Date

February 2012

Document Type

Thesis

Degree Name

M.P.H.

Department

Dept. of Public Health and Preventive Medicine

Institution

Oregon Health & Science University

Abstract

Objective Adolescent contraceptive use is an important determinant of teen pregnancy, abortion and sexually transmitted disease rates in the United States. In spite of a similar age at sexual debut, U.S. rates remain elevated above those of other developed countries. Although sex education continues to play a central role in the effort to reduce US teen pregnancy and STD rates, the content of the education and the effect that this information has on adolescent behaviors like contraceptive choice is not well understood. This is particularly true for boys. The objective of this thesis was to determine whether exposure to sex education regarding methods of contraception, STDs and Human Immunodeficiency Virus prevention are independent factors associated with greater condom use at first sexual intercourse among US adolescent males and with more frequent use of a hormonal method by the boy’s partner compared to exposure to abstinence messages. Methods This thesis comprises a secondary data-analysis of a sample of never-married males aged 15-19 from the nationally representative weighted database, the 2006-2008 National Survey of Family Growth. Analyses were performed using Stata/IC version 11.1 (College Station, TX). Descriptive statistics were generated to compare demographic and socioeconomic variables between sex education groups. The primary outcome variable was contraceptive use at coital debut; measures of association and multiple logistic regression were used to analyze the influence of formal sex education after adjusting for confounders. Results We found that receipt of sex education that included an abstinence message was statistically significantly associated with increased condom use at first intercourse compared to receiving other types of education among never-married male adolescents age 15 to 19 who reported formal sex education prior to coital debut. We did not find a statistically significant relationship between type of sex education and reliable contraceptive use at first coitus. Those who received abstinence education without methods education prior to first coitus had 5.6 times the odds of using a condom the first time they had sex compared to those with neither abstinence nor methods education after adjustment for school enrollment, year in school and the importance of religion in their life (OR=5.6, 95% CI [1.82-17.2]) and six times the odds of using a condom compared to those who received methods education without abstinence education (OR=6.09, 95% CI[1.81-20.45]). Conclusions The results of our study, demonstrated that receipt of sex education that included an abstinence message without messages about methods of birth control was associated with increased reported condom use at first intercourse. Additionally, we found that type of sex education was not associated with reported reliable contraceptive use at first coitus. These results suggest that programs containing abstinence messages should be examined for their benefit in motivating male use of condoms. The apparent lack of association between education about methods of birth control and use of such methods among teenage boys leads to concern over the content and delivery of these programs and suggests that new approaches may need to be developed.

Identifier

doi:10.6083/M4RV0KQQ

School

School of Medicine

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