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APHA Scientific Session and Event Listing

Recorded presentation

Alice Richman, MPH¹, Kathleen O'Rourke, PhD, MPH², Mary Roddy, PhD, MPH², and Michael Custer, DrPH³. (1) Community and Family Health, University of South Florida College of Public Health, 13201 Bruce B. Downs Blvd., MDC 56, Tampa, FL 33612, 813-732-1903, arichman@hsc.usf.edu, (2) Department of Epidemiology and Biostatistics, University of South Florida, 13201 Bruce B. Downs Blvd., MDC 56, Tampa, FL 33612, (3) Walter Reed Army Medical Center, 6900 Georgia Avenue, NW, Washington, DC 20307

Background: The U.S. Armed Forces represents a community of young adults at risk for unintended pregnancy/paternity and sexually-transmitted infections (STIs).

Objective: This study evaluated the effect of pregnancy and paternity intention on contraceptive choice among new Army recruits who were sexually active and not pregnant.

Methods: 592 males and 503 females completed self-administered surveys asking about pregnancy/paternity intention, contraceptive use at last intercourse, and potential confounding factors. A multidimensional measurement of pregnancy intention was developed. Contraceptive efficacy was categorized as a 4-level ordinal variable. Multivariate ordinal regression measured the association between pregnancy/paternity intention and the most efficacious birth control method used at last intercourse. Multiple logistic regressions were used to examine factors associated with condom use and dual protection.

Findings: Only 7% of participants planned a pregnancy in the next six months, but almost 33% of them used no birth control at last intercourse. Each unit increase in pregnancy avoidance scale was associated with a 14% increase in efficacy of birth control method used (p<.0001). Effectiveness of birth control method increased for age (p=0.0873), postsecondary education (p=0.0142) and male gender (p=0.0019.). Binge drinking reduced likelihood of being in a higher category of birth control use (p=0.0258). Intention not to get pregnant was associated with a 9.6% increase in condom use (p=0.0025) and a 6.9% increase in dual protection birth control (p=0.0824).

Conclusion: Intention to avoid pregnancy and being male was associated with the use of higher level birth control methods, higher use of condoms and dual protection.

Learning Objectives: