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  • Title: Measuring contraceptive use patterns among teenage and adult women.
    Author: Glei DA.
    Journal: Fam Plann Perspect; 1999; 31(2):73-80. PubMed ID: 10224545.
    Abstract:
    CONTEXT: Measures of contraceptive use at one point in time do not account for its changing nature. A measure that addresses the pattern of method use over time may better predict the cumulative risk of unintended pregnancy. METHODS: Women at risk of unintended pregnancy were selected from the 1995 National Survey of Family Growth, and their contraceptive use patterns were compared across age-groups. Survival analysis was used to validate women's long-term use pattern as an indicator of pregnancy risk, and multivariate regression analyses were used to explore potential covariates of current patterns of contraceptive use. RESULTS: More than two-thirds of women aged 15-19 report long-term uninterrupted contraceptive use, but they are more likely to report sporadic use and less likely to report uninterrupted use of a very effective method than are women aged 25-34. Compared with women aged 25-34, women aged 20-24 have higher rates of sporadic use and lower rates of effective uninterrupted use. Among teenagers, nonusers are 12 times as likely as uninterrupted effective users to experience an unintended pregnancy within 12 months at risk. Women in less stable relationships, those having more infrequent intercourse and women who have recently experienced nonvoluntary intercourse for the first time are more likely than others to have a high-risk contraceptive pattern. Women aged 17 and younger whose current partner is more than three years older are significantly less likely to practice contraception than are their peers whose partner is closer in age. CONCLUSIONS: Long-term contraceptive use pattern is a valid predictor of unintended pregnancy risk. Policies aimed at reducing unintended pregnancies should target women who do not practice contraception and those who are sporadic users. Women in unstable relationships, those having infrequent sex and women who experience sexual coercion need access to methods, such as emergency contraception, that can be used sporadically or after unprotected intercourse. This study examined determinants of unintended pregnancy in the US. Data were obtained from the 1995 National Survey of Family Growth among 7221 women 15-44 years old at risk of unintended pregnancy. Findings indicate that adolescents were not mainly sporadic method users in 1995. Most used a method without interruption for an extended period. Teenagers were more likely to report sporadic contraceptive use and were less likely to be uninterrupted users of effective methods. Women 20-24 years old were no more likely than 18-19 year old women to report long-term sporadic use and were more likely than women 25-34 years old to report long-term sporadic use. Nonusers and sporadic users contributed significantly to the high rate of unintended pregnancies. Logistic models reveal that women who were married or cohabiting were more likely to be uninterrupted effective contraceptive users than those not in long-term relationships. Frequency of intercourse had a consistent, strong positive relationship with contraceptive use. Women who had nonvoluntary intercourse and teenagers with significantly older partners were less likely to use contraceptives. Condoms are appropriate for infrequent intercourse, but couples must know the risks of pregnancy even with infrequent intercourse and know about postcoital methods of pregnancy prevention.
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