Adolescent Contraceptive Use and Communication: Changes over a Decade

Article excerpt

Public concern about the AIDS crisis has emphasized the importance of safe behavior. For adolescents, safe sexual behavior recommendations have included abstinence and postponement of sex. For those who are sexually active, the advice has been to limit the number of partners, ideally to one mutually faithful partner; to use condoms consistently and correctly for all acts of intercourse; to refrain from unsafe practices such as anal sex; and to learn about the sex histories of prospective partners (CDC, 1988).

While the total number of cases of adolescents who have AIDS is currently quite low, adolescents are a group of high concern since risk-related sexual behavior begins in adolescence (Hein, 1989). A majority of teenagers have had sexual intercourse by age 19 (CDC, 1991); by adulthood, most will have had several partners (Hein, 1992); levels of contraceptive use (Hofferth, Kahn, & Baldwin, 1987) and condom use (DiClemente, 1992) have been low. Moreover, the estimated latency period of 11 years from time of infection to development of AIDS (Gayle, Manoff, & Rogers, 1989) means that many adolescents will contract the HIV virus as adolescents but not realize it until much later.

In the past decade there has been increased urgency about the need for adolescents to change behavior or avoid certain practices because of the fatal consequences of contracting the HIV virus. As a result, there have been major efforts to disseminate information about the need for change. The national distribution of the pamphlet "Understanding AIDS" by the Surgeon General (CDC, 1988) illustrated the importance of encouraging safe sex practices. In addition to this national household distribution, there have been many other large-scale efforts through various media (Romer & Hornik, 1992) as well as local programs such as school condom distribution (Kirby, 1992).

Considering these efforts, it is important to determine whether there have been changes in behaviors to those that are "safe." These possible changes can be examined in the life histories of individuals as well as in new cohorts who begin their sexual careers.

This current study addressed the issue of change over the past decade. It examined sexual behavior of heterosexual college students in 1979 and 1989 to see whether "safe sex" behaviors changed over the decade and also over sexual careers during adolescence. It reports data from students on the same campus by examining aspects of contraceptive use. Comparisons were made between the 1979 and 1989 samples as well as within each sample by examining respondents' first sexual experience with first partner and current (or most recent partner). This comparison provided an indication of change associated with sexual career.

Safe Sex

While "safe sex" has had many meanings throughout history, in the past few years it has usually been referred to as "safe sex practices" and generally understood as engaging in behaviors that minimize the likelihood of transmitting sexually transmitted diseases (see, for example, the national mailout of the Surgeon General (CDC, 1988). This represents a significant shift from about a decade ago, when the term referred to using contraception or engaging in sexual activities in ways that minimized the likelihood of conception. In addition to this change in meaning, increased importance has been attached to the necessity of encouraging safe sex.

For persons who are sexually active, having sex "with one mutually faithful, uninfected partner" (Surgeon General, 1988) would be safe. Other behaviors involve some risk, although the risks may be minimal. Various sexual practices such as anal sex are discouraged by nearly all sources, while limiting the number and nature of sexual partners is encouraged. Condom use is recommended as an important method of reducing the spread of AIDS (e.g., DiClemente, 1992; Everett & Glanze, 1987). In fact, the United State Public Health Service has recommended specific levels of increase of condom use for the decade of the 1990s (see USDHHS, 1991 report on Healthy People 2000). …