Characteristics of Adolescent Women Who Stop Using Contraception after Use at First Sexual Intercourse

Study Objective Identify correlates of contraceptive discontinuation, which if modified, might make teenagers more, not less, effective contraceptors as they age. Setting Teen clinic. Participants Teenagers who used contraception at first intercourse (N = 120). Some “never” used contraception during the 4 months immediately prior to the survey (“contraceptive stoppers”; n = 38). The others (n = 82) did so “always” or “most of the time” (“consistent contraceptive users”). Interventions Questionnaire responses were used to determine univariate and multivariate associations between contraceptive use group and five categories of factors: inability to plan for sex, belief that pregnancy is unlikely to occur, belief that contraceptives are unsafe, inability to negotiate contraceptive use, and lack of desire to remain non-pregnant. Main Outcome Measure Odds of being a contraceptive stopper. Results In univariate analyses contraceptive stoppers scored significantly higher on scales that assessed inability to plan for sex, belief that pregnancy is unlikely, and lack of desire to remain non-pregnant. Contraceptive stoppers were also older and more likely to have been sexually active for at least 6 months. In multivariate analyses, those who were sexually active for at least 6 months (odds ratio [OR]: 2.9, confidence interval [95%CI]: 1.1–7.1), those who believed that pregnancy was unlikely (OR: 3.8; 95% CI: 1.7–8.6), and those who lacked the desire to remain non-pregnant (OR: 2.7; 95% CI: 1.4–5.1) were more likely to stop using contraception. Conclusions Our findings suggest that teens who use contraception at coitarche stop doing so as they mature sexually because they begin to doubt the necessity and desirability of using contraceptives. Longitudinal studies are needed to determine if such doubts are preventable and if doing so encourages teens to continue to use contraception.