Associations between religiosity and sexual and contraceptive behaviors

"An obedient wife never says "no" to her virtual god." High fertility conceptions and barriers to contraceptive use among mothers of Southern Pakistan: a qualitative study

ISSUE

Biomedical approaches want to change locals' behaviors without understanding the sociocultural rationales and contextualizing the cultural and structural backdrop of women's agency.

OBJECTIVES

This study explored the perceptions and practices of rural mothers about fertility and reproductive health and further examine the lack of preference for contraception and birth spacing in Southern Pakistan.

METHODOLOGY

Using purposive sampling we recruited 15 healthcare providers and 20 mothers from Southern Punjab. Key informants and in-depth interviews were used for data collection. We extracted themes and sub themes to analyse qualitative data.

FINDINGS

Five major themes identified preventing birth spacing and contraceptive use: (1) cultural barriers (2) economic difficulties and demographic factors; (3) gender-related hurdles; (4) spiritual and religious obstacles, and (5) medico-ethical complications. Nearly, ten sub-themes contributing to these major themes were: custom of girls' early marriages, in-laws' permission for contraception, women's concern for medical complications and preference for safer methods, misuse of contraceptive methods by the medical community, mothers' perception of contraception as sinful act and controlling birth is against faith, economic and rural-ethnic factors for high fertility, masculine disapproval of condom use, and wishing to give birth to male children.

SUGGESTIONS

We advocate for understanding the sociocultural explanations for low contraceptive use and urge practice of more natural methods of birth spacing over commercial solutions. The study suggests socio-economic development of less developed communities and empowerment of poor, illiterate, and rural women along with behavior change communication strategies.

An Analysis of the Impact of Religious Affiliation and Strength of Religiosity on Sexual Health Practices of Sexually Active Female College Students

Despite great strides in the development of contraceptive technologies, the United States has one of the highest teen pregnancy rates in the world. Religion and associated values may shape the sexual health behaviors of college students, as prior studies have aimed to determine how social factors may influence the use of contraception amongst college students. Thus, we sought to examine the differences in current contraceptive methods and the age of first contraceptive usage among sexually active female college students with different religious affiliations and strengths of religiosity. It was hypothesized that there would be no difference in current contraceptive methods among different religious affiliations and strengths of religions and that there would be a difference in the age of first contraceptive usage among different religious affiliations and strengths of religiosity. Two hundred and twenty-four college-aged females completed a 20-question survey about sexual health and religious practices. Chi-squared tests were implemented to determine the frequencies of responses across religious affiliations and strengths of religiosity. Significant differences in the frequency of responses for the age of first contraceptive usage were observed across different strengths of religiosity (p = 0.016) and for the self-perceived impact of religion on sexual health across different religious affiliations (p = 0.033) and strengths of religiosity (p = 0.005). All other differences were found not to be statistically significant. It was determined that increased strengths of religiosity resulted in delayed onset of contraceptive usage and that both different religious affiliations and greater strengths of religiosity lead to different self-perceived impacts of religion on sexual health despite low levels of current practice.

'The wife should do as her husband advises': Understanding factors influencing contraceptive use decision making among married Pakistani couples-Qualitative study

This paper explores the perceptions and attitudes of married couples which prevent them from using modern contraceptive for purpose of family planning, based on semi-structured interviews with 16 married couples from rural Pakistan. This study, with married couples, not using any modern contraceptives, discussed issues of spousal communication and religious norms using qualitative methods. Despite near universal knowledge of modern contraceptives among married Pakistani women, the use continues to be low, with high unmet need. Understanding the couple context about reproductive decision making, pregnancy and family planning intentions is imperative to helping individuals fulfil their reproductive desires. Married couples may have varying intentions and desires about family size; a lack of alignment between partners may lead to unintended pregnancies and affect uptake and use of contraception. This study specifically explored the factors which prevent married couples from using LARCs for family planning, despite their availability, at affordable prices in the study area of rural Islamabad, Pakistan. Findings show differences between concordant and discordant couples regarding desired family size, contraceptive communication and influence of religious beliefs. Understanding the role that male partners play in family planning and use of contraceptives is important in preventing unintended pregnancies and improving service delivery programmes. This study also helped identify the challenges married couples, particularly men have in understanding family planning and contraceptive use. The results also show that while men's participation in family planning decision making is limited, there is also a lack of programs and interventions for Pakistani men. The study findings can support development of appropriate strategies and implementation plans.

