Understanding College-Aged Women’s Attitudes Toward Contraception Use

Despite the wide range of contraceptives available, almost 50% of pregnancies in the United States are unintended, with the highest rates among women aged 18 to 24 years. Meanwhile, few studies have explored contraceptive responsibility and no studies since the 1980s have looked at female college students’ perceptions of such. Without this data, physicians and health educators are unable to adequately and effectively address STD and pregnancy prevention among this patient population.

To better understand how these young women think about and approach contraception, Dr Larissa R. Brunner Huber, associate professor of epidemiology in the department of public health sciences at the University of North Carolina, and Jennifer L. Ersek, Blumenthal Cancer Center, Carolinas Medical Center, Charlotte, NC, conducted an analysis of anonymous questionnaires completed by 247 female college students at the University of North Carolina at Charlotte; data were collected October 2006 to August 2007. Participants were 18 to 45 years old, with the majority of students younger than 25 years. Nearly 75% of participants were non-Hispanic white and had never been married.

The women were presented with a 48-item questionnaire about contraceptive use and behaviors; the questions elicited demographic information, contraceptive use data, sexual intercourse information, and thoughts on contraceptive responsibility. Study invitations were sent via email; participants completed the questionnaires online.

According to the study, 22.3% of the women had a previous pregnancy. Of those reporting current contraceptive use, the majority were using hormonal methods (52.6%). The remainder used barrier (11.7%) or other, nonspecified methods (11.3%). Approximately one quarter (24.3%) of the respondents did not use any contraceptives.

Huber and Ersek found that 89.1% of respondents thought responsibility for contraception should be shared. However, only 51.8% of women reported that contraceptive responsibility was actually shared. Interestingly, two women (0.8%) reported that contraception was solely the man’s responsibility (Figure). Older women (≥ 25 years of age) and those in graduate school were more likely to believe that responsibility should be shared. Women who lived on campus were more likely to actually share responsibility for contraceptive use as compared to those who lived off-campus (either with a roommate or with family).

Figure. Responses: Responsibility for contraception.

Most respondents (97.3%) said they used contraceptives to prevent pregnancy, and only 27.3% said they also used contraceptives to prevent STDs. In fact, this study found lower rates of condom use than what has been found in previous studies of college populations. Since condom use is one way men can share in contraceptive responsibility, the lower rate of actual shared responsibility may be correlated with the lower rates of condom use in this study.

"Clearly, there is a discrepancy between male and female perceptions of who is actually responsible for contraception,” the authors concluded. “If additional studies confirm that contraceptive responsibility is perceived by both males and females as a shared responsibility, then healthcare professionals should consider tailoring contraception and sexual education programs to include both males and females in the decision-making process.”
 

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Reference

Brunner Huber LR, Ersek JL. Perceptions of contraceptive responsibility among female college students: an exploratory study. Ann Epidemiol 2011 Mar;21(3):197-203.