Oral contraceptive use may not preclude condom use: a study of non-pregnant African-American adolescent females

Emergency Contraceptive Pill Use and its Impact on Condom Utilization Among University Students: A Cross-Sectional Study

Purpose

Emergency contraceptive pills (ECPs) prevent unplanned pregnancy but not sexually transmitted infections (STIs), and the practice of ECP may affect condom use. This study, therefore, aimed to assess ECP use and its impact on condom utilization among female students of private universities in Nekemte town, western Ethiopia.

Methods

An institution-based cross-sectional study was conducted on 400 female students in three different private universities from February 1 to 28, 2019. Study samples were selected through simple random sampling technique. Data collected from a structured self-administered questionnaire were analyzed using SPSS version 23.0. Bivariate and multivariate logistic regression were performed to determine factors associated with condom utilization, and statistical significance was set at 95% confidence interval (CI) using a p-value of <0.05 as a cutoff point.

Results

The response rate was 95.3% (381/400). Overall, 51.4% (196/381; 95% CI = 45.1%, 57.7%) had awareness of ECP. Besides, 186 (48.8%) students reported history of sexual intercourse, of which 115 (61.8%) have ever practiced ECP and 96 (51.6%) have ever used condom. However, only 11 (5.9%) have ever utilized ECP and condom concurrently. Use of ECPs (adjusted odds ratio (AOR) = 0.32; 95% CI = 0.164, 0.632; p = 0.001), belief that condom prevents STI (AOR = 3.17; 95% CI = 1.045, 8.646; p = 0.041) and thought that ECP does not prevent STI (AOR = 2.217; 95% CI = 1.172, 4.59; p = 0.032) had statistically significant association with condom utilization.

Conclusion

The practice of ECP was average, while dual method contraception use was low in the study area. History of ECP use and beliefs that ECP is not effective to prevent STI or condom protects against STI were factors associated with condom use.

Emergency Contraceptives: Knowledge and Practice towards Its Use among Ethiopian Female College Graduating Students

Introduction

Ethiopia has a high incidence of unwanted pregnancies and incomplete and unsafe abortions, particularly among adolescents. This can be avoided by using different contraceptive methods including emergency contraceptives (EC). This study aimed to assess the knowledge and practice of EC among female college graduating students in Harar, Eastern Ethiopia.

Methods

Institution based cross-sectional study was conducted on 214 female students selected from two randomly selected colleges. Data was collected using a self-administered questionnaire and analyzed using SPSS for Windows version 20.1. Level of significance was taken at P <0.05.

Results

The mean (±SD) age of the participants was 21.06 (±2.14) years. Of the 200 (93.5%) study participants who had ever heard of ECs, 140 (70.0%) had good knowledge. Among the 214 graduating female students, 66 (33.0%) had ever used EC. Being above the age of 20 years old, father's and mother's literacy were found to be determinants of knowledge of EC. Moreover, knowledge was the only determinant factor of practice of EC.

Conclusion

Most of the respondents had relatively good knowledge of EC. The study revealed that female students of older age and higher educational status of parents had higher knowledge and practice of EC.

Dual contraceptive use among adolescents and young adults: correlates and implications for condom use and sexually transmitted infection outcomes

BACKGROUND

Simultaneous condom and hormonal contraception usage ('dual method use') maximises protection against pregnancy and sexually transmitted infection (STI), although there is concern that promotion of this strategy could result in diminished condom use and inadvertently increase STI risk. In this study, we (1) assessed how the use of dual methods, versus condoms alone, related to STI and consistency of condom use and (2) described the correlates of dual use.

METHODS

A sample of 1450 young people aged 12-25 years were surveyed and screened for chlamydia and gonorrhoea at non-clinical sites in two high morbidity Californian counties in 2002-2003. Differences in STI prevalence and reported consistency of condom use were assessed for 'condom only' and 'dual method' users. Correlates of dual use were analysed via multivariate polytomous logistic regression.

