Contraceptive Attitudes among Inner-City African American Female Adolescents: Barriers to Effective Hormonal Contraceptive Use

Study Objective: To better understand the contraceptive attitudes of low-income, inner-city African American female adolescents. Design: We conducted four focus group sessions with African American female adolescents. Setting: An urban, community health clinic serving low-income patients on Chicago's south side. Participants: African American female adolescents (n = 15) between 14 and 19 years of age. Interventions: Focus group sessions lasting approximately 90 minutes in length were conducted using a predetermined script with set probes and open-ended questions. Main Outcome Measures: Qualitative analysis was conducted to identify major themes related to adolescents' contraceptive attitudes. Results: Six themes related to the contraceptive attitudes of these adolescents emerged: Concerns About Hormones, Concerns About Privacy, Concerns About Compliance, Limited Awareness of New Methods of Hormonal Contraception (HC), Preference for Condoms, and Acceptability of Emergency Contraception (EC). Overall, adolescents in these sessions expressed skepticism and unwillingness to use continuous methods of HC. For some adolescents, concerns about hormones, privacy, anti compliance outweighed their concerns about pregnancy. Conclusion: Concerns about perceived side effects and long-term health risks associated HC and privacy in obtaining contraception and reproductive health care, as well as concerns about ability to comply with daily and weekly HC regimens are common among African American female adolescents and may deter consistent HC use. Although condoms and EC appear to be highly acceptable among this group, adolescents also report a number of barriers to their consistent use. Efforts to reduce early, unintended pregnancy among African American youth should focus on addressing adolescents' HC-related concerns, improving access to EC, and helping female adolescents effectively negotiate condom use.