The Impact of Religious Participation and Religious Upbringing on the Sexual Behavior of Emerging Adults in the Southern United States

Emerging adults face a disproportionate burden of unintended pregnancies and sexually transmitted diseases, especially in the southern United States. This study investigates how multiple dimensions of current religiosity as well as religious upbringing influence the sexual behaviors, including contraceptive usage, of individuals 18-25 years old (n=211) in the South. Based on regression analyses, results suggest that emerging adults with higher levels of current religiosity are more likely to remain abstinent, but less likely to use pregnancy prevention methods, such as birth controls pills and long-acting reversible contraceptives. Having a religious upbringing is also associated with lower contraceptive usage. Through the assessment of multiple dimensions of religiosity and various sexual behaviors, this study presents a nuanced picture of the complex associations between religion and sexual health, specifically among emerging adults in the southern United States.

Religiosity and Sexual Initiation Among Hispanic Adolescents: The Role of Sexual Attitudes

Introduction: Religiosity and sexuality present numerous interconnections. Little is known regarding the specific causal pathways between each religiosity dimension and sexual behavior. The objectives of this study were (1) to explore the relationship between religiosity (measured through attendance at religious services, salience, and prayer) and sexual initiation in adolescents and (2) to establish the role of sexual permissiveness as mediator of the impact produced by religiosity in sexual initiation. Methods: This study analyzes data from an ongoing school-based international study examining what young people feel and think about relationships, love, and sexuality. An anonymous, self-administered online questionnaire was developed in Spanish. A total of 4,366 students, aged 14-18, completed the questionnaire. A final sample of 2,919 questionnaires was analyzed. Two unconditional logistic regression models were fit with religiosity variables and possible confounders as independent variables (with and without permissiveness, respectively). The dependent variable was sexual initiation. A final path analysis was performed to further understand the results. Results: Our study highlights that, in predominantly Catholic and Spanish-speaking countries, the fact of attending church and praying may greatly contribute to postponing sexual relations during adolescence, even independently of their attitudes on sexual permissiveness. Conversely, the effect of salience on sexual initiation seems to be fostered only through the mediation of sexual permissiveness. Our findings point to an indirect effect of the three religiosity dimensions (and in particular, religious salience) through permissive attitudes. Conclusion: Religiosity could be a relevant factor to explain sexual initiation during adolescence.

Awareness and Use of Contraceptive Methods and Perceptions of Long-Acting Reversible Contraception Among White and Non-White Women

Background: Unintended pregnancies continue to account for half of all pregnancies in the United States, primarily due to incorrect or inconsistent use of contraception methods. Long-acting reversible contraception (LARC) methods are safe and highly effective, yet underutilized. Low uptake of LARC may be due to inadequate education, misconceptions, and cultural factors such as race, ethnicity, or religion. This study examined racial differences in contraceptive awareness and use among women seeking care at family health centers. Materials and Methods: Focus groups were used to identify recurrent themes in contraceptive choice of participants and develop a survey, completed by nonpregnant female patients 18-45 years of age from seven family health centers. Results: Among a total of 465 participants, 210 (46.2%) of whom were non-white, awareness of most types of birth control was generally high. Awareness of all types of contraceptives was significantly higher among white than non-white women (p < 0.001). Across most types of contraceptives, use was significantly higher among white women than non-white women with the exception of injectable hormones which were used significantly more often by non-white women (46.0% vs. 28.5%; p < 0.001). Reasons for using LARC did not vary by type nor by race but reasons for not using LARC varied by race and by specific method. Conclusions: Differing patterns of awareness, use, and perceptions of contraceptive methods between white and non-white women were revealed. By understanding factors that influence contraceptive awareness, use, and perceptions, clinicians can better address the contraceptive needs and concerns of their female patients. Clinical Trial # NCT03486743.

Prospective Associations Among Youth Religiosity and Religious Denomination and Youth Contraception Use

This study prospectively investigates associations among youth religiosity, religious denomination, and contraception use. Associations between youth religiosity and religious denomination, and type of contraceptive used and consistent contraceptive use among sexually active youth (N = 757) were analyzed using multinomial and binomial logistic regression. Identifying with a religious denomination was a predictor of dual contraceptive use relative to using no method of contraception (AOR = 2.17). There was no association between youth religiosity and type of contraceptive use or contraceptive consistency. Religious leaders and public health practitioners should collaborate to develop strategies to engage in conversations with sexually active youth about contraceptive use.

