NEW ORLEANS — Changes in contraceptive methods are frequent among adolescent girls, and tend to reflect pregnancy status and changes in sexual relationships and behaviors, Jennifer L. Woods, M.D., reported at the annual meeting of the North American Society for Pediatric and Adolescent Gynecology.
A 27-month longitudinal study of 275 sexually active girls aged 14–17 produced 1,513 pairs of sequential reports on contraceptive use. Of these, 19% consistently used no contraception, 38% consistently used condoms or hormonal contraception, and 43% changed contraceptive methods between quarterly reports during the study period, said Dr. Woods of Indiana University, Indianapolis.
Of those girls who said they changed contraception, 82% switched methods at least once during the period of the study, and 44% of the girls changed at least three times. About 4% of the changes were from hormonal contraception to no contraception, about 5% of the changes were from no contraception to hormonal contraception, 5% were from condoms to no contraception, and 5% were from no contraception to condoms.
Participants in the study included adolescent patients at primary care clinics. They completed interviews at study entry and exit, and every 3 months during the study period, during which they reported the types of contraceptive method used in the previous 3 months.
Method change was defined as any change in the reported contraceptive method at any two sequential quarterly visits.
Significant predictors of change included pregnancy and fewer sexual partners (which predicted both a change from hormonal to no contraception, and from condoms to no contraception), as well as not being pregnant and increased number of sexual partners (which predicted a change from no contraception to the use of condoms only). There were no significant predictors of a change, however, from no contraception to hormonal contraception, Dr. Woods noted.
The findings are of concern, particularly given that consistent use of effective contraceptives by sexually active adolescents, which is among the federal government's Healthy People 2010 national health objectives most relevant to adolescents, has been shown to protect against sexually transmitted diseases and/or pregnancy, Dr. Woods said.
Improved understanding of the factors related to contraceptive method changes could help improve contraceptive compliance, Dr. Woods explained, adding that health providers should emphasize the importance of contraceptive method stability.