Race, adolescent contraceptive choice, and pregnancy at presentation to a family planning clinic

Abstract

Abstract OBJECTIVE: To assess racial/ethnic differences in pregnancy and contraceptive choice among adolescent family planning patients. METHODS: The charts of 605 female adolescents presenting to a teen family planning clinic for an initial visit were retrospectively reviewed for demographic and reproductive health information, sexual risk behaviors, pregnancy, and current and dispensed contraceptive method. Logistic and multinomial logistic regression analysis were used to estimate the association of these factors with pregnancy and contraceptive choice. RESULTS: Black adolescents were three times more likely than white adolescents to be pregnant at presentation to the clinic ( P = .05). Ninety-one percent of adolescents did not want to be pregnant; pregnancy desire was highly correlated with current contraceptive method. None of the adolescents who reported being unsure or wanting to be pregnant used hormonal methods. Black adolescents were more likely to rely on barrier methods than hormonal methods ( P = .04); choice of barrier methods over hormonal methods was not correlated with risk for sexually transmitted diseases. There were no differences, however, in method dispensed by race. Black and white adolescents were equally likely to choose hormonal methods at the end of the visit, but adolescents who used hormonal methods at presentation—who were more likely to be white—were significantly more likely to leave the clinic with hormonal methods. CONCLUSION: Black race/ethnicity was an independent risk factor for use of less effective barrier contraceptive methods and pregnancy at presentation to the clinic. Understanding how black adolescents make contraceptive choices is essential to helping them avoid unintended pregnancies.