Messages About Contraception and Condoms in Mother-Adolescent Dyadic Conversations: Knowledge, Risks, and Effectiveness

STUDY OBJECTIVE

Little is known about the content of parental discussions with young adolescents about reproductive health topics. We sought to characterize the messages mothers share about contraception and condoms.

DESIGN

Recruitment occurred between January 2012 and May 2013. Mothers and their 12- to 14-year-old adolescent son or daughter were invited to participate in a semistructured conversation about everyday issues and health topics, including reproductive health topics. Discussions were audio-recorded, transcribed, and a grounded theory approach to content analysis was performed. Content analysis was performed to characterize maternal messages regarding contraception and condoms.

SETTING

Urban city in western Pennsylvania.

PARTICIPANTS

Twenty-five dyads; 14 mother-daughter dyads and 11 mother-son dyads.

INTERVENTIONS

None.

MAIN OUTCOME MEASURES

Maternal reproductive health messages during conversations with early adolescent children.

RESULTS

Four key themes emerged. Theme 1 focused on general facts about condoms and contraceptive methods, how each works, and how to obtain them. Theme 2 emphasized the consequences of sexual behaviors and the advantages of safe sex. Theme 3 conveyed the effectiveness of condoms and contraceptive methods for preventing pregnancy and sexually transmitted infections. Theme 4 described where adolescents could get more information about condoms and contraception.

CONCLUSION

Mothers convey a broad range of information about contraceptives and condoms to young adolescents.

Intrinsic Religiosity and Health Risk Behaviours Among Black University Students in Limpopo, South Africa

Not much is known about religiosity's protective role against health risk behaviour in the South African context. As such, the study investigated the relationship between intrinsic religiosity and health risk behaviours in a sample of Black university students (N = 335). Two-way ANOVA showed that there were intrinsic religiosity main effects for alcohol use and sexual behaviour, gender and intrinsic religiosity main effects on tobacco and marijuana use, and gender main effects and gender and intrinsic religiosity interaction effects for engagement in physical activity. Thus, religiosity is an inner resource available to avert engagement in varied health risk behaviours.

Multidimensional Profiles of Religiosity Among Adolescents: Associations With Sexual Behaviors and Romantic Relationships

Religiosity is associated with sexual behavior in adolescence; however, religiosity is a multidimensional construct, and it is not clear how different patterns of religiosity may differentially predict sexual behaviors and romantic relationships. We apply latent class analysis to nationally representative data from the National Longitudinal Study of Adolescent to Adult Health (Add Health; N = 10,149) to examine (1) what religiosity profiles exist among adolescents and (2) how they predict sexual behavior and romantic relationship status in adolescence and young adulthood. Religiosity in multiple domains was associated with lesser odds of sexual behavior compared to profiles marked by only affiliation, private, or public religiosity. Findings suggest that examining multiple facets of religiosity together is important for understanding how religiosity is associated with sexual behavior.

Factors associated with family, school and behavioral characteristics on sexual initiation: A gender analysis for Brazilian adolescents

Adolescence is a period of transition between childhood and adulthood. The article aims to study the individual, family and school characteristics of adolescents beginning their sexual lives. The database we used was the 2015 PeNSE (National Adolescent School-based Health Survey) and the methodology was the survival analysis. The results show that boys initiate sexual activity before girls and risky behaviors associated with the use of licit and illicit drugs increase the chance of having early sex. In addition, this work highlights the importance of parental practices in reducing the chances of beginning sexual activity, as well as the presence of school workshops on the risks of pregnancy. It should be noted that intervention strategies need to be differentiated according to gender in order to increase effectiveness.

What's Religion Got to Do with It? Exploring College Students' Sexual and Reproductive Health Knowledge and Awareness of Sexual and Reproductive Health Services in Relation to Their Gender and Religiosity

The purpose of this study was to examine the relationship between religiosity and sexual and reproductive health (SRH) knowledge and awareness of campus SRH services among college students on a racially and ethnically diverse college campus. The sample included 996 undergraduate students at a large public university in California. For women, there was a consistent pattern across religious affiliations of more frequent attenders reporting lower SRH knowledge than less frequent attenders. These findings suggest that higher rates of religious attendance among Catholic, Protestant, and Evangelical women pose a risk for lower SRH knowledge. The results suggest the need for SRH outreach and educational materials targeting men in general, who had lower levels of SRH knowledge and awareness of SRH services overall, and taking religiosity into account, particularly with regard to women.

