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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