized nations. Then, as now, most pregnancies among teenagers were unintended, the result of contraceptive failure or nonuse. In a special Perspectives issue comprising analyses based on Add Health data, a study by Jennifer Manlove et al. examined the variables associated with contraceptive use and consistency in teenagers’ most recent relationship.

This study, which used nationally representative data, differed from earlier ones in a number of ways. It examined contraceptive use and consistency throughout teenagers’ most recent relationship (rather than just use at last sex), the associations of use and consistency with relationship and partner characteristics, whether contraceptive use at first sex was associated with current use, and whether the variables associated with use and consistency varied by gender.

The results highlighted the inconsistency of contraceptive use within and across relationships. Most notable, perhaps, were the differences between women and men. In general, for males, family and individual characteristics were associated with use and consistency (e.g., males who lived with two biological or adoptive parents during adolescence had elevated odds of always using contraceptives). For females, however, method choice and relationship and partner characteristics generally were the associated variables (e.g., the odds of consistent use were reduced with each additional partner). One association was common to both genders: Contraceptive nonuse at first sex was associated with reduced odds of teenagers’ ever having used contraceptives in their most recent relationship.

In their conclusion, the researchers offered several recommendations for pregnancy prevention programs, including that programs highlight the importance of contraceptive consistency across relationships and expand their focus to include adolescent males.

Perspectives on Sexual and Reproductive Health and Family Planning Perspectives may be accessed through Wiley Online Library (2003–) and JSTOR (1969–2011).

Cover illustrations of Margaret Sanger © Matthew and Eve Levine

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