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Young teenagers starting their first sexual relationships may use oral contraception less efficiently than condoms for pregnancy prevention, with teenage girls who report using oral contraception (OC) at first intercourse more than twice as likely as condom users to report a pregnancy by the time they were surveyed at age 16.

Study suggests teenage girls risk pregnancy by using the pill rather than condoms as their first contraceptive

posted on: Jan 22, 2009

Young teenagers starting their first sexual relationships may use oral contraception less efficiently than condoms for pregnancy prevention, with teenage girls who report using oral contraception (OC) at first intercourse more than twice as likely as condom users to report a pregnancy by the time they were surveyed at age 16.

A paper led by Dr Alison Parkes and published in the January issue of Journal of Adolescent Health examined associations between contraceptive method at first intercourse and subsequent pregnancy risk, using survey data provided by 1,952 16 year-old girls in two sex education trials (SHARE and RIPPLE). One in ten girls reported a pregnancy by the time of the survey. Girls who did not use contraception (barrier or hormonal) at first intercourse were nearly three times more likely to report a pregnancy as those who used condoms. Girls who used OC at first intercourse were more than twice as likely to report a pregnancy as those who used condoms. Pregnancy risk for dual contraception (condom plus OC), and pregnancy risk for emergency contraception did not differ from use of condoms only.

The greater pregnancy risk associated with OC was partially explained by user characteristics that may reflect ambivalent attitudes towards pregnancy risk. Girls who used oral contraception were from more deprived family backgrounds, were more likely to have expectations of early childrearing and were more sexually active than their counterparts who used condoms. However even when these characteristics were accounted for, the association between use of oral contraception and pregnancy remained. This suggests that we need to look for additional explanations of ineffective use of oral contraception. Ineffective OC use could reflect dislike of side effects, difficulties over concealment, insufficient knowledge of correct use, or chaotic sexual lifestyle. Our findings support the need for counselling to ensure proper understanding of common side effects, good compliance, and what to do when a pill is missed.

 

Parkes, Alison; Wight, Daniel; Henderson, Marion; Stephenson, Judith; Strange, Vicki. Contraceptive Method at First Sexual Intercourse and Subsequent Pregnancy Risk: Findings from a Secondary Analysis of 16-Year-Old Girls from the RIPPLE and SHARE Studies. Journal of Adolescent Health 2009; 44:55-63.