Gender, relationship type and contraceptive use at first intercourse.

BACKGROUND Most of the sexually transmitted infection prevention programs fail to attend to the relationship type of individuals at first sexual intercourse and how it influences contraceptive behavior. STUDY DESIGN A national sample of adolescents (3084 females and 2745 for males) was analyzed to determine the associations between relationship types (committed, going steady and casual), use of contraception and methods of contraception at first intercourse using logistic and multinomial logistic regressions. RESULTS Two thirds of females and over three quarters of males used a condom at first intercourse while reported use of dual methods was 12.7% and 14.0%, respectively, for females and males at first intercourse. Bivariate and multivariate analyses confirmed that relationship type was associated with contraceptive use at first intercourse. Males in casual relationships had low odds (0.586) of using any method of contraception at first intercourse. Among contraceptive users, females in committed relationships had high odds (5.016) of using hormonal methods at first intercourse while males in casual relationships had low odds (0.379) of using dual methods at first intercourse. CONCLUSION The results suggest that adolescents are at sexual health risk when first sexual relationship types are taken into account. Sexual health programs must focus on enhancing communication skills among adolescents so that regardless of relationship type, correct contraceptive behavior is practiced.