Half of pregnancies in the United States are unintended, with the highest proportions occurring among Blacks, Hispanics, and teenagers. Understanding differences in knowledge and attitudes about contraception by race/ethnicity and age can improve efforts to reduce disparities in unintended pregnancy.
This analysis used data from the 897 female respondents in National Survey of Reproductive and Contraceptive Knowledge, a survey exploring young adults' knowledge and attitudes about contraception and pregnancy. Bivariate and multivariate logistic regression analyses were used to assess racial/ethnic and age group differences in knowledge and attitudes about contraceptives.
Hispanics and teenagers (aged 18–19) had lower awareness of available contraceptive methods, and lower knowledge about individual methods compared with White women and young adults (age 20–29). For example, Hispanics (74%) and teenagers (77%) were less likely to have heard of the intrauterine device (IUD) than were White women (90%) and young adults (90%), and were less likely to know that a woman experiencing side effects could switch brands of oral contraceptive pills (72% of Hispanics vs. 86% of White women; 76% of teenagers vs. 90% of young adults). Hispanics born outside the United States had lower knowledge about contraceptives than U.S.-born Hispanics. For example, foreign-born Hispanics were less likely than U.S.-born Hispanics to have heard of the IUD (59% vs. 82%) or the vaginal ring (55% vs. 95%).
Lower contraceptive knowledge among teenagers and Hispanics, particularly immigrants, suggests the importance of disseminating family planning information to these women as one means to address disparities in unintended pregnancy.
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- Reproductive health service preferences and perceptions of quality among low-income women: racial, ethnic and language group differences.Perspectives on Sexual and Reproductive Health. 2008; 40: 202-211
- Misunderstanding the risk of conception from unprotected and protected sex.Womens Health Issues. 2013; 23: e47-e53
- Committee opinion no. 539: Adolescents and long-acting reversible contraception: implants and intrauterine devices.Obstetrics and Gynecology. 2012; 120: 983-988
- The association of health insurance with use of prescription contraceptives.Perspectives on Sexual and Reproductive Health. 2007; 39: 226-230
- Race, ethnicity and differences in contraception among low-income women: Methods received by Family PACT Clients, California, 2001-2007.Perspectives on Sexual and Reproductive Health. 2011; 43: 181-187
- Intrauterine devices and pelvic inflammatory disease: An international perspective.Lancet. 1992; 339: 785-788
- Unintended pregnancy among U.S. adolescents: Accounting for sexual activity.Journal of Adolescent Health. 2010; 47: 312-314
- Changes in use of long-acting contraceptive methods in the United States, 2007-2009.Fertility & Sterility. 2012; 98: 893-897
- Unintended pregnancy in the United States: incidence and disparities, 2006.Contraception. 2011; 84: 478-485
- The family planning attitudes and experiences of low-income women.Family Planning Perspectives. 1996; 28: 246-255
- Factors associated with contraceptive choice and inconsistent method use, United States, 2004.Perspectives on Sexual and Reproductive Health. 2008; 40: 94-104
- Young adults' contraceptive knowledge, norms and attitudes: Associations with risk of unintended pregnancy.Perspectives on Sexual and Reproductive Health. 2012; 44: 107-116
- Factors associated with contraceptive use and nonuse, United States, 2004.Perspectives on Sexual and Reproductive Health. 2007; 39: 90-99
- Contraceptive attitudes among inner-city African American female adolescents: Barriers to effective hormonal contraceptive use.Journal of Pediatric and Adolescent Gynecology. 2009; 22: 97-104
- Familial, cultural and psychosocial influences of use of effective methods of contraception among Mexican-American adolescents and young adults.Journal of Pediatric and Adolescent Gynecology. 2011; 24: 79-84
- Concerns about contraceptive side effects among young Latinas: A focus-group approach.Contraception. 2004; 70: 299-305
- Perceptions of hormonal contraceptive safety and side effects among low-income Latina and non-Latina women.Maternal and Child Health Journal. 2000; 4: 233-239
- Factors associated with effective contraceptive use among a sample of Latina women.Womens Health. 2006; 43: 1-16
- Contraceptive technology.20th ed. Bridging the Gap Communications, Atlanta2011