Messages About Abstinence, Delaying Sexual Debut and Sexual Decision-Making in Conversations Between Mothers and Young Adolescents

STUDY OBJECTIVE

Little is known about the information shared during family discussions about sexuality. From a public health perspective, abstinence is one of the most important sexuality topics parents can talk about with adolescents. We sought to characterize the messages mothers communicate to young adolescents regarding abstinence.

DESIGN

Content analysis of dyadic discussions that occurred between June 2011-December 2012 between mothers and their 10- to 14-year-old adolescent sons and daughters. Discussions were audio-recorded, transcribed, and a grounded theory approach to content analysis performed.

SETTING

Urban city in Western Pennsylvania.

PARTICIPANTS

Twenty-one dyads; 15 mother-daughter dyads and 6 mother-son dyads.

INTERVENTIONS

None.

MAIN OUTCOME MEASURES

None.

RESULTS

Four key themes emerged reflecting the high priority mothers placed on abstinence, delaying their adolescent's sexual debut, and nurturing sexual decision-making skills. Theme 1 focused on ensuring that adolescents understand what abstinence means. In defining abstinence, only 1 mother explained what sex is. The 3 remaining themes emphasized sexual decision-making and emphasized when it is acceptable to stop being abstinent (theme 2), why abstinence is important (theme 3), and mothers' desire to engage in ongoing discussions, particularly when an adolescent was considering becoming sexually active (theme 4). Messages did not vary according to mothers' age or according to adolescent age, gender, or race.

CONCLUSION

Mothers convey complex information about abstinence and sexual decision-making to young, non-sexually active adolescents. Message tailoring on the basis of the adolescents' age or sex was not observed.

Role of Religion in Preventing Youth Sexual Activity in Malaysia: A Mixed Methods Study

One of the popular approaches of preventing youth sexual activity in Malaysia is using religion to promote premarital sexual abstinence. Despite this intervention, youth continue to practise premarital sex. Thus, the purpose of this exploratory mixed methods study was to understand the role of religion on sexual activity among college students in Klang Valley, Malaysia. A self-administered questionnaire survey to determine the relationship between religiosity and youth sexual activity was carried out on 1026 students recruited from 12 randomly selected colleges. Concurrently, face-to-face interviews were conducted on 15 students to explore how religiosity had influenced their decision on sexual activity. The survey data were analysed using logistic regression, while the qualitative data from the interviews were examined using thematic analysis with separate analysis for each gender. Both quantitative and qualitative results were then compared and integrated. Religious activity significantly reduced the risk of continuing sexual activity among female students (AOR = 0.67, CI = 0.47, 0.95, p = 0.02) but not male students. There was no significant relationship of religious affiliation and intrinsic religiosity (inner faith) to sexual activity by gender. Having faith in religion and strong sexual desire were the main themes that explained participants' sexual behaviour. Engaging in religious activity might be effective at preventing female students from being sexually active. However, when sexual urges and desires are beyond control, religiosity might not be effective.

Sense of Mission and Sexual Health Outcomes Among Young Adult Women

STUDY OBJECTIVE

To examine the association between self-reported sense of mission and sexual health behaviors in a geographically diverse cohort of U.S. young adult females in the Growing Up Today Study (GUTS).

DESIGN

We conducted a cross-sectional analysis of the 2007 wave of GUTS data from self-reported online or mailed surveys. Outcomes were early sex initiation and history of sexually transmitted infection (STI), which were analyzed as a binary outcome using logit link, and number of sex partners, which was analyzed as a continuous outcome. Models for number of sex partners and history of STIs were adjusted for age.

PARTICIPANTS

There were 5,624 young women aged 20 to 25 years who participate in GUTS and who answered the question on "sense of mission."

MAIN OUTCOME MEASURES

Age at sexual initiation, history of STIs, and number of lifetime partners.

RESULTS

When asked whether they had a sense of mission in their life, 28.1% of women strongly agreed, 54.9% agreed, and 17% disagreed. Women with a low sense of mission had higher odds of reporting a history of STI (odds ratio 1.35, 95% confidence interval 1.08 to 1.70), and more lifetime sexual partners (β = .83, P < .001).

