TY - JOUR
T1 - Role of young women's depression and stress symptoms in their weekly use and nonuse of contraceptive methods
AU - Hall, Kelli Stidham
AU - Moreau, Caroline
AU - Trussell, James
AU - Barber, Jennifer
N1 - Funding Information:
This work was supported by the National Institute of Child Health and Human Development for grant # R01-HDHD050329 (principal investigator J. B., University of Michigan), by an NICHD Building Interdisciplinary Careers in Women's Health K-12 Career Development grant (project principal investigator K.S.H., # K12HD001438 ), and by NICHD center grant for Infrastructure for Population Research at Princeton University (J.T. and K.S.H. while the latter was a postdoctoral research fellow at Princeton University, # R24HD047879 ).
PY - 2013/8
Y1 - 2013/8
N2 - Purpose: We prospectively examined the influence of young women's depression and psychological stress symptoms on their weekly contraceptive method use. Methods: We examined data from 689 women ages 18-20 years participating in a longitudinal cohort study. Women completed 8,877 weekly journals over the first year, which assessed reproductive, relationship, and health information. We focused on baseline depression (Center for Epidemiologic Studies-Depression Scale) and stress (Perceived Stress Scale) symptoms and weekly contraceptive method use. Analyses used multivariate random effects and multinomial logistic regression. Results: Approximately one quarter of women exhibited moderate/severe depression (27%) and stress (25%) symptoms at baseline. Contraception was not used in 10% of weekly journals, whereas coital and noncoital methods were used in 42% and 48% of weeks, respectively. In adjusted models, women with moderate/severe stress symptoms had more than twice the odds of contraception nonuse than women without stress (odds ratio [OR] 2.23, confidence interval [CI] 1.02-4.89, p =.04). Additionally, women with moderate/severe depression (RR.52, CI.40-.68, p <.001) and stress (relative risk [RR].75, CI.58-.96, p =.02) symptoms had lower relative risks of using long-acting methods than oral contraceptives (OCs; reference category). Women with stress symptoms also had higher relative risks of using condoms (RR 1.17, CI 1.00-1.34, p =.02) and withdrawal (RR 1.29, CI 1.10-1.51, p =.001) than OCs. The relative risk of dual versus single method use was also lower for women with stress symptoms. Conclusion: Women's psychological symptoms predicted their weekly contraceptive nonuse and use of less effective methods. Further research can determine the influence of dynamic psychological symptoms on contraceptive choices and failures over time.
AB - Purpose: We prospectively examined the influence of young women's depression and psychological stress symptoms on their weekly contraceptive method use. Methods: We examined data from 689 women ages 18-20 years participating in a longitudinal cohort study. Women completed 8,877 weekly journals over the first year, which assessed reproductive, relationship, and health information. We focused on baseline depression (Center for Epidemiologic Studies-Depression Scale) and stress (Perceived Stress Scale) symptoms and weekly contraceptive method use. Analyses used multivariate random effects and multinomial logistic regression. Results: Approximately one quarter of women exhibited moderate/severe depression (27%) and stress (25%) symptoms at baseline. Contraception was not used in 10% of weekly journals, whereas coital and noncoital methods were used in 42% and 48% of weeks, respectively. In adjusted models, women with moderate/severe stress symptoms had more than twice the odds of contraception nonuse than women without stress (odds ratio [OR] 2.23, confidence interval [CI] 1.02-4.89, p =.04). Additionally, women with moderate/severe depression (RR.52, CI.40-.68, p <.001) and stress (relative risk [RR].75, CI.58-.96, p =.02) symptoms had lower relative risks of using long-acting methods than oral contraceptives (OCs; reference category). Women with stress symptoms also had higher relative risks of using condoms (RR 1.17, CI 1.00-1.34, p =.02) and withdrawal (RR 1.29, CI 1.10-1.51, p =.001) than OCs. The relative risk of dual versus single method use was also lower for women with stress symptoms. Conclusion: Women's psychological symptoms predicted their weekly contraceptive nonuse and use of less effective methods. Further research can determine the influence of dynamic psychological symptoms on contraceptive choices and failures over time.
KW - Contraceptive behavior
KW - Contraceptive methods
KW - Contraceptive nonuse
KW - Depression
KW - Psychological stress
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U2 - 10.1016/j.jadohealth.2013.02.009
DO - 10.1016/j.jadohealth.2013.02.009
M3 - Article
C2 - 23582524
AN - SCOPUS:84880742494
VL - 53
SP - 241
EP - 248
JO - Journal of Adolescent Health
JF - Journal of Adolescent Health
SN - 1054-139X
IS - 2
ER -