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Importance of adolescents’ attitudes towards contraception, early parenthood and abortion

Importance of adolescents’ attitudes towards contraception, early parenthood and abortion

Methods: We surveyed adolescents in three settings in Perth, Western Australia to capture a range of sexual and reproductive experiences: secondary schools (males and females), antenatal clinics (females) and termination clinics (females). We collected data on attitudes, psychosocial functioning, sexual behaviour and pregnancy history. The Rasch model was applied to establish the internal consistency and reliability of three attitudinal scales: adolescent attitudes to contraception, early parenthood and abortion. Scales were analysed to determine functioning within different group characteristics, association with RSBs and relationships between scales.

Results: 490 males (75.7% sexually inactive, 23.7% sexually active) and 1126 females (58.6% sexually inactive, 40.8% sexually active) participated. Of the 459 sexually active females, 268 (58.4%) had been pregnant (live birth = 76, abortion = 192). For all participants, support for each attitude held some significant associations with age, gender, sexual activity status and duration, and pregnancy history. Early sexual activity (<16 years) was associated with support for abortion and, for females, support for early parenthood. For females, being drunk/high at last sexual encounter was associated with reduced support for early parenthood. Infrequent or non-use of condoms/ contraception was associated with less support for contraception, greater support for abortion and, for females, support for early parenthood. 3+ sexual partners in the past year was associated with less support for contraception and support for abortion. An unwanted sexual encounter was associated with less support for contraception. Positive attitudes towards contraception were linked with a desire to postpone parenthood.

Conclusions: The unidimensional scales of adolescent attitudes towards contraception, early parenthood and abortion helped identify associations between these attitudes and demographic, psychosocial and behavioural characteristics. Contraception attitudes were strongly associated with RSB and should be targeted in adolescent sexual health programs.