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Childbearing Motivations and Desires, Fertility Beliefs, and Contraceptive Use among Urban African-American Adolescents and Young Adults with STI Histories

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Abstract

This study explored the influence of STI history on childbearing motivations, fertility beliefs, current childbearing desires, and contraception use among urban African-American adolescents and young adults (AYA). Secondary data were from the Neighborhood Influences on Adolescent and Young Adult Health (NIAAH) study, conducted from 2004 to 2007. Sample included 517 AYA ages 15–24 years (male: n = 199, female: n = 318). Linear and logistic regression models examined gender differences in childbearing motivations (CBM) and desires, fertility beliefs, condom, and contraception use. Logistic regression models were constructed to examine age, pregnancy history, and STI fertility knowledge as potential confounders. AYA men (3.29) and AYA women (3.23) had similar CBM mean scores. AYA women had more positive CBM and used condoms less. Condom use was not associated with CBM among AYA men (OR = 0.71, p = 0.069). Low beliefs about fertility (OR = 0.52, p = 0.003) and prior pregnancy (OR = 5.27, p = 0.002) were associated with current childbearing desires among AYA women. AYA men’s low fertility beliefs were only associated with current childbearing desires (OR = 0.56, p = 0.044). AYA men reported more contraception use (67.46 vs. 55.04%), especially with no partner pregnancy history (OR = 0.26, p = 0.017). Younger men (15 to 18 years old) reported more contraception or condom use compared to older AYA men (19–25 years old) (OR = 0.40, p = 0.016). Young men reporting a partner’s prior pregnancy used fewer condoms or contraception (OR = 0.23, p = 0.028). STI history did not influence CBM in this sample of urban youth. Prior pregnancy experiences and chronological age, however, were important milestones shaping proximal motivations and desires to bear children, beliefs about fertility, and contraception behaviors.

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Acknowledgments

This work was supported by the National Institutes of Health [grant number 3R011NE013507-04S1].

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Authors and Affiliations

  1. Department of Community Public Health, Johns Hopkins School of Nursing, 525 N. Wolfe Street, 417, Baltimore, MD, 21205, USA

    Kamila A. Alexander & Nancy Perrin

  2. Department of Pediatrics, Bayview Medical Center, Johns Hopkins School of Medicine, 5200 Eastern Ave., Baltimore, MD, 21224, USA

    Jacky M. Jennings

  3. Johns Hopkins All Children’s Hospital, 501 6th Ave South, St. Petersburg, FL, 33701, USA

    Jonathan Ellen

  4. Department of Pediatrics, Johns Hopkins School of Medicine, 600 N. Wolfe Street, Baltimore, MD, 21287, USA

    Maria Trent

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  1. Kamila A. Alexander
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  2. Nancy Perrin
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Correspondence to Kamila A. Alexander.

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Key Messages

• Effective fertility-related education and behavior change counseling for African-American adolescents during STI diagnosis may be underutilized.

• Younger age and positive pregnancy history was the greatest predictor of condom and contraception use in this sample.

• Current STI and pregnancy-prevention initiatives should be tailored to incorporate secondary prevention approaches that consider the influence of pregnancy history on prevention behaviors.

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Alexander, K.A., Perrin, N., Jennings, J.M. et al. Childbearing Motivations and Desires, Fertility Beliefs, and Contraceptive Use among Urban African-American Adolescents and Young Adults with STI Histories. J Urban Health 96, 171–180 (2019). https://doi.org/10.1007/s11524-018-0282-2

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