6 CONTRACEPTIVE COMPLIANCE IN THE PRIVATE SECTOR

Abstract

Erratic contraceptive usage is a major factor in teenage pregnancy. Many studies have addressed the predictors of non-compliance in the use of oral contraceptives in adolescent clinics. This study was designed to focus on the previously ignored private sector, examining their contraceptive behaviors and predictors of their compliance. Patients from a suburban private practice of adolescent medicine were compared to the adolescent clinic population of The Children's Hospital. Profiles commonly associated with contraceptive compliance were recorded at the initial and return visits. Study subjects were randomly assigned to 2 groups receiving either simplified or detailed instructions on pill usage and management of bleeding and amenorrhea. All patients were provided 3 packs of Norinyl 1+35 and scheduled for a 3 month return visit. 51 private and 60 clinic patients (15–22 yrs) were studied. Of the private patients 42 made their own appointments, 29 without parental knowledge; 77% were sexually active before first-visit, 30% having never used contraception. 82% of private and 47% of clinic patients returned at 3 months. Prior completion of a course of antibiotics did not predict O.C. compliance. The type of instruction (simplified vs. detailed) did not affect pill usage (p=.10). The many epidemiologic factors associated with receiving health care in the private sector were major determinants of compliance (p<.001).