Young People's Perceptions of Why Sexually Active Peers May Not Use Prescribed Contraception

Access to contraception is a necessary component of reproductive autonomy for adolescents and young adults (AYAs). AYAs persistently face barriers to accessing confidential, affordable contraception. In this study, we characterize and describe the most common reasons AYAs perceive that their sexually active peers might not use prescribed contraception.

Using a cross-sectional national text-based survey of AYAs aged 14-24, we conducted a content analysis of open-ended text responses to a question about why AYAs' sexually active peers might not use prescribed contraception (n = 554). We identified the most common reasons for non-use and examined differences in reported reasons for non-use by demographic factors.

AYAs reported that their sexually active peers may not use prescribed contraception because they have concerns about it being harmful, they may be stigmatized for using contraception, and it can be logistically difficult for AYAs to obtain. Older and pregnancy-capable respondents were more likely to perceive contraceptive harm as a reason for prescribed contraception non-use (P < .05) but were less likely to perceive stigma and logistical barriers as a reason for non-use (P < .05) compared to younger and pregnancy-incapable respondents.

We found that perceptions of contraceptive non-use by peers vary by respondents' age and pregnancy capability, likely due to differences in exposure to contraception information in peer groups and their own contraceptive use experiences. Understanding AYAs' perceived reservations towards prescribed contraception is vital to inform clinicians' counseling conversations and for public health messaging.