Primary contraceptive method use and sexually transmitted infections in a nationally representative sample of young women
Rates of sexually transmitted infections (STIs) in the U.S. have increased for the sixth consecutive year and people ages 15-24 account for over half of all new infections despite comprising only a quarter of the sexually active population. A potential explanation for rising STI rates is the increased use of long-acting reversible contraceptive (LARCs) methods which may result in lower condom use and/or increased sexual risk-taking due to higher pregnancy prevention efficacy. This paper uses the National Survey of Family Growth to examine the relationship between primary contraceptive method use among women ages 15-24 and STI treatment in the past year, and the extent to which this association is mediated by relationship status and frequency of condom use. Findings did not show differences in STI treatment in the past year by primary contraceptive method indicating that LARC use among young women does not equate to increased STI risk. Findings did show that young women who had been in only casual relationships or a mix of serious, dating, and/or casual relationships in the past year were more likely to have been treated for an STI than young women in serious- or dating-only relationships, regardless of primary method use. Additionally, young women who reported using condoms only “some of the time” were more likely to have been treated for an STI in the past 12 months compared to women who used condoms “all of the time” or “most of the time.” This association was moderately mediated by relationship status (p=0.05).