Abstract

PIP: Use of contraception among adolescents, particulary those unmarried, is significantly different from that among older couples, and is influenced by educational, developmental, social, and psychological factors. Even when family planning services are available and teens are properly educated, compliance tends to be poor. Contributory factors to poor contraceptive use include: services not attuned to adolescent needs; lack of guaranteed confidentiality; unsuitable contraceptive methods; little psychological support; immaturity of cofnitive thought processes in the adolescent with an inability to appreciate longterm consequences of current acts; and a developmental tendency to take risks coupled with a denial of the possibility of pregnancy. A particularly significant finding is the importance of psychological conflict associated with sexual activityand contraception. The adolescent suffers less anxiety by denying the risk of pregnancy than by taking responsibility for it through conscious, consistent contraception. The emotional costs of admitting the possibility of pregnancy are unacceptably high in terms of personal devaluation, guilt, and risk of rejection by the partner. Family planning programs for unmarried adolescents should include clinic sessions exclusively for young people, after school; they should guarantee privacy and confidentiality, and should accept the adolescent in a nonjudgemental manner. Examinations should be carried out in such a way as to minimize embarassment, and thorough counseling should be available to allow the adolescent to choose a suitable method. Frequent follow-up should be arrangged, and particular attention should be given to identifying and relieving conflict. Broad social policy also can influence adolescent contraceptive behavior. Sex education in schools and through the media has significantly improved levels of contraceptive use among teens. There is not evidence that such initiatives promote premarital sexual activity. (author's modified)