Withdrawal as Pregnancy Prevention & Associated Risk Factors among US High School Students
PURPOSE:
Withdrawal
is less effective for preventing pregnancy than other contraceptive methods and
offers no protection against sexually transmitted infections including HIV. Little is
known from a national perspective about adolescents who primarily use
withdrawal. This study describes the prevalence of withdrawal as their primary
method of pregnancy prevention at last sexual intercourse among sexually active
US high school students and associations with sexual risk and substance use.
METHODS:
Data from
the 2011 National Youth Risk Behavior Survey were used to estimate sexually
active students' most recent contraceptive method. Logistic regressions
examined sexual behaviors and substance use, comparing students who used
withdrawal to those who used no method, a condom and a highly effective method.
RESULTS:
Among
4793 currently sexually active students, 10.2% used withdrawal only, 12.4% used
no method, 53.6% used a condom and 23.8% used a more effective method as their
primary form of pregnancy prevention during last sexual intercourse. Students
who used withdrawal were less likely than those who used no method to have had
sexual intercourse before age 13 years (Adjusted Prevalence Ratio (APR) =.56)
and currently use cocaine (APR=.36). Among females, students who used
withdrawal were more likely to engage in risky behaviors than those who used a
condom and those who used a highly effective method of pregnancy prevention in
a number of ways (e.g., having multiple sex partners during the past 3 months,
current alcohol use, binge drinking, current marijuana use, drank alcohol or
used drugs before last sexual intercourse).
CONCLUSIONS:
Approximately
1 in 10 sexually active students used withdrawal only, about the same
percentage as those who used no method. Health care providers and others who
serve adolescents may want to discuss its pros and cons with their clients and
help ensure that they have information about and access to other contraceptive
methods that are more effective at preventing pregnancy and sexually
transmitted infections. Health care professionals should not consider young
people who use withdrawal similar in risk to those that use no method.
- 1Centers for Disease Control and Prevention, Division of Adolescent and School Health. Electronic address: nel6@cdc.gov.
- 2Centers for Disease Control and Prevention, Division of Adolescent and School Health.
- 3Centers for Disease Control and Prevention, Division of STD Prevention.
- 4Centers for Disease Control and Prevention, Division of Reproductive Health.
- Contraception. 2016 Feb;93(2):126-32. doi: 10.1016/j.contraception.2015.08.015. Epub 2015 Sep 10.
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