247557 Attitudes toward unprotected intercourse and risk of pregnancy among women seeking abortion

Tuesday, November 1, 2011: 12:30 PM

Diana Greene Foster, PhD , Bixby Center for Global Reproductive Health, Department of Ob/Gyn, University of California, San Francisco, Oakland, CA
Deborah Karasek, MPH , Advancing New Standards in Reproductive Health; Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, Oakland, CA
Jenny Higgins, PhD, MPH , Mailman School of Public Health, Columbia University, New York, NY
Daniel Grossman, MD , Ibis Reproductive Health, Oakland, CA
Introduction: Many heterosexual couples have intercourse without using a method of contraception. This study examines attitudes towards unprotected intercourse (UI) among women at risk of unintended pregnancy.

Methods: Between April and September 2010, 602 women at 6 abortion clinics across the country completed an anonymous survey on laptops. We asked about frequency and motivations for UI in the three months prior to conception, current attitudes towards the risks and benefits of UI, likelihood of engaging in UI in the next three months and perceptions of the risk of conception.

Results: Women had an average of 18 acts of UI in the three months leading to conception. Women who had frequent UI (3 or more times) reported more problems with access to contraceptives, a history of side effects, partners who did not want to use birth control and pregnancy ambivalence. Women who overestimate the risk of conception from one act of UI (believe it is more than 50%) report being less likely to have future UI. Multivariable regression models found three factors to be significantly associated with future UI: holding a view that UI improves one's relationship with their partner (OR=2.24, 95% CI[1.38, 3.64]), underestimating the risk of conception in a year of UI(OR=1.58, 95% CI[1.00, 2.51]), and having an age under 20 (OR=2.59, 95% CI[1.30, 5.16]).

Conclusion: Couples have myriad reasons for engaging in UI. Public health interventions designed to reduce the incidence of unwanted pregnancy need to take account of the risks and benefits women see in having UI.

Learning Areas:
Assessment of individual and community needs for health education
Clinical medicine applied in public health
Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe the reasons women engage in unprotected intercourse despite seeking to avoid pregnancy. Evaluate the predictors of being willing to engage in unprotected intercourse.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I designed the study and analyzed the data.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.