Communication about contraception and knowledge of oral contraceptives amongst Norwegian high school students

How have changes in accessibility and public funding influenced contraceptive use among Norwegian adolescents? A cohort study

INTRODUCTION

The Norwegian Government introduced in 2002 a reimbursement scheme for hormonal contraceptives to adolescents at the same time as public health nurses and midwives received authorization to prescribe hormonal contraceptives. This study examines the impact of increased accessibility and public funding on hormonal contraceptive use among adolescents.

MATERIAL AND METHODS

The Norwegian Prescription Database, Statistics Norway, and Norwegian Institute of Public Health served as data sources for this cohort study. The study population comprised 174 653 Norwegian women born 1989-1990, 1994-1995, and 1999-2000. We examined use of hormonal contraceptives through dispensed prescriptions from age 12 through age 19 with duration of first continuous use as primary outcome. The statistical analyses were done in SPSS using chi-squared test, survival analysis, and Joinpoint regression analysis with p-values < 0.05.

RESULTS

By age 19, ~75% of the cohorts had used at least one hormonal method. The main providers of the first prescription were general practitioners and public health nurses. Starters of progestogen-only pills (POPs) have increased across the cohorts, while starters of combined oral contraceptives (COCs) have decreased. The use of long-acting reversible contraceptives (LARCs) has increased since its inclusion in the reimbursement scheme (2015). Most switchers shifted from COCs or POPs as a start method to implants after LARCs became part of the reimbursement scheme. There has been a significant increase across the cohorts in the number of women who continuously used hormonal contraceptives from start to the end of the calendar year they became 19 years with the same method and after switching methods. We could not correlate changes in decreasing trends for teenage births or induced abortions (Joinpoint analysis) to time for implementation or changes in the reimbursement of hormonal contraceptives from 2002.

CONCLUSIONS

Primarily public health nurses and to a lesser extent midwives became soon after they received authorization to prescribe COCs important providers. The expansion of the reimbursement scheme to cover POPs, patches, vaginal ring, and depot medroxyprogesterone acetate in 2006 had minor impact on increasing the proportion of long-term first-time users. However, the inclusion of LARCs in 2015 significantly increased the proportion of long-term first-time hormonal contraceptive users.

Sexual understanding, sources of information and social networks; the reports of young people with intellectual disabilities and their non-disabled peers

BACKGROUND

Sexual development plays a vital part in young people's emotional adjustment.

METHOD

This study compared the sexual understanding of 30 adolescents with mild intellectual disabilities (ID) and 30 non-disabled adolescents, along with their reports of where they obtained sexual information, and the nature of their social networks and support.

RESULTS

As expected, the non-disabled young people had superior levels of knowledge. However, an interaction was found between group and gender. The non-disabled young women had a better grasp of sexual matters than men, whereas the opposite was the case for those with ID. The non-disabled young people reported more formal and informal sources of sexual information and described larger social networks than those with ID.

CONCLUSIONS

These findings highlight the need to tackle the barriers to sexual knowledge faced by young people with ID, and the need to take account of the broader social context of their lives when doing so. This includes the attitudes to the developing sexuality of young women with ID in particular.

Predicting Willingness to Engage in Unsafe Sex and Intention to Perform Sexual Protective Behaviors Among Adolescents

This article examines the sociocognitive processes contributing to intention to use contraception and willingness to engage in unsafe sex, using extended versions of the theory of planned behavior (TPB) and the Prototype/Willingness model (Gibbons & Gerrard, 1995, 1997). Data were obtained from a questionnaire delivered to all the pupils in ninth grade ( N = 196) at three schools in Oslo. Hierarchical multiple regression analysis was used to predict intention and willingness. The results showed that subjective norm was the most important predictor of intentions for girls, whereas moral norm was most important for boys' intentions and willingness. Prototypes were the most important predictor for girls' willingness. Implications of the findings are discussed.