CONCLUSIONS

Having a high sense of mission is associated with lower sexual risk in young women. Interventions to increase sense of mission among young women may improve sexual health outcomes.

Religiosity and Health Risk Behaviour Among University Students in 26 Low, Middle and High Income Countries

The aim of this study was to assess religiosity and health risk behaviours among university students from 26 low, middle and high income countries. Using anonymous questionnaires, data were collected from 20,222 undergraduate university students (mean age 20.8, SD = 2. 8) from 27 universities in 26 countries across Asia, Africa and the Americas. Among all students, 41.1 % engaged at least once a week in organized religious activity, 35.8 % practised a non-organized religious activity daily or more than once daily, and more or less two-thirds of the students agreed to the three different statements on intrinsic of subjective religiosity. In multivariate logistic regression analysis, higher reported involvement in organized religious activity was associated with addictive, injury, sexual and oral health risk behaviour, while lower reported involvement in organized religious activity was associated with physical inactivity and oral health risk behaviour. Lower reported involvement in non-organized religious activity was associated with addictive, nutrition risk, injury, sexual and oral health risk behaviour, while higher reported involvement in non-organized religious activity was associated with physical inactivity. Finally, lower reported intrinsic religiosity was associated with addictive and sexual risk behaviour, while higher reported intrinsic religiosity was associated with nutrition risk behaviour, physical inactivity and oral health risk behaviour.

What Matters: Quantity or Quality of Pornography Use? Psychological and Behavioral Factors of Seeking Treatment for Problematic Pornography Use

INTRODUCTION

Pornography has become popular with Internet technology. For most people, pornography use (PU) is entertainment; for some, it can result in seeking treatment for out-of-control behavior. Previous studies have suggested that PU can influence sexual behaviors, but the direct relation between frequency of PU and treatment-seeking behaviors has not been examined.

AIMS

To investigate whether individuals seeking treatment as a consequence of their problematic PU do so because of their quantity of pornography consumption or because of more complex psychological and behavioral factors related to PU, such as the severity of negative symptoms associated with PU and/or subjective feeling of loss of control over one's behavior.

METHODS

A survey study was conducted of 569 heterosexual Caucasian men 18 to 68 years old, including 132 seeking treatment for problematic PU (referred by psychotherapists after their initial visit).

MAIN OUTCOMES MEASURES

The main outcome measures were self-reported PU, its negative symptoms, and actual treatment-seeking behavior.

RESULTS

We tested models explaining sources of seeking treatment for problematic PU with negative symptoms associated with PU and additional factors (eg, onset and number of years of PU, religiosity, age, dyadic sexual activity, and relationship status). Seeking treatment was significantly, yet weakly, correlated solely with the frequency of PU (r = 0.21, P < .05) and this relation was significantly mediated by negative symptoms associated with PU (strong, nearly full mediation effect size; k(2) = 0.266). The relation between PU and negative symptoms was significant and mediated by self-reported subjective religiosity (weak, partial mediation; k(2) = 0.066) in those not seeking treatment. Onset of PU and age appeared to be insignificant. Our model was fairly fitted (comparative fit index = 0.989; root mean square error of approximation = 0.06; standardized root mean square residual = 0.035) and explained 43% of the variance in treatment-seeking behavior (1% was explained by frequency of PU and 42% was explained by negative symptoms associated with PU).

CONCLUSION

Negative symptoms associated with PU more strongly predict seeking treatment than mere quantity of pornography consumption. Thus, treatment of problematic PU should address qualitative factors, rather than merely mitigating the frequency of the behavior, because frequency of PU might not be a core issue for all patients. Future diagnostic criteria for problematic PU should consider the complexity of this issue.

A Randomized Controlled Trial to Compare Computer-assisted Motivational Intervention with Didactic Educational Counseling to Reduce Unprotected Sex in Female Adolescents

STUDY OBJECTIVE

To examine a computer-assisted, counselor-guided motivational intervention (CAMI) aimed at reducing the risk of unprotected sexual intercourse. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: We conducted a 9-month, longitudinal randomized controlled trial with a multisite recruitment strategy including clinic, university, and social referrals, and compared the CAMI with didactic educational counseling in 572 female adolescents with a mean age of 17 years (SD = 2.2 years; range = 13-21 years; 59% African American) who were at risk for pregnancy and sexually transmitted diseases. The primary outcome was the acceptability of the CAMI according to self-reported rating scales. The secondary outcome was the reduction of pregnancy and sexually transmitted disease risk using a 9-month, self-report timeline follow-back calendar of unprotected sex.

