What influences young people’s contraceptive choice?
R. E. Say, D. Mansour
Newcastle Contraception and Sexual Health Service, Newcastle upon Tyne, UK
Introduction: Clinicians have suggested that use of long-acting
contraceptive methods such as Evra the contraceptive patch, NuvaRing the
contraceptive vaginal ring and Implanon the contraceptive implant may help
reduce teenage pregnancy rates. However, little is known about young people’s
attitudes towards these methods.
Objectives: The aim of this project was to explore the attitudes of
young people towards Evra, NuvaRing and Implanon in order to contribute towards
the improved understanding of the choices which young people make about
contraception.
Design and Methods: A cross sectional survey was carried out using a
self-completion questionnaire developed for this study. Participants were a
self-selecting sample of young people attending young people’s contraception
and sexual health clinics. Statistical analysis was carried out using
appropriate univariate tests. Qualitative analysis involved detailed
identification of key themes which were continuously challenged by looking for
conformity and variation and by identifying disconfirming cases.
Results: One hundred and twenty nine questionnaires were returned. The
majority of participants had no prior knowledge of Evra, NuvaRing or Implanon.
Approximately one third indicated that they would wish to use Evra; five percent
that they would wish to use NuvaRing and approximately one quarter that they
would use Implanon. Statistically significant associations were found between
participants’ attitude towards using these contraceptives and their age,
experience of a pregnancy scare, experience of an unplanned pregnancy and prior
knowledge of the contraceptive. Five major themes emerged relating to the
advantages and disadvantages of Evra, NuvaRing and Implanon: convenience,
effectiveness, safety and side effects, invasiveness and discretion.
Conclusions: There is variation in young people’s knowledge of and
attitudes towards long-acting contraceptives which may be influenced by
contraceptive need, experience of lack of effective contraception and access to
information. The themes identified in their perceptions of these contraceptives
are useful in developing an understanding of what young people look for in a
contraceptive. It will be important for health professionals to provide
information on all these themes when assisting a young person in making an
informed decision about contraception.