Factors affecting British teenagers' contraceptive use at first intercourse: The importance of partner communication

CONTEXT: Despite the growing body of knowledge about teenager's sexual and contraceptive behavior in the United Kingdom, much quantitative work has failed to consider the broader social contexts in which this behavior occurs. METHODS: A 1999 survey of 963 full-time students aged 16-18 gathered information on individual, contextual and background factors. Logistic regression analyses were conducted to investigate how these factors determine use of a modern method at first sex and whether such use is discussed beforehand. RESULTS: Three factors were significantly associated with the odds of contraceptive use at first sex among young men-discussing contraception beforehand (odds ratios, 5.7-13.8), giving an intimate reason for having sex the first time (6.4) and having parents who portrayed sexuality positively during childhood and the early teenage years (1.2). For young women, five factors significantly predicted use-communication (odds ratios, 6.2-15.0), age at first sex (1.8), not having visited a service provider (5.0), feeling comfortable interacting with teenage males (1.2) and "sort of" or not expecting to have sex (0.2 and 0.4, respectively). Among young men, the factors significantly associated with the odds of having discussed contraception were the level of social deprivation, the length of the relationship and parents' openness to talking about sex; among young women, the factors were the number of intimate reasons given for having sex and the warmth and availability of parents. CONCLUSIONS: Efforts to increase young people's ability to negotiate sexual and contraceptive decision-making should be multifaceted. It is essential that parents provide a supportive climate throughout childhood and adolescence, where discussions of sexual issues are acceptable and where families feel comfortable talking openly.