RESULTS

The CAMI was rated easy to use. Compared with the didactic educational counseling, there was a significant effect of the intervention which suggested that the CAMI helped reduce unprotected sex among participants who completed the study. However, because of the high attrition rate, the intent to treat analysis did not demonstrate a significant effect of the CAMI on reducing the rate of unprotected sex.

CONCLUSION

Among those who completed the intervention, the CAMI reduced unprotected sex among an at-risk, predominantly minority sample of female adolescents. Modification of the CAMI to address methodological issues that contributed to a high drop-out rate are needed to make the intervention more acceptable and feasible for use among sexually active predominantly minority, at-risk, female adolescents.

An integrative research review of instruments measuring religious involvement: implications for nursing research with African Americans

BACKGROUND AND PURPOSE

Many instruments in which religious involvement is measured often (a) contain unclear, poorly developed constructs; (b) lack methodological rigor in scale development; and (c) contain language and content culturally incongruent with the religious experiences of diverse ethnic groups. The primary aims of this review were to (a) synthesize the research on instruments designed to measure religious involvement, (b) evaluate the methodological quality of instruments that measure religious involvement, and (c) examine these instruments for conceptual congruency with African American religious involvement.

METHODS

An updated integrative research review method guided the process (Whittemore & Knafl, 2005).

RESULTS

152 articles were reviewed and 23 articles retrieved. Only 3 retained instruments were developed under methodologically rigorous conditions. All 3 instruments were congruent with a conceptual model of African American religious involvement.

CONCLUSIONS

The Fetzer Multidimensional Measure of Religious Involvement and Spirituality (FMMRS; Idler et al., 2003) was found to have favorable characteristics. Further examination and psychometric testing is warranted to determine its acceptability, readability, and cultural sensitivity in an African American population.

Religion and Sex Among College Freshmen

The purpose of this study was to use the social networking site Facebook to explore the relationship between religion and sex in emerging adults. Public profiles were examined at four Time points during freshman year. One hundred fifty profiles were analyzed for self-displayed religious affiliation, references to religiosity, and references to sexual behavior. Analyses included mixed-effects logistic regression, mixed-effects Poisson regression, and nonparametric Kruskal-Wallis test. Displayed religious affiliation and references to sexual behavior decreased over the year. References to religiosity slightly increased. Across all Time points, displayers of religiosity had 65% fewer sexual references compared with non-displayers. Facebook is a venue to evaluate how emerging adults are displaying the relationship between religion and sex over time.

Lower use of sexual and reproductive health services among women with frequent religious participation, regardless of sexual experience

PURPOSE

To investigate associations between religious characteristics and sexual and reproductive health (SRH) service use among young women in the United States.

METHODS

We combined two cycles of data from the U.S. population-based reproductive health survey, The National Survey of Family Growth (2002 and 2006-2008). Our analysis was restricted to young women aged 15-24 years (n=4421). We tested relationships between religious characteristics, including religious affiliation, service participation, and importance of religion in daily life, and use of SRH services for contraception, sexually transmitted infection (STI) testing/treatment, and routine gynecologic examination care within the last year.

RESULTS

Nearly all young women identified a current religious affiliation (82%), with 46% identifying Protestant and 28% Catholic. Three quarters (75%) of young women reported current religious service participation, the majority of whom had experienced sexual intercourse (70%); 31% reported weekly religious service participation. Over half (59%) had used SRH services recently. In unadjusted analyses, young women with current religious affiliation who participated in services weekly and deemed religion important had lower proportions of SRH service use than their counterparts (all p<0.001). In multivariate regression models, young women with less-than-weekly religious service participation were 50% more likely to use services than those participating weekly (odds ratio [OR] 1.5, confidence interval [CI] 1.3, 2.1, p<0.001), even among sexually experienced women.

CONCLUSIONS

Increasing frequency of current religious service participation was negatively associated with SRH service use among young women, despite sexual experience. Religiously and sexually active young women in the United States may have an unmet need for SRH care.