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  • Title: Adolescent contraception.
    Author: Polaneczky M.
    Journal: Curr Opin Obstet Gynecol; 1998 Jun; 10(3):213-9. PubMed ID: 9619344.
    Abstract:
    Adolescent pregnancy rates have declined modestly, most likely because of the increased use of condoms, especially at first intercourse. Condom distribution in schools appears to be effective in promoting condom use without increasing sexual activity. Although, to date, no contraceptive has been as effective as Norplant in reducing teen pregnancy, use of the method has declined dramatically. Depo-Provera use is increasing, but continuation rates are disappointing and the impact on teen pregnancy rates is as yet unknown. Emergency contraception remains underutilized, and interventions to improve oral contraceptive compliance are beginning to be explored. School-based programs that provide contraception without adding a strong educational component fail to improve contraceptive use or reduce pregnancy rates. Use of any contraceptive by teens is cost effective. The high rate of adolescent pregnancy in the US is primarily reflective of nonuse or misuse of contraception. Most research in the area of adolescent pregnancy prevention has focused on programmatic issues, with little consideration of the acceptability and impact of individual contraceptive methods in an adolescent population. As adolescent use of long-acting methods and condoms (either alone or in combination with hormonal methods) increases, the impact of method choice assumes greater significance and merits serious attention. At present, 45% of US contracepting adolescents 15-19 years of age rely on the pill, 38% use condoms, 10% select injectables, 3% use implants, 4% rely on withdrawal, and 1% practice periodic abstinence. This article reviews current and potential adolescent use patterns of the major contraceptive methods: emergency contraception, oral contraceptives, condoms, Depo-Provera, the IUD, and Norplant. The reviews points to a need for more research on the management of side effects associated with adolescents' use of hormonal contraception, interventions to improve compliance with condom and pill use, and strategies to reduce the impact of misinformation provided by family and peers on risks associated with hormonal contraceptive use. Most effective in preventing teen pregnancy are likely to be multicomponent programs that encompass education, psychosocial interventions, and contraceptive provision.
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