259674 Influence of depression and stress symptoms on young women's consistency of contraceptive use

Monday, October 29, 2012 : 10:30 AM - 10:45 AM

Kelli Hall, PhD, MSN, NP , Department of Obstetrics and Gynecology; Population Studies Center, University of Michigan, Ann Arbor, MI
Caroline Moreau, MD, PhD , School of Public Health, Johns Hopkins University, Baltimore, MD
James Trussell, PhD , Office of Population Research, Princeton University, Princeton, NJ
Jennifer Barber, PhD , Department of Sociology, University of Michigan, Ann Arbor, MI
Objective Depression and psychological stress contribute to high-risk sexual behavior and medication misuse yet their influence on contraceptive use patterns is unknown. We examined relationships between young women's psychological symptoms and consistency of contraceptive use.

Methods Women ages 18-19 years (n=1,250) participating in a longitudinal cohort study completed weekly journals assessing contraceptive, reproductive, relationship and health characteristics and outcomes. Excluding journals in which women were pregnant or sexually inactive, we examined 7829 pairs of journals (weeks) from 12 months follow-up (n=639). Our outcome was consistency of contraceptive use during the last week (dichotomous). Predictors were baseline depression (CESD-5, range 0-15) and stress (PSS-4, range 0-16) scores and moderate/severe psychological symptoms (standardized score cut-offs). Analyses used random effects multivariate logistic regression models.

Results Mean depression and stress scores were 23 and 63 points; 26% and 25% of the sample met criteria for moderate/severe depression and stress symptoms, respectively. Consistent contraceptive use was reported for 72% of weeks. Proportions of consistent contraceptive use were lower among women with moderate/severe depression and stress symptoms than those without (64% vs. 74% and 61% vs. 76%, respectively, p-values<0.001). Controlling for covariates, the odds of consistent contraceptive use were reduced by 12% and 15% for each point increase in depression (OR 0.88, CI 0.81-0.96, p=0.004) and stress (OR 0.85, CI 0.78-0.92, p<0.001) scores. Women with moderate/severe stress symptoms were less likely to use contraception consistently than those without stress (OR 0.35, CI 0.20-0.63, p<0.001).

Conclusion Psychological symptoms predict subsequent inconsistent contraceptive use patterns among young women.

Learning Areas:
Epidemiology
Public health or related research
Social and behavioral sciences

Learning Objectives:
To describe associations between young women's depression and stress symptoms and time-varying contraceptive use patterns

Keywords: Contraception, Mental Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a adolescent and reproductive health researcher and practitioner.
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.