Contraceptive choice for young people

R.E. Say, D. Mansour

Newcastle Contraception and Sexual Health Service, Newcastle upon Tyne, UK

Introduction: Clinicians suggest that use of long-acting contraceptive methods such as Evra the contraceptive patch, NuvaRing the contraceptive vaginal ring and Implanon the contraceptive implant may help reduce teenage pregnancy rates. However, little is known about young people’s attitudes towards these methods or about how their personal experience may affect them.

Objectives: The aim of this study was to compare contraceptive use, experience of contraceptive failures and knowledge of and attitude towards long-acting contraceptives between a group of young people attending young people’s contraception and sexual health clinics and young people at school who were not necessarily sexually active in order to contribute towards the improved understanding of the choices which young people make about contraception. Design and Methods: A cross sectional survey was carried out using a self-completion questionnaire developed for this study. Participants were a self-selecting sample of young people attending three young people’s contraception and sexual health clinics; a school health drop-in or a Year 10 (age 14–15) Personal and Social Education class. Statistical analysis was carried out using appropriate univariate tests.

Results: There were 129 participants in the clinic group and 24 in the school group. The clinic group was older than the School Group. Condoms were the most commonly used method of contraception in both groups. Of pill users approximately 50% had missed at least one pill in the last month. Over half the clinic group had experienced a pregnancy scare and 8.6% had experienced an unplanned pregnancy; 16.7% of the school group had experienced a pregnancy scare but none had experienced an unplanned pregnancy. The majority of participants in both groups had no prior knowledge of Evra, NuvaRing or Implanon. Approximately one third of participants in both groups indicated that they would wish to use Evra; five percent of the clinic group and none of the school group that they would wish to use NuvaRing and approximately one quarter of the clinic group and one eighth of the school group that they would use Implanon. Participants in the clinic group were more likely to wish to use NuvaRing and Implanon than the school group but the proportion of participants who stated they would wish to use Evra was approximately the same for both groups.

Conclusions: Young people’s use of and attitude towards contraception is variable. Awareness of this variability and recognition that attitudes may change with experience will be important for health professionals in assisting young people in making informed decisions about contraception.