Purpose: The purpose of the present study was to examine condom use by teens who use hormonal contraceptives [i.e., Depo-Provera, Norplant, or oral contraceptives (OCs)].
Methods: This is a cross-sectional study of 578 Hispanic and African-American female adolescents between the ages of 12 and 21 years who came to a reproductive health care clinic. A paper-and-pencil questionnaire which addressed sexual behaviors, sexual history, and communication about sexuality was distributed to adolescent girls attending the clinic. Several important analyses included only those who had been sexually active in the last 4 weeks (n = 452).
Results: Adolescents who used OCs [odds ratio (OR) 1.7], long-acting agents (i.e., Depo-Provera or Norplant) (OR 1.6), were less likely to have used a condom in the last 4 weeks than teens whose only method of birth control was condoms. Only those teens who had previously been diagnosed with a sexually transmitted disease (STD) were more likely to have used a condom (OR .67 for not using a condom). Overall, condom use by teens in this sample was low, with only 19% reporting that they "always" use a condom, and 47% of the teens who had been sexually active in the last 4 weeks reporting that they had not used a condom at least once during that time.
Conclusions: This study provides data which suggest that adolescent girls who use hormonal contraceptives are less likely to use condoms than other sexually active teens. Therefore, when prescribing hormonal contraception to prevent pregnancy, clinicians must provide appropriate counseling to mitigate against the potential to increase the risk of STDs.
PIP: AIDS is the leading cause of death among people 25-44 years old, with young women comprising the largest category of new AIDS cases. Minority women are at greatest risk of HIV infection; nationally, 1% and 0.5% of African-American and Hispanic women, respectively, aged 27-39 years may be infected. A cross-sectional study of 578 Hispanic and Black female, sexually experienced adolescent users of hormonal contraceptives aged 12-21 years who came to a reproductive health care clinic were surveyed about their condom use, for the correct and consistent use of condoms can reduce the risk of contracting HIV through sexual contact. 54% of the women reported that they have sexual intercourse at least once per week, 12% had intercourse daily, and 32% had had 4 or more lifetime sex partners. Adolescents who used OCs and long-acting hormonal contraceptive agents were less likely to have used a condom in the past 4 weeks than teens whose only method of birth control was condoms. Only those women who had previously been diagnosed with a sexually transmitted disease (STD) were more likely to have used a condom. Overall condom use by teens in the sample was low, with only 19% reporting that they always used a condom, and 47% of the teens who had been sexually active in the past 4 weeks reporting that they had not used a condom at least once during that time. Family planning providers must counsel their clients who use hormonal contraceptives on the need to also protect themselves against HIV and other STDs.