This article reviews the literature on psychosocial correlates of contraceptive practices among sexually active late adolescents (primarily college undergraduates). It seeks to help identify subgroups of adolescents who either do not use or misuse contraceptive means, putting them at risk for unwanted pregnancy, AIDS, and other sexually transmitted diseases. The intent is to promote further research on those variables with the most potential for predicting contraceptive behaviors, which will assist in the development and implementation of effective prevention and intervention programs.
This article summarizes some of the major empirical findings on psychosocial correlates of contraceptive practices adopted by young people, mainly undergraduate college students. It does not focus on safer sex practices; rather, it is dedicated primarily to reviewing the literature concerning correlates of birth control practices, usually pill and condom use. However, barrier contraceptives such as the condom offer protection against sexually transmitted diseases (STDs) as well, and the findings discussed here may be useful to sexuality experts involved in the development and promotion of safer sex programs (see Lagana & Hayes, 1993, for a critical review of some of those projects).
Societal Acceptance of Contraception
Societal acceptance or rejection of any private behavior, including contraception, is likely to affect that behavior profoundly. According to Hall (1990), some instructional books and women's magazines provide contradictory messages regarding condom use. Specifically, they portray the condom either as a symbol of pleasure and of a life associated with responsible sexual intercourse, or as a symbol of promiscuity and disease.
Stycos (1977) traced the history of contraceptive distribution and information, emphasizing the conscious effort made by proponents of birth control to dissociate the sexual implications of contraception. Supporters of contraception have thus taken a position which is in accord with that adopted by ecologists, demographers, eugenicists, and the medical profession. Stycos has pointed out the appropriateness of reestablishing the natural association between sexual behavior and contraception. This could be accomplished through programs and educational materials aimed at reducing the risk of STD contraction and unwanted pregnancy while noting the implications for enhanced sexual freedom and pleasure.
Given the fact that the target population here is primarily college undergraduates, a relevant question is whether providing contraceptives to unmarried youth is socially accepted. Several investigators, including Bardis (1982), Bulatao and Lee (1973), and Carballo et al. (1983), have studied the issue of acceptability in different countries. Overall, the findings indicate that a negative attitude toward contraception is not limited to specific age groups.
Availability and Accessibility of Contraception
Allgeier and Allgeier (1991) listed four conditions they believe to be essential for acceptance of contraception by young people: birth control education, motivation to employ contraception, existence of reliable contraceptives, and easy access to them. In a study by Steinfirst, Cowell, Presley, and Reifler (1985), the condom was the most frequently purchased item in vending machines dispensing contraceptives and over-the-counter medicines in a 24-hour health service facility. It is possible that contraceptives are not used consistently because they are not easily available. According to Richwald, Friedland, and Morisky (1989), action could be taken to increase condom distribution to young people. More extensive marketing programs may also be needed. In a study by Buchta (1989), 92% of adolescent males, 89% of adolescent females, and 83% of their parents approved of condom advertisements on television. …