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Differences in Adolescent Effective Contraception Use between Population Densities

Undesired pregnancy is a particular problem in the adolescent population. Close to 90% of the pregnancies in this population are unintended and account for significant economic and health burdens. Studies addressing effective contraceptive use by population density are lacking. In this paper, the authors hypothesize that contraception counseling and effective contraception use varied by population density. 

This was a cross-sectional study using the 2006-2010 National Survey of Family Growth data, including female subjects aged 15 to 19. The primary exposure was population density, defined as Principal city of a Metropolitan Statistical Area (MSA) or “city”, Other MSA or “non-city urban”, and Not MSA or “rural.” The primary outcome was effective contraception use and the secondary outcome was contraceptive counseling exposure. Multivariate analysis using logistic regression was performed to estimate the association between population density and effective contraception use, as well as the likelihood of receiving contraceptive counseling. 

There were 2284 females aged 15 - 19 included for analysis, with a mean age of 17. Compared to non-city urban dwellers, city adolescents had similar effective contraception use (aOR: 0.99, [0.79, 1.24]), whereas rural adolescents had significantly higher use (aOR: 1.79, [1.35, 2.36]). Among sexually active respondents who were not using contraception, the rate of contraception counseling in non-city urban adolescents was 66.7%. In comparison, the city dwellers had higher rate of counseling (79.1%, aOR: 1.87; 95% CI: [1.09, 3.22]). Similarly, rural adolescents also had higher rate of counseling (81.5%, aOR: 2.37; 95% CI: [1.08, 5.19]). 

In short, rural residents were more likely to use effective contraception methods than their city and non-city urban counterparts. However, higher rates of contraception counseling among sexually active adolescents not using contraception in city and rural densities could suggest ineffective counseling in these groups. So there are differences in contraceptive use between rural and urban adolescents which warrant further study. And more studies are needed to understand how to more effectively increase contraception knowledge across all populations, for an ever-changing group of adolescents.


Article by Tess M. Crouss, et al, from USA.

Full access: http://mrw.so/4z781j

Image by babyhow, from Flickr-cc.

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