- Current contraceptive use in the United States, 2006–2010, and changes in patterns of use since 1995.National Center for Health Statistics, Hyattsville, MD2012
- Characteristics of women in the United States who use long-acting reversible contraceptive methods.Obstetrics and Gynecology. 2011; 117: 1349-1357
- The fog zone: How misperceptions, magical thinking, and ambivalence put young adults at risk for unplanned pregnancy.The National Campaign to Prevent Teen and Unplanned Pregnancy, Washington, DC2009
- Partner influence on early discontinuation of the pill in a predominantly Hispanic population.Perspectives on Sexual and Reproductive Health. 2003; 35: 256-260
- Estimates of contraceptive failure from the 2002 National Survey of Family Growth.Contraception. 2008; 77: 10-21
- Contraceptive choice: How do oral contraceptive users differ from condom users and women who use no contraception?.American Journal of Obstetrics and Gynecology. 2008; 198: e46-e47
- Teenagers in the United States: Sexual activity, contraceptive use, and childbearing, 2006–2010 National Survey of Family Growth.Vital Health Statistics. 2011; 23: 31
- Missed conceptions or misconceptions: Perceived infertility among unmarried young adults in the United States.Perspectives on Sexual and Reproductive Health. 2012; 44: 30-38
- Race, adolescent contraceptive choice, and pregnancy at presentation to a family planning clinic.Obstetrics and Gynecology. 2002; 99: 241-247
- Determinants of contraceptive method among young women at risk for unintended pregnancy and sexually transmitted infections.Contraception. 2003; 68: 19-25
- One-year contraceptive continuation and pregnancy in adolescent girls and women initiating hormonal contraceptives.Obstetrics and Gynecology. 2011; 117: 363-371
- Do racial and ethnic differences in contraceptive attitudes and knowledge explain disparities in method use?.Perspectives on Sexual and Reproductive Health. 2012; 44: 150-158
- The use of effective contraception among young Hispanic women: The role of acculturation.Journal of Pediatric and Adolescent Gynecology. 2012; 25: 35-38
- Disparities in contraceptive knowledge, attitude and use between Hispanic and non-Hispanic whites.Contraception. 2006; 74: 125-132
- Prevalence and correlates of ambivalence towards pregnancy among nonpregnant women.Contraception. 2007; 75: 305-310
- Decision aids for people facing health treatment or screening decisions.Cochrane Database of Systematic Reviews. 2011; : CD001431
- Overview of the uninsured in the United States: A summary of the 2012 current population survey report.Department of Health and Human Services; Office of Assistant Secretary for Planning and Evaluation, Washington, DC2012
- Discontinuation and resumption of contraceptive use: Results from the 2002 National Survey of Family Growth.Contraception. 2008; 78: 271-283
- Characteristics related to effective contraceptive use among a sample of nonurban Latinos.Perspectives on Sexual and Reproductive Health. 2011; 43: 255-262
- Factors affecting sex education in the school system.Journal of Pediatric and Adolescent Gynecology. 2011; 24: 142-146
- Contraceptive nonuse among US women at risk for unplanned pregnancy.Contraception. 2008; 78: 284-289
Amaranta D. Craig, BS, is a medical student at the University of California, San Francisco, in the UCSF Clinical and Translational Research Fellowship and PROF-PATH (Promoting Research Opportunities Fully- Prospective Academics Transforming Health) Fellowship. Her research interests include women's health and health disparities.
Christine Dehlendorf, MD, MAS, is an Associate Professor in the Department of Family and Community Medicine at the University of California, San Francisco. Her research interests include family planning disparities and contraception counseling.
Sonya Borrero, MD, MS, is an Assistant Professor of Medicine and Clinical and Translational Science at the University of Pittsburgh. Her research interests include disparities in contraceptive use and unintended pregnancy and contraceptive care in the VA Healthcare System.
Cynthia C. Harper, PhD, is Associate Professor at the Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco. Her research interests include social and policy aspects of family planning.
Corinne H. Rocca, PhD, MPH, is an Epidemiologist at the Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco. Her research interests include unintended pregnancy prevention, pregnancy ambivalence, and reproductive health disparities.
Published online: April 11, 2014
Accepted: February 3, 2014
Received in revised form: January 20, 2014
Received: August 26, 2013
© 2014 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.