Changes over Time in College Student's Family Planning Knowledge, Preference, and Behavior and Implications for Contraceptive Education and Prevention of Sexually Transmitted Infections (1)

Article excerpt

College students today face new challenges in family planning. A mail survey with multiple follow-ups was used to assess changes in college students' knowledge, use, and preference about family planning from 1969 to 1996 at the same university. Data from a representative sample of undergraduates indicate that students in 1996 preferred fewer children than in 1969 and women preferred more children than men did. Knowledge about all contraceptive methods increased and more women were knowledgeable about sterilization than men. In 1996, knowledge of relatively newer methods (e.g., implants and injectables) was less than knowledge of the pill. The condom remained the most commonly used method, followed by abstinence and the pill. The pill was most preferred for spacing births. These results suggest that although efforts to educate young people about sexually transmitted infections (STI) prevention have had an impact on knowledge and behavior, increasingly comprehensive education about contraception and STIs is necessary.

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The sexual behaviors and beliefs of young adults in the United States today are considerably different from 30 years ago. The children of the American "sexual revolution," today's college students face new challenges in sexuality and family planning. Studies of college and university students conducted between the 1970s and 1980s indicated that 75-80% of males and 60-70% of females had engaged in sexual intercourse, with a general trend of increasing prevalence over time (Reinisch, Sanders, Hill, & Ziemba-Davis, 1992). Not only are more young people deciding to engage in sexual activity without the intention of childbearing, but these decisions can have consequences beyond unplanned pregnancy. Young adults today must factor the risk of contracting the human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs) into the sexual decision-making process (Caron, Davis, Halteman, Stickle, 1993). The Centers for Disease Control and Prevention (CDC) estimated that two-thirds of STIs occur in people 25 years or younger (CDC, 1998). Latest estimates indicate that more than 15 million Americans per year become newly infected with an STI and individuals who are infected with an STI are at least 2-5 times more likely than uninfected individuals to acquire HIV in exposure to the virus through sexual contact (Cates, 1999; CDC, 2000).

The prevalence rates for other STIs such as herpes, genital warts, and chlamydia are higher than for HIV. An estimated 1 in 5 men and 1 in 4 women in the total adolescent and adult population carries genital herpes, or the herpes simplex virus (HSV) (CDC, 2000). An estimated 20 million people are infected with the human papilloma virus (HPV), the virus that causes genital warts, and studies have found that from 28% to 46% of women under the age of 25 are infected with HPV (CDC, 2000). Chlamydia, affecting over 3 million people each year, is the most common STD in the United States (CDC, 2000). Increases in the prevalence of sexual activity among young Americans place today's college and university students at a high risk for contracting an STI. Moreover, consistent use of protection is lacking. Results from the National College Risk Behavior Survey indicate that 84% of college men and 88% of college women report ever having had sexual intercourse. Among the 68% who reported having intercourse in the 3 months prior to the survey, however, only 26% of women and 35% of men reported using a condom at last intercourse. Only one-third reported consistent condom use (Douglas, Collins, Warren, Kann, Gold, et al, 1997). Longitudinal data indicate that condom use may drop off abruptly over the time of a college relationship. In one study, nearly half (43%) of college women reporting condom use at baseline no longer reported condom use at a 6-month follow-up (Kusseling, Wender, & Shapiro, 1995).

Improved technology for contraception and safer sex presents more options for students, particularly women. …