Does the expectation or perception of noncontraceptive benefits lead to higher rates of short-acting reversible contraceptive continuation for adolescents and young adult women?

ObjectiveContinuation rates of short-acting contraception among young women are low; we attempted to determine if continuation is higher when women expect noncontraceptive benefits at initiation or perceive benefits 6 months later.Study designA total of 243 young women ages 13–24 years initiating short-acting methods in an adolescent-only family planning clinic completed post-visit surveys that included directed and open-ended questions about anticipated noncontraceptive benefits. The study participants were contacted 6 months later. We compared contraceptive continuation between those who expected noncontraceptive benefits and those who did not and between those who reported experiencing benefits and those who did not. We examined the concordance between expectations and reported experiences.ResultsSix months after initiation, 69.3% of women were using the same method. Baseline expectation of noncontraceptive benefits was not associated with 6-month continuation. The experience of any benefit listed by the patient (odds ratio=2.69, 95% confidence interval 1.1, 6.0) was associated with greater continuation. Concordance between expectation and perception of noncontraceptive benefits was low (Kappa=0.2).ConclusionsWomen who experienced noncontraceptive benefits at 6 months of use were more likely to continue short-acting contraception. Women who expected benefits when initiating were not more likely to report experiencing them, and many women who did not expect benefits reported them and were more likely to continue. These findings imply that building expectations of noncontraceptive benefits, e.g., through counseling, may not improve continuation and that new contraceptive development should include consideration of tangible noncontraceptive benefits.ImplicationsAlthough adolescents and young women who perceive noncontraceptive benefits after 6 months of use are more likely to continue, the expectation of such benefits does not correlate with continuation.