Contraceptive Method Choice among Youth in the United States: The Importance of Relationship Context

Involvement in romantic and sexual relationships increases during adolescence and young adulthood as does the significance of these relationships. Relationship experiences during this period are influential for reproductive health outcomes and set the stage for future family formation choices and behaviors. This study utilizes retrospective sexual relationship histories of young adults available in the most recent wave (2001-2002) of the National Longitudinal Study of Adolescent Health to obtain a better understanding of the factors associated with contraceptive method choice, with a focus on relationship context. Multilevel analysis is conducted to investigate associations between individual- and relationship-level characteristics and relationship-specific type of contraceptive method used at last sexual intercourse. Results indicate that for a given individual, contraceptive method choice varies across relationships as a function of relationship commitment and couple heterogamy, even accounting for individuals’ own characteristics and prior relationship experiences. The results also confirm the importance of individuals’ own characteristics and reveal that early perceptions of risk and severity of negative reproductive health outcomes and contraceptive self-efficacy have enduring effects on later contraceptive method choices. Furthermore, the patterns of associations between both relationship and individual characteristics and contraceptive use differ depending on the specific type of contraceptive method.