Young Adults' Contraceptive Knowledge, Norms and Attitudes: Associations with Risk Of Unintended Pregnancy

TLDR

Women aged 18–29 experience the highest rates of unintended pregnancy among all age groups. The study aims to identify characteristics linked to risky contraceptive practices in this demographic to inform strategies that reduce unintended pregnancy risk. Using telephone surveys of 1,800 unmarried adults aged 18–29 in 2009, the authors applied multiple logistic regression to examine how contraceptive knowledge, norms, and attitudes relate to risky behaviors. Results show that over half of young men and a quarter of young women scored poorly on contraceptive knowledge, 60 % underestimated oral contraceptive effectiveness, and each correct knowledge item lowered the odds of anticipating unprotected sex by 9 % while raising hormonal/long‑acting method use by 17 % and reducing no‑method use by 17 %; fear of side effects, permissive norms, pregnancy ambivalence, and mistrust of government were also linked to risky use, underscoring the need for knowledge‑enhancing programs.

Abstract

CONTEXT: Women aged 18–29 have higher rates of unintended pregnancy than any other age‐group. Information is needed to understand what characteristics are associated with risky contraceptive use practices among this population and to develop new strategies for reducing these women's risk of unintended pregnancy. METHODS: Data related to unintended pregnancy risk were collected from a nationally representative sample of 1,800 unmarried women and men aged 18–29 surveyed by telephone in 2009. Among those at risk of unintended pregnancy, multiple logistic regression was used to assess associations between contraceptive knowledge, norms and attitudes and selected risky contraceptive behaviors. RESULTS: More than half of young men and a quarter of young women received low scores on contraceptive knowledge, and six in 10 underestimated the effectiveness of oral contraceptives. Among women, for each correct response on a contraceptive knowledge scale, the odds of expecting to have unprotected sex in the next three months decreased by 9%, of currently using a hormonal or long‐acting reversible method increased by 17%, and of using no method decreased by 17%. Fear of side effects, norms and attitudes that favor nonmarital pregnancy or undervalue the importance of contraception, pregnancy ambivalence and mistrust of government's role in promoting contraception were also associated with one or more risky contraceptive use behaviors. CONCLUSIONS: Programs to increase young adults’ knowledge about contraceptive methods and use are urgently needed. Given the demonstrated link between method knowledge and contraceptive behaviors, such programs may be useful in addressing risky behavior in this population.