Condom use drops when young women use hormonal contraceptives

ScienceDaily (Oct. 12, 2012) — Young women who start using hormonal contraceptives for birth control often stop using condoms, but a new study in the Journal of Adolescent Health finds that if they later discontinue using hormonal contraceptives, they tend not to resume using condoms. This leaves them open to both unintended pregnancy and sexually transmitted infections (STIs).

The prospective year-long study included 1,194 sexually active women aged 15 to 24 visiting Planned Parenthood clinics and who were starting on contraceptive pills, patches, injections, or vaginal rings and not planning a pregnancy within the year. The researchers collected data on the young women's beliefs toward condom use and their knowledge of their partners' beliefs toward condoms.

At the beginning of the study, 36 percent of the young women used condoms consistently. Condom use dropped to 27 percent by 3 months later. Over the year, some women discontinued using hormonal contraception. More than half did not resume using condoms after they stopped using other contraception, according to Rachel Goldstein, M.D., of Stanford University School of Medicine and lead author of the study.

Using condoms together with other contraception (dual method use) decreases both the risk of pregnancy and sexually transmitted infections. The single largest predictor of using condoms and other contraception is the attitude of the woman's partner toward condoms, Goldstein noted. Women who said their partner thought condoms were "very important" or did not know how their partners felt about condom use were more likely to be dual method users than women who said their partner thought condoms were "not at all important."

"It appears that her partner's feelings may be more important than her perceived risk of a sexually transmitted infection or her own beliefs about dual method use," said Goldstein. This finding underscores the fact that a woman's decisions about contraception and preventing STIs may depend on factors over which she has little control. "Although a woman feels like she is at risk for an STI, she may not be able to advocate for herself and successfully negotiate condom use with her partner," Goldstein explained. Because a lapse in hormonal contraceptives may lead to unintended pregnancy, it may be better practice to advise young women to use longer-acting reversible contraceptives, such as implants or IUDs, and about the importance of condoms in preventing STIs, she recommended.

The study did not look at the use of hormonal implants or IUDs, also noted Mark Nichols, M.D., professor of obstetrics and gynecology at Oregon Health and Science University in Portland. IUDS, which protect against pregnancy for several years, are an increasingly popular and highly recommended choice for women who are starting contraception now. Furthermore, although the study concluded that more counseling was needed, it did not describe the kind of counseling the women received either when they started hormonal contraception or at later clinic visits, he added.

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The above story is reprinted from materials provided by Health Behavior News Service, part of the Center for Advancing Health.

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Journal Reference:

Rachel L. Goldstein, Ushma D. Upadhyay, Tina R. Raine. With Pills, Patches, Rings, and Shots: Who Still Uses Condoms? A Longitudinal Cohort Study. Journal of Adolescent Health, 2012; DOI: 10.1016/j.jadohealth.2012.08.001

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

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Social Media Could Boost Condom Use, Study Suggests

THURSDAY, Oct. 11 (HealthDay News) -- Social media can be used to help convince young adults to use condoms to prevent sexually transmitted diseases, a new study finds.

Researchers enrolled online networks of friends who were randomly assigned to an intervention group or a "control" group.

The 942 participants in the intervention group signed up to "like" and receive news from Just/Us, a Facebook community created to promote sexual health. The site featured weekly discussions about topics such as condom use, talking with partners about sexual history, and how to get tested for sexually transmitted diseases. In addition, there were daily updates in the form of video links, quizzes, blogs and discussion threads.

The 636 people in the control group, called 18-24 News, shared general news of interest to 18- to 24-year-olds.

Two months after taking part in the social networking groups, 68 percent of those in the Just/Us group reported using a condom the last time they had sex, compared with 56 percent of those in the 18-24 News group. The rate of condom use during sex in the previous two months was 63 percent in the Just/Us group and 57 percent in the 18-24 News group, the investigators found.

However, the effects seen in the Just/Us group faded over time and there were no differences between the two groups at the six-month follow-up, according to the report published in the November issue of the American Journal of Preventive Medicine.

"The use of social media to influence sexual risk behavior in the short term is novel. It is a first step in considering how to reach the overwhelming numbers of youth online, and how to maximize approaches to technology-based interventions," lead investigator Sheana Bull, of the Colorado School of Public Health's University of Colorado Anschutz Medical Campus, said in a journal news release.

The author of an accompanying commentary, Dr. Nathan Cobb, from the Schroeder Institute for Tobacco Research and Policy Studies at the American Legacy Foundation in Washington D.C., agreed that this use of social media was a step in the right direction. "For health-behavior change intervention designers, Facebook offers something unprecedented -- direct access to an individual's social network, in real time, and without the need for tedious network enumeration by participants," he wrote.

"However, such approaches require multidisciplinary teams that include social media specialists, marketers, and software developers as equal partners in design and intervention development. Building such teams will undoubtedly require changes to traditional funding and development models, but the potential is too large to be ignored or minimized," Cobb added.

-- Robert Preidt Copyright © 2012 HealthDay. All rights reserved. SOURCE: American Journal of Preventive Medicine, news release, Oct. 9, 2012

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