Original Articles
Condom use by hispanic and african-american adolescent girls who use hormonal contraception

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Abstract

Purpose: The purpose of the present study was to examine condom use by teens who use hormonal contraceptives [i.e., Depo-Provera, Norplant, or oral contraceptives (OCs)].

Methods: This is a cross-sectional study of 578 Hispanic and African-American female adolescents between the ages of 12 and 21 years who came to a reproductive health care clinic. A paper-and-pencil questionnaire which addressed sexual behaviors, sexual history, and communication about sexuality was distributed to adolescent girls attending the clinic. Several important analyses included only those who had been sexually active in the last 4 weeks (n = 452).

Results: Adolescents who used OCs [odds ratio (OR) 1.7], long-acting agents (i.e., Depo-Provera or Norplant) (OR 1.6), were less likely to have used a condom in the last 4 weeks than teens whose only method of birth control was condoms. Only those teens who had previously been diagnosed with a sexually transmitted disease (STD) were more likely to have used a condom (OR .67 for not using a condom). Overall, condom use by teens in this sample was low, with only 19% reporting that they “always” use a condom, and 47% of the teens who had been sexually active in the last 4 weeks reporting that they had not used a condom at least once during that time.

Conclusions: This study provides data which suggest that adolescent girls who use hormonal contraceptives are less likely to use condoms than other sexually active teens. Therefore, when prescribing hormonal contraception to prevent pregnancy, clinicians must provide appropriate counseling to mitigate against the potential to increase the risk of STDs.

Section snippets

Subjects

A total of 616 adolescent and young adult women attending a clinic for young women in Northern Manhattan took part in the study. The present report discusses the 578 adolescents, from 12–21 years of age with a mean age of 18 years, who participated in the study. A description of the full cohort can be found elsewhere 29. The clinic is primarily a reproductive health clinic, and young women come almost exclusively for those services. Seventy-nine percent were Hispanic, 16% were African-American,

Sexual behaviors of the sample

The teens in this sample were sexually experienced. Over half (54%) reported that they had intercourse at least once a week, and 12% had intercourse every day. The majority of these teens have had multiple lifetime partners. Thirty-two percent have had four or more partners. (Table 1).

Factors associated with condom use

The multivariate logistic regression testing the effect of key variables on use of a condom at least once in the last 4 weeks was significant (Chi-square = 44; p < 0.001). Variables significantly associated with

Discussion

This study provides data which suggest that teenage girls who use hormonal contraceptives are less likely than other sexually active teens to use condoms. There was no difference in condom use between users of OCs and those who use long-acting agents. While few teens in this sample were consistent condom users, they were even less likely to use condoms if they were using OCs or long-acting agents.

Because long-acting agents have only recently come into widespread use in the United States, there

Acknowledgements

This research was supported by Sigma Theta Tau—The Lucie Kelly Small Grant Award.

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    Copyright © 1998 Society for Adolescent Medicine. Published by Elsevier Inc. All rights reserved.