RESULTS

Condom only and dual method users did not significantly differ in terms of STI prevalence or reported consistency of condom use. Sex, age, race and relationship tenure were significant correlates of dual use.

DISCUSSION

In these observational data, dual method use did not detrimentally affect STI risk. If interpreted alongside each subgroups' risk patterns for STI and unplanned pregnancy, the correlates of dual use can inform STI and pregnancy prevention interventions.

Oral contraceptives in adolescent women

Taking into account the biological and psychosocial changes during the transition from childhood to adulthood adolescents would need a contraceptive method which ideally would be very effective, independent of compliance, without major health risks during use and no negative impact on the future health of the adolescent, protective against STI, favorable for bone development, with no or only few side effects and having some preventive and therapeutic potential with respect to frequent health problems of adolescent girls. Combined oral contraceptives (COC) used regularly and consistently have a more than 99% efficacy to prevent a pregnancy. COCs have a very low health risk (almost exclusively thromboembolic disease) which seems to differ marginally with respect to dosage and type of the components. Progestogen only oral contraceptives do not have any major negative health impact. The leading side effect is irregular bleeding which in COC users is mainly during the first 3 months and in progestogen only users during the period of use. Other side effects are reported but their frequency is similar to placebo. COC protect against endometrial and ovarian cancer and they may have beneficial effects on a variety of menstrual complaints and acne, which are frequent problems during adolescence. To be effective COCs have to be taken regularly which is frequently not the case. This diminishes considerably their effectiveness depending on the individual compliance. They do not protect against STI and may even have an inhibitory effect on the use of condoms. For most adolescents the risk benefit profile of oral contraceptives is favorable and makes this method valuable. At the same time the prescription of oral contraceptives for adolescents need to be individualized by taking into account the individual risk/benefit profile. Specialized counseling with a high degree of confidentiality adapted to the knowledge and needs of the individual adolescent is desirable.

Adolescent condom use consistency over time: global versus partner-specific measures

BACKGROUND

The conundrum of measuring condom use consistency, particularly with adolescents, has left researchers with a cacophony of strategies, thereby limiting comparability and interpretation.

OBJECTIVE

The aim of this analysis was to compare and contrast two measures of condom use consistency, global versus partner specific, and their relationships with key covariates, using trajectory groups differentiated by stability of condom use consistency over three time points.

METHOD

Using self-report data from sexually active girls (aged 13-17 years) in a clinic-based intervention study aimed at lowering risk for early pregnancy, this analysis compared two measures of self-reported condom use consistency: (a) a global measure: overall condom use consistency in the past 6 months and (b) a partner-specific measure: condom use consistency with the most recent sex partner in the last 6 months. Using a subjective rule-based approach, the adolescent girls in the study (n = 151) were classified into trajectory groups representing their condom use consistency at three time points (baseline and 6 and 12 months). Then, using bivariate methods, trajectory groups were compared on four baseline covariates (age, treatment condition, hormonal use in the last 6 months, and number of sex partners in the last 6 months) and three time-varying covariates measured at baseline and at 6 and 12 months (hormonal use stability, stability of primary sex partner, and stability of number of sex partners).

RESULTS

For the trajectory groups formed using the global measure of condom use consistency, stability of the primary sex partner differed significantly between trajectory groups. For the partner-specific trajectory groups, two baseline and one time-varying covariate relationships were significant: hormonal use in the 6 months prior to baseline, number of sex partners in the past 6 months (baseline), and stability of the primary sex partner (time varying), with hormonal use stability (time varying) trending toward significance.

DISCUSSION

The larger number of significant covariate relationships with the partner-specific trajectory groups suggests greater utility in assessing partner-linked behavior rather than a global measure. Despite limitations of the analytic strategy, this study sheds light on a measurement conundrum that has been an obstacle to comparing and contrasting indicators of condom use consistency during adolescence.