The contraceptive vaginal ring: female adolescents' knowledge, attitudes and plans for use

BackgroundThis study aimed to determine female adolescents' knowledge about the contraceptive vaginal ring and to assess their attitudes toward and consideration of ring use.Study DesignWe recruited 164 participants, ages 14–21, who completed a 62-item, 15-min interview assessing tampon and vaginal product use history, reproductive health history and ring awareness. Among those who had heard of the ring, knowledge was assessed with a 15-item pretest. All participants received a 2-min description of the ring with a demonstration, after which attitudes, consideration of use and posttest knowledge were assessed.ResultsOur study population is unique in that 92% had been sexually active and 22% who had been sexually active had also been pregnant. The mean age of coitarche was 15.2 years, and 35% had ever used emergency contraception. More than half (52%) had never heard of the ring. Of those who had heard of it, only 35% had sufficient knowledge. After a brief demonstration with a vaginal model, 98.2% acquired sufficient knowledge to use the ring correctly. More than half (57.9%) liked the idea of the ring, and 45.7% said that they would consider using it. Logistic regression demonstrated that liking the idea of the ring and considering its use were associated with comfort using at least one vaginal product, with those who were comfortable using a vaginal product being 3.1 times more likely to like the idea of the ring compared to those who were not comfortable using a vaginal product. Logistic regression also showed that liking the idea of the ring was associated with having had at least one pelvic exam.ConclusionsMost participants had limited or no prior ring knowledge. Once briefly educated, all had sufficient knowledge and a substantial percentage would consider using it. The ring appeals to adolescents and should be routinely offered as a method of contraception. Comfort using at least one vaginal product is associated with liking the idea of the ring and considering its use.