How your relationship affects your contraception choice

Researchers from Oregon State University looked at data from a longitudinal study which conducted 1 280 interviews with 470 young adults, tracking their relationships over one year.

Participants were asked about their sexual activity, partners, contraceptive use, and relationship factors such as duration of sexual relationship, frequency of sex and perceived exclusivity with a partner.

The team also measured commitment levels in the relationship, as well as how involved participants were in the couple’s decisions around use of contraceptives.

The researchers found that during the one-year study, 41% of participants reported using only condoms; nearly 25% used only a hormonal/long-acting form a birth control, and 13% reported using both methods. The rest of the participants used either no method or a less effective method of birth control.

Factors that influenced these contraception choices included the participants’ perceived vulnerability to pregnancy and STIs. However, the study’s lead author S. Marie Harvey pointed out that the qualities and dynamics of a relationship are also significant predictors of contraceptive use.

In particular, participants who reported greater exclusivity and commitment with their partner were less likely to use condoms and more likely to use hormonal or long-acting methods of birth control, or a less effective or no birth control.

Coloured condoms. Image: Supplied

Those who reported that they had a strong role in the sexual decision-making in the relationship were more likely to use condoms, either alone or with a hormonal or long-acting method of birth control.

“It has to do with how much you trust your partner and how committed you feel in that relationship,” Harvey said. “As relationships become more trusting and committed, individuals may be less likely to protect themselves from disease transmission and condom use will decline. As commitment develops between sexual partners, trust in one’s partner may become a substitute for safer sex behavior for both disease and pregnancy prevention.”

The findings could be significant as young adults are at the greatest risk for contracting STIs, and young women have the highest rates of unintended pregnancy.

Co-author Lisa Oakley commented that an understanding of how young adults make their decisions about birth control use, and a knowledge of their relationship status, could help health professionals advise them better about their birth control options.

“If it is a committed relationship and the couple is sharing in decision-making about birth control, it may be wise to involve the partner in those discussions,” added Harvey. “If it’s not a committed relationship, then it’s really important to talk to the patient about being proactive in protecting themselves from unintended pregnancy or STIs.”

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