Reasons for unprotected intercourse in adult women

Despite the increased availability of contraception, unprotected intercourse and unintended pregnancy are common among adult women. We sought to identify reasons why adult women at risk of unintended pregnancy have unprotected intercourse.

A comprehensive search of electronic databases of MEDLINE, CINAHL, and PSYCHOINFO, from 1995 to 2005, was conducted. Reference lists from relevant published papers and reviews related to contraceptive practices and pregnancy intendedness were also hand searched. The Bronfenbrenner ecological framework was used as a guide in the discussion of the findings.

There were 16 studies that met inclusion criteria, and these provided numerous reasons why adult women had unprotected intercourse. Reasons were found at the individual, interpersonal, and societal levels. Individual reasons included concerns with contraceptive side effects, a low perceived risk for pregnancy, lack of knowledge, and attitudes and beliefs. Interpersonal reasons included partners, families, or friends who discouraged the use of contraception. Societal reasons included access problems, inconvenience, and cost.

There are multiple reasons why women have unprotected intercourse. These reasons were located in overlapping domains of influence. Factors in a woman's environment at the interpersonal and societal level may significantly influence her contraceptive use behavior.