Advancing Sexual and Reproductive Health and Rights
 
Perspectives on Sexual and Reproductive Health
Volume 34, Number 1, January/February 2002

The Trade-Off Between Hormonal Contraceptives And Condoms Among Adolescents

By Mary A. Ott, Nancy E. Adler, Susan G. Millstein, Jeanne M. Tschann and Jonathan M. Ellen

CONTEXT: Adolescents' dual use of condoms and hormonal contraceptives is low, and the motivations underlying their decisions to combine contraceptives are not understood.

METHODS: To examine how pregnancy concerns, sexually transmitted disease (STD) concerns and type of sexual partner influence contraceptive use, we recruited 436 sexually experienced adolescents from two clinics. In structured interviews, we asked adolescents to describe their recent partners, their method use, and their pregnancy and STD concerns. Data were analyzed using logistic regression.

RESULTS: The odds that adolescents used condoms with main partners were significantly lower among those who used hormonal contraceptives than among nonusers of these methods (odds ratios, 0.4 for young women and 0.3 for young men). With casual partners, no association existed between adolescents' condom and hormonal contraceptive use. Concerns about pregnancy and STDs influenced this association for women with main partners. Among young women who perceived pregnancy as more negative, hormonal contraceptive users had reduced odds of using condoms (0.1). No association existed between use of the two methods among young women whose view of pregnancy was less negative. Young women who perceived themselves to be less at risk of acquiring an STD had reduced odds of using condoms if they were using hormonal contraceptives (0.2). Among young women who perceived themselves to be more at risk of acquiring an STD, no association existed.

CONCLUSIONS: Adolescents trade off between hormonal contraceptives and condoms according to partner type and perceived risks. Adolescents' dual-method use may improve if providers tailor counseling to adolescents' perceived risk of STDs and pregnancy, and if they address prevention of both as a related decision.

Perspectives on Sexual and Reproductive Health, 2002, 34(1):6-14

DOI:10.1363/3400602







 

 
 

Mary A. Ott is fellow and Susan G. Millstein is professor of pediatrics, Division of Adolescent Medicine, Department of Pediatrics, University of California, San Francisco (UCSF). Nancy E. Adler is professor of psychology, Departments of Psychiatry and Pediatrics, UCSF. Jeanne M. Tschann is professor of psychology, Department of Psychiatry, UCSF, and Jonathan M. Ellen is associate professor of pediatrics, Department of Pediatrics, Johns Hopkins University, Baltimore.