Patterns of Oral Contraceptive Pill-Taking and Condom Use Among Adolescent Contraceptive Pill Users

The authors of this study sought to describe daily adherence patterns of youth oral contraceptive pill (OCP) use, to analyze OCP protection on an event level basis, and to examine pill-taking and condom use during method transitions.

Females ages 14-17 (n=123) completed quarterly interviews to classify OCP method choice into four categories: stable, initiated, stopped, and discordant use. For each OCP category, daily diaries were used to assess occurrence of coitus, condom use, and patterns of daily OCP use (i.e., consecutive days of reported OCP use with no more than two consecutive days of nonuse). A coital event was OCP protected if pills were taken on both the day of sex and the day preceding.

In 210 diary periods (average diary length = 75.5 days), all participants reported at least some OCP use. Fifty-three participants classified as stable users reported 87 diary periods. In this group, the average interval of consecutive OCP was 32.5 days. Among stable users, just 45 percent of coital events were associated with both OCP and condom use. No method of protection was reported in more than one-fifth of coital events in all groups.

"Dual use of OCP and barrier contraception remains an elusive goal," the researchers concluded. "The time during OCP adoption or discontinuation is often unprotected by condoms. However, concurrent missed pills and condom nonuse increase pregnancy and infection risk even among stable OCP users. Understanding motivation for method usage may improve education and prevention techniques."

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