Sex Differences in Contraception Non-Use Among Urban Adolescents: Risk Factors for Unintended Pregnancy.
Allison R Casola, Deborah B Nelson, Freda Patterson
PMID 28766314WHAT IT FOUND
Among sexually active Philadelphia high school students, girls and adolescents who had ever used marijuana were more likely to report not using contraception at last sex.
Boys offered or given drugs at school also reported higher non-use.
Key findings
01In the adjusted model, girls had 1.73 times the odds of reporting contraception non-use compared with boys (95% CI 1.04 to 2.88).
02Adolescents who had ever used marijuana had more than a 2-fold increased adjusted odds of contraception non-use (aOR = 2.30, 95% CI 1.31 to 4.02).
03Adolescents offered, sold, or given illegal drugs on school property had almost a 60% increased adjusted odds of contraception non-use (aOR = 1.59, 95% CI 1.00 to 2.51); among boys, the adjusted odds were 2.42 times higher (95% CI 1.20 to 4.90).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The data were self-reported in a school survey, so students may have underreported or misreported sexual behavior, substance use, and illegal drug access. Because the survey was school-based, students who did not attend school were not included. The analysis excluded students who had never had sexual intercourse and students who identified as gay or lesbian, so it does not describe contraception non-use in those groups. The survey was cross-sectional, so it cannot show whether marijuana use or drug access led to contraception non-use, or whether contraception non-use led to those behaviors. The sample was limited to Philadelphia high school students.
The easy way to misread this
Do not read the marijuana and drug-access associations as proof that these exposures cause contraception non-use. The survey was cross-sectional and relied on self-report, so it cannot establish which behavior came first or whether reducing marijuana use or drug access would increase contraceptive use.