Transitions onto and off of hormonal methods among teens and young adults

Hormonal methods of contraception are important for effective pregnancy prevention, yet many teens and young adults do not use hormonal methods, and many who do begin using hormonal methods eventually transition away to less effective methods. A better understanding of factors associated with method switching will inform program efforts to improve the consistency of hormonal method use. We will use data from the National Longitudinal Survey of Youth, 1997 cohort to examine relationship and partner factors associated with the transition onto hormonal methods, consistency of hormonal method use and transitioning from hormonal methods to less effective methods. Relationship and partner factors include age at first sex, number of sexual partners, relationship type (casual or more serious), relationship length, and first/most recent partner's age, race/ethnicity and education level. We hypothesize that longer-term relationships and more frequent sexual activity will be associated with transitions onto hormonal methods. Alternatively, inconsistent sexual activity and relationship changes, including ending a relationship, will be linked with method switching, especially transitions away from hormonal method use. We will also explore transitions between hormonal methods, such as from using birth control pills to use of longer acting methods (IUD, implant). Preliminary analyses have identified 2,280 never-married women ages 14-18 in 1999 who had not used a hormonal method and were followed annually until 2009. Of this sample, 56% transitioned onto a hormonal method at some time during the study period. Among those who began using a hormonal method, 60% stopped using a hormonal method in a